Possible northwest Ga. case of virus awaits confirmation

Hospital officials say it took ‘adamant urging’ to get state, federal health officials to OK test for virus.

A 46-year-old woman in northwest Georgia has preliminarily tested positive for coronavirus, officials at Floyd Medical Center said Friday. The results are not final; an official diagnosis from the Centers for Disease Control and Prevention is expected within a couple of days.

But hospital officials, in a news release, said it took “adamant urging” from the local workers to get state and federal health officials to approve a coronavirus test.

In her first visit to the emergency room Feb. 29, the woman complained of mild flulike symptoms, was screened according to current guidelines and did not meet criteria for a test, the hospital said. She said she had not traveled to high risk areas including Italy, China or South Korea.

On her second visit, hospital officials contacted the state

Department of Public Health. Public health officials did not approve testing for coronavirus and cleared the woman to return home, according to the hospital. Instead, clinicians at the facility decided to admit her to the hospital and put her in isolation, based on the severity of her symptoms, hospital officials said.

Her doctors, joined by their local district’s director with the state Department of Public Health, once again pushed for a coronavirus test and received approval from the state and the CDC. The preliminary positive result came back late Thursday.

Not confirmed

Kurt Stuenkel, CEO of Floyd Medical Center, told The Atlanta Journal-Constitution that he is not casting blame but wants people to understand that not every coronavirus patient will fit the same mold.

“We may be the first one going public on this, and it may be going on everywhere — I suspect that may be true,” Stuenkel said. “It’s a very fluid situation. We are learning about this all over the world. And here we are in Rome, Georgia, with a case not fitting the criteria.”

The patient is in stable condition. One of her relatives is in quarantine.

Gov. Brian Kemp stressed the preliminary nature of the result and urged Georgians to rely on CDC and state health leaders for guidance.

“To prevent the spread of incomplete or inaccurate information, we encourage Georgians to rely on guidance from the CDC, the DPH, and my office,” Kemp said in a statement. “We will continue to provide regular updates to keep the public informed and ensure the health and safety of families across our state.”

The state public health official who helped push for the test, Dr. Gary Voccio, also emphasized that the case has not been confirmed. And if it is confirmed, Voccio added, “it has not spread anywhere else that we know of.”

“This is not a communitywide outbreak,” said Voccio. “It is one patient.”

“Could there be more? Yes,” he said. “As you know, the world is global. People travel all over the world.”

The patient had recently traveled to Washington, D.C.

‘We need to expand testing’

If confirmed, the patient’s case raises questions about whether the criteria for testing are broad enough, and if there are enough tests available in Georgia and the U.S.

The source of her possible exposure is unknown at this time, according to hospital officials. The main lesson of the Floyd County incident, said Dr. Carlos Del Rio, “is that we need to expand, not restrict testing.”

“As a clinician,” Del Rio said in an email, “I find it inappropriate to have to get approval from DPH to have a test performed that I think is clinically indicated.”

Del Rio is chairman of Emory University’s Hubert Department of Global Health.

If confirmed, the case would be the third known case in Georgia. Earlier this week, a Fulton County father and his teenage son were diagnosed with COVID-19, the disease caused by coronavirus.

Several experts have urged wider testing. The CDC’s initial test kits malfunctioned; functioning ones are being distributed, but there are still not enough, according to health officials. The city of New York on Friday pleaded with the CDC for more.

Georgia’s public health labs conducted 30 tests for the coronavirus on Thursday, and federal authorities are gearing up for a rapid expansion of the nation’s testing capacity, U.S. Surgeon General Jerome Adams said during a news conference in Atlanta on Friday.

Experts say a dangerous weapon of the virus is its ability to sit for weeks in patients who look mildly sick or even healthy as they go about their business.

“I am afraid we’re going to hear more of this,” said Dr. William Schaffner, a Vanderbilt University infectious diseases expert. “Whether we see a few or many more remains to be determined. But my colleagues and I are concerned we may see quite a few cases.”

The local level

In an interview with the AJC, Stuenkel said that, after the woman returned to the Floyd County hospital Tuesday with worsening symptoms, clinicians did a CT scan of her chest.

It revealed hazy abnormalities, which are considered markers of coronavirus and not typical of lung diseases.

“Our radiologists, being current on what’s going on, said, ‘This looks like what we’ve been reading about,’” Stuenkel said.

Stuenkel said about two dozen staff members who may have been in contact with the woman have been notified and are self-quarantining for 14 days.

In addition to protecting the facility’s workers, Stuenkel said, the hospital felt a sense of urgency to go public with this case to reach the community at large.

Although the risk of exposure to other patients is low, the hospital has been advised by state health officials to notify those who may have come in contact with the woman, as well as caregivers.

In the meantime, Floyd Medical Center is assuring the public that it is safe to seek care at the hospital, and employees are taking all necessary steps to prevent spread of the disease.

Though he is frustrated by the delay in testing, Stuenkel refrained from criticizing state and federal public health officials.

“We want a perfect world, but we know it isn’t,” he said. “This is very complex. We have limited resources, and we are all doing the best we can.”