By Anne Blythe
Amir Barzin, the UNC Health physician at the helm of the Respiratory Diagnostic Center, says he and his team are seeing from 70 to 150 people a day coming in for drive-through COVID-19 testing at the Ambulatory Care Center site in Chapel Hill.
In a half-hour Zoom video conference with reporters on Thursday, Barzin described the testing process, the follow-up calls and texts for those who get tested, as well as the community support buoying his spirit and that of other health care workers on pandemic frontlines.
Barzin is part of a 35-member team pulled together in recent weeks as the extremely contagious pathogen spread around the world.
There are several avenues for getting into the queue for drive-through testing. Physicians and providers in the UNC system can add someone to the schedule and that patient is then notified of when to come in.
The virtual care center also routes patients to the testing center if they have a cough and a history of asthma.
“We’re assessing them here as opposed to having every single clinic in the UNC system see those patients so that we can hopefully try to localize any potential spread if that’s the case,” Barzin said.
Drive-through testing nuts and bolts
Getting the testing done is similar to going through a circular multi-stop checkpoint.
While in the loop, a person is registered for an appointment, then given paperwork that the Centers for Disease Control and Prevention recommend for contact tracing. The next stop is a tent where the person to be tested gets labels for the paperwork and lab, then that is all reviewed.
Then there’s a review of the patient while still in the car, which is also where the person is swabbed.
That whole process, Barzin said, takes only a few minutes.
Then there’s the wait for results.
“If we’re testing someone, we’re usually getting that result within either that same day or the next day,” Barzin said. “So we’re really quick in identifying and don’t have to wait the seven to 10days that some other patients and communities have to wait.”
What happens afterward is a process that Barzin says has been praised by those who have been tested at the center.
“Quickly into this process, we wanted to adequately be able to address the needs of our patients that were coming through the testing process,” Barzin said.
Texts and calls from testing team
Everyone who comes through receives a text chat sent to them daily. Through that process, a nurse can be flagged if someone is feeling worse, regardless of their testing status.
“This could be a person who tested negative or a person who tested positive,” Barzin said.
That nurse then decides if it would be helpful to get a physician’s assessment and funnel them through a virtual care center, set up for such purposes.
“That’s been very helpful to our patients who may just be wondering how they can best manage their symptoms or at that point, identify early: ‘Well this looks like someone who is having a little more difficulty due to respiratory distress,’ ” Barzin said.
If someone has tested positive for COVID-19 and has not been admitted to a hospital, the team does not wait for text responses.
“We’re doing a more collaborative approach, where we’re calling them every day regardless of if they’re engaging in the chat function or not,” Barzin said. “They like the chat function because of the ease and we like it, too. But we’re really just trying to focus in on making sure they’re receiving attention, knowing that they’re positive as well. That has been very well received from our patients.”
Barzin praised the nursing team that helps with the daily messaging. “They’ve done a really bang-up job of making sure patients feel really comforted and have their questions answered on the spot,” he said.
They come in masks
As of Thursday, the site had conducted 1,800 tests, Barzin said, contributing to the some 47,000 reported by the state Department of Health and Human Services from across the state.
Barzin regularly checks the state for the most recent guidelines on who should get testing while also keeping an eye on the UNC Health supply. Patients in the hospital are a priority for tests.
State public health officials discourage people with mild symptoms from getting testing in an effort to preserve supplies through the pandemic as well as limit the risk of cross-infection.
“We’re really leaning on our colleagues from the state,” Barzin said. “Once we hit community spread, the state recognized that just a general recommendation for isolation as opposed to saying everyone with symptoms come out to be tested because what you do at times is you say, ‘You have mild symptoms and you’re doing relatively well at home, it’s actually a bigger risk to come out and be tested because then you could potentially, while you’re in your car, you could stop at a grocery store and expose more people.”
If the state at some point recommends widespread testing, Barzin said his team would be happy to play a part.
The spectrum of people showing up for tests is demographically broad, and at the Chapel Hill site can come from Orange, Chatham, Durham and Wake counties. More recently, many show up in the loop wearing masks, some of them homemade.
The testers and the tested seem to form bonds through the process, especially with the follow-up texts and calls.
“We’ve had the ability to touch base with the people who are kind of tipping or leaning in the direction that we don’t want them to go to,” Barzin said. “When they do go to the hospital and they come out of the hospital, they send us messages that are really, really meaningful and thoughtful, and you would think that just a 10-minute interaction with someone did not make that much of a difference, but it truly has been wonderful to see that it does make that much of a difference.”
As is the case with many health care providers in close contact with people suspected of having the virus, Barzin and his team are super cautious about donning and taking off their protective equipment.
There are numerous hand sanitizing stations at the site. Monitors are in place to make sure no one misses a step when removing gloves, masks and coveralls.
Morning huddles with 35 people take up a whole parking lot with physical distancing playing such an important role.
When Barzin goes home, he has disinfectant by the door that he uses to wipe down the doorknob after he enters. Then he goes straight to the laundry room, removes his scrub and hits the shower. He tries to confine himself to a portion of the house separate from his wife and young child. A friend of his in Charlotte set up an outdoor shower to protect family members.
“We are trying to be really good stewards,” Barzin said.
What has touched him and others with whom he works, he said, is how the community has stepped up to help them while they try to help the community. Supplies have been donated as well as food. On Thursday morning, the team was greeted with fresh bagels, a gift of sustenance that has followed many others.
“That kind of two-way street of showing that the community is supporting us and we’re supporting them, it really, really makes the staff do really well in terms of understanding that that support system is there from people that they might not have ever known, Barzin said. “And I think that makes it a really pleasant experience in terms of a place to work. We’re making sure that everyone is tended to, getting breaks if they need it. If they feel like they have any additional needs, we’re addressing that as well. UNC has done a really excellent job of identifying support systems for people who may emotionally feel like they need some extra support.”