Friday, March 13, 2020

Public Health Purgatory

 The Twitter thread begins like this

THREAD: Last Thursday I was admitted to the ER w/ #coronavirus symptoms, including chronic cough, shortness of breath & lung pain. I was given a #COVID19 test and told I’d have the results within 48 hrs. Nearly a week later, I still don’t have the results.  1/N #covid19purgatory

If you are on Twitter you have probably seen it already. It is relevant here because the man in question, Andy Carvin, was a patient at Howard County General Hospital. Carvin is a reporter and published author. You can learn more about him on his Facebook page.

The above mentioned thread and subsequent follow up tweets tell the story of how Carvin was tested for Coronavirus and then couldn’t get his results. In fact, despite multiple daily inquiries on his part, he couldn’t even find out who had his results. This is not because people responsible for his treatment were incompetent or unfeeling. The system that should have worked to connect each step of the process just did not work.

Each piece should have ideally clicked together to the next like a series of Lego bricks. It didn’t. This meant that no matter who Carvin called to follow up on the Coronavirus test, they a) didn’t have the information and b) didn’t know who did.

What’s important here is not one man who had a truly difficult experience, although I think anyone who reads the threads feels for him, his family, and coworkers as they self quarantine and worry about the outcome. I believe that the reason Carvin shared his experience was to report on how a system that should be seamless and ready to go for the general public was clearly not.

That matters for all of us. It’s not a customer service story. It’s a public health story.

In the end there is a happy resolution for Carvin as he finally learned that he has tested negative. Another positive outcome:

I did, however, have a very constructive call with a representative from Howard County General’s patient relations team. She didn’t have any information on my results, but she talked about the procedures that should be in place, and listened to my suggestions on how to avoid this  happening to someone else.

Howard County General will be able to learn a lot from Mr. Carvin’s detailed documentation of his experience. That’s a good thing. And I hope his experience informs their protocols as the local covid -19 experience unfolds. I am grateful to him for making his ordeal a learning experience for others.

But the bigger picture remains: it takes a concerted investment of both money and time to develop and maintain public health systems that click together from the top on down to the smallest unit. And it’s something we need to be committed to following through on, even when there isn’t a crisis. Even when it isn’t raining and the roof isn’t leaking.

If all the pieces of the process aren’t in good condition, if all the people who are involved aren’t able to work at their best level of expertise, then everyone is at risk.

A tip of the hat to Mr. Carvin and a huge HoCoHoller to everyone working in healthcare right now.

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