Coronavirus Testing: Would On-Demand, In-Home Testing Reduce Exposure and Keep 9-1-1 From Getting Overwhelmed?

PROBLEM

9-1-1 Was Not Set Up to Handle Epidemics
But For Many It’s the Only Place to Find Help

If the spread of coronavirus continues on its current trajectory, 9-1-1 systems will soon be overwhelmed by calls from high-risk people with non-acute, fever-like symptoms.

 

These people need to be tested, but not in the hospital, and not by an ambulance crew. While many others can’t travel to “drive-through” testing sites.

SOLUTION*

On-Demand, In-Home Coronavirus Testing
Provided by Community Healthcare Workers

Instead of increasing exposure risks to vulnerable patients, hospitals, and first responders, community healthcare workers could be deployed to provide on-demand, in-home testing for high-risk patients with non-acute symptoms who can’t travel to “drive-through” testing sites.

(*The situation is dynamic and information isn’t perfect, so consider this our attempt at sending it up the flagpole. Feedback is welcome.)

HOW IT COULD WORK*

(*The situation is dynamic and information isn’t perfect, so consider this our attempt at sending it up the flagpole. Feedback is welcome.)

Coronavirus COVID 19 - Beacon Emergency Dispatch

STEP 1:
A Suspected Coronavirus Case
Calls 9-1-1

A high-risk, vulnerable person is concerned that they may have contracted coronavirus, but they’re too scared and/or unable to get to the hospital on their own, so they call 9-1-1.

Coronavirus Testing: Would On-Demand, In-Home Testing Reduce Exposure and Keep 9-1-1 From Getting Overwhelmed?

STEP 2:
9-1-1 Dispatcher Triage

When the caller dials 9-1-1, the dispatcher determines that the patient is at-risk, but without a life-threatening emergency, so they are identified as a “Person Under Investigation” (PUI) and referred/connected to a local coronavirus hotline.[1]

Coronavirus Testing: Would On-Demand, In-Home Testing Reduce Exposure and Keep 9-1-1 From Getting Overwhelmed?

STEP 3:
Coronavirus Hotline In-Take

When the caller is connected to the local coronavirus hotline, they are walked through approved guidelines to determine the severity of the caller’s symptoms. [2]

Coronavirus Testing: Would On-Demand, In-Home Testing Reduce Exposure and Keep 9-1-1 From Getting Overwhelmed?

STEP 4:
Community Dispatch

If the patient meets the guideline’s criteria, the coronavirus dispatcher sends a text message alert through Beacon to all or select community responders equipped with proper PPE and COVID-19 testing supplies[3]. As replies from responders come in, Beacon[4] determines the nearest and most appropriate resources and personnel, and instructs the responders to proceed to the incident location.

Coronavirus Testing: Would On-Demand, In-Home Testing Reduce Exposure and Keep 9-1-1 From Getting Overwhelmed?

STEP 5:
Confirm On-Scene

Once the community healthcare worker has located the PUI, they inform Beacon that they are on-scene.

 Depending on local resources and protocols, scene confirmation can also be sent to formal responders and other community health providers to notify them and/or prompt further intervention.

Coronavirus Testing: Would On-Demand, In-Home Testing Reduce Exposure and Keep 9-1-1 From Getting Overwhelmed?

STEP 6:
In-Home Testing

The community health worker administers the test and completes additional assessment steps.

 The test samples are packaged and prepared for delivery to test facilities.[5]

Coronavirus Testing: Would On-Demand, In-Home Testing Reduce Exposure and Keep 9-1-1 From Getting Overwhelmed?

STEP 7:
Transport / Referral / Release

After testing and assessment, the PUI gets registered in local health system’s monitoring and surveillance system, and quarantine/follow-up care/continuous monitoring begins without the patient having to leave home or create exposure risks for self/others. When test results are received, they are communicated back to the patient by the local health authorities and a continuing care plan is implemented.

SUMMARY

Utilizing local health workers to conduct on-demand, in-home testing for suspected coronavirus cases could prove vital in:

  • Keeping local 9-1-1 systems from being overwhelmed by calls from high-risk, non-acute patients, and
  • Reducing exposure risks to the first responders and hospitals who are needed to attend to acute conditions

Three major bottlenecks still exist to making this model possible:

  1. Communities will need to be able to recruit and train enough health workers
  2. PPE will have to be readily available to them
  3. Labs will need to be able to process the tests

If/when these bottlenecks are overcome, we believe the central premise remains true:

If the spread of coronavirus continues on its same trajectory, local 9-1-1 systems will soon be overwhelmed by high-risk, non-acute callers. These persons need to be tested, but not in the hospital, and not by the limited EMS professionals who are currently responding to acute, life-threatening emergencies.

If you’d like to learn more about how the Beacon Emergency Dispatch Platform could help your community reduce the strain on your 9-1-1 system, please contact us at [email protected] to set up a demo.

FOOTNOTES

  • [1] Read about a similar program we’ve implemented with the University of Florida in Haiti using the Twilio Flex platform.
  • [2] See: CDC’s Interim Guidance for Emergency Medical Services (EMS) Systems and 911 Public Safety Answering Points (PSAPs) for COVID-19 in the United States; and Alberta Health Services COVID-19 Self-Assessment
  • [3]Wait. There’s a global shortage of PPE. Doesn’t that make this whole thing irrelevant?” For the time being, yes, that’s possible.. There have been suggestions that post-exposure coronavirus survivors could provide a pool of “immune” candidates, but the CDC recently reported that, “The immune response to COVID-19 is not yet understood. Patients with MERS-CoV infection are unlikely to be re-infected shortly after they recover, but it is not yet known whether similar immune protection will be observed for patients with COVID-19.” We hope sufficient PPE will be available again on a widespread basis, and when it is, healthcare systems should be ready to involve non-EMS health workers in the testing of suspected coronavirus cases.
  • [4]Why Beacon? Why not some other ride-sharing app or messaging app?” It’s a good question. The short answer is that this is exactly the niche dispatching scenario that Beacon was designed for – i.e., when 9-1-1 is overwhelmed (or doesn’t exist) and health workers from within the community need to be deployed and coordinated to fill in the gaps. It’d be one thing to say, “We have a ride-sharing app that you could refashion for coronavirus testing.” But it’s another thing to say, “We have an end-to-end call intake and dispatching solution for community-based health crisis response.” As for messaging apps, they’re just not appropriate for large-scale/high-volume response systems, and they provide little in the way of documentation or reporting options.
  • [5] We are aware that the availability and capacity of appropriate laboratories to run and process tests for coronavirus are currently limited. We are hopeful that also changes.
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