Implementation of Drive-Through Testing for COVID-19 With Community Paramedics

Abstract

Background: In this manuscript, we discuss the implementation and deployment of mobile integrated health/community paramedicine (MIH/CP) testing sites to provide screening, testing and community outreach during the first months of the coronavirus 2019 (COVID-19) pandemic in the metropolitan region of Charlotte, North Carolina, USA. This program addresses the need for an agile testing strategy during the current pandemic. We disclose the number of patients evaluated as “persons under investigation” (PUI) and the proportion with positive severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) results from these sites. We describe how the programs were applied to patient care and include considerations on how additional staffing, scalability, and flexibility of these services may be applied to future patient and healthcare crises. Methods: This is a descriptive report of the implementation of MIH/CP test sites in our healthcare system’s early response to the COVID-19 pandemic in March 2020. Retrospective data on the number of patients and their associated demographics are reported here as raw data. No statistical analysis was performed. Results: Between March 15, 2020 and April 15, 2020, our six MIH/CP test sites evaluated 4342 patients. Of these, 401 patients (9.2%) had test results positive, 62.8% of whom were women. The estimated duration of each patient under investigation encounter was 3 to 5 minutes. The paramedics were able to perform a brief history, specific physical examination, and screening for signs of hypoxemic respiratory failure. There were no cases of accidental exposure or failure of PPE for the MIH/CP paramedics. Conclusions: In our healthcare system, we pivoted the traditional MIH/CP model to rapidly initiate remote drive-through testing for COVID-19 in pre-screened individuals. This model allowed us to test patients with suspected COVID-19 patients away from traditional healthcare sites and mitigate exposure to healthcare workers and other patients.