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A handful of people sit at a banquet table in a second-floor room at Scripps Health's corporate offices — they each have their own phone and desktop computer with antibacterial wipes and hand sanitizer just a reach away. The incident command is one of many across Scripps locations in San Diego County.
Five new presumptive cases of coronavirus in San Diego County — bringing the total to six, plus two previous cases among repatriated individuals — have medical centers anticipating more potential patients. The Centers for Disease Control and Prevention still have to confirm the positive tests in their own laboratory but county officials on Thursday said the development indicates the virus is now spreading in the community.
Scripps Health President and CEO Chris Van Gorder, wearing a black vest with an "incident commander" tag, said the operation that launched two weeks ago helps them coordinate and monitor resources across facilities as they prepare for more cases.
"We are seeing a spread," Van Gorder said. "Initially, it was from travel, but there certainly could be community spread now."
Scripps is treating two of the county's coronavirus patients and expects that may increase as testing is expanding. Under government guidelines, testing was previously limited to patients who had symptoms and had traveled to impacted countries or had close contact with someone who tested positive for coronavirus, but now physicians can make that call.
"We can actually order a test whenever we want," he said. "The problem is most hospitals — and even the capacity within the government is still limited," he said.
The CDC has slowly supplied testing kits to public health labs, including San Diego County, but private companies now have the ability.
Scripps hopes to have in-house testing by next week that can check up to 80 patients a day, but plans to use Quest Diagnostics in Orange County in the interim. Gov. Gavin Newsom also announced some University of California medical centers have testing abilities, including UC San Diego.
Scripps Chief Medical Officer Dr. Ghazala Sharieff said the health system is working to streamline the testing process with a call center that will help direct patients who need to be checked to a pop-up location outside one of its urgent care centers.
"If the provider feels like testing needs to be done then we can send them to this cabana," she said. "It's kind of like those drive-through things you’ve been hearing about but not quite a drive-through."
The call center and first cabana will open Friday in Torrey Pines, a spokeswoman said. Two more cabanas are expected at other urgent care locations.
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For patients, Scripps has 99 specialty containment rooms and can expand capacity to some other rooms if necessary. They can also add surge tents to help with emergency department triage, which hospitals have done in severe flu seasons. If the situation grows even more intense, they could reach out to the state for its mobile medical unit, Van Gorder said.
At the same time, Van Gorder said he's focused on the wellness of his employees. He said staffing levels aren't a problem currently but Scripps is drafting plans in case they face a shortage because of illness or workers have to stay home in the event of school closures.
They're also working to keep up an ample supply of personal safety equipment, even amid shortages. He said Scripps ordered reusable powered air respirators when its N95 mask reserves dwindled to a three-day supply at one point, but that has changed since government agencies have tapped into emergency stockpiles.
"When we need masks, we can reach out to the county and the county delivers us the masks," he said.
However, dozens of Scripps employees were recently quarantined under suspicion they were exposed to a coronavirus-infected patient, reported earlier this week as the county's first resident to test positive. Van Gorder said it wasn't due to lack of equipment — the patient had recently had an operation, felt ill and sought care thinking it was related to the surgery, so some staff didn't immediately take preventive measures.
He said they identified 60 staff members to have possible exposure and sent them home but have allowed about 10 or more to return as their ongoing review determined they didn't have enough interaction to warrant concern.
Employees are now screening every patient, regardless of what brought them in to the facility, to determine if they have coronavirus symptoms or recently traveled, said Sharieff, chief medical officer.
