COVID-19 updates: California DO set up testing sites in underserved areas

In March, it became clear to Eugene Allen, DO, that the novel coronavirus disease (COVID-19) would soon be widespread in his South Los Angeles community. He took quick action, independently setting up testing centers for an estimated 25- to 30-mile radius of LA that he says still has nowhere else nearby to go for testing.

“I jumped in the beginning and said we would start testing immediately, and treating them as much as we could,” Dr. Allen said. “We were at the forefront of the wave of giving people an opportunity to get tested early, and then quarantining them to try to flatten the curve.”

Over the last month, The DO has been speaking with osteopathic physicians on the front lines of COVID-19, including an infectious disease-focused family physician in Connecticut, an infectious disease specialist in Oregon, an emergency physician outside of Philadelphia, another who works in the city, and a family physician in Detroit.

If you are a physician and would like to be featured in an interview as we continue our COVID-19 coverage, please email abrown@osteopathic.org.

This week we continue with Dr. Allen, an emergency physician and the founder of Dusk to Dawn Urgent Care, which sees a large number of patients from underserved communities in the LA area.

In this edited Q&A, he describes how he organized his testing sites, the lengths he’s gone to get a consistent supply of PPE, and what daily life on the front lines has been like.

How are these testing sites set up and how many have come out to get tested?

We have tents set up that are like pre-screening areas. So if you come with a cough, cold, fever or chills, we will evaluate you in the tent. And if you need any type of treatment associated with a respiratory illness, you’ll be tested.

We started the first site on March 16, and added three more over the last two weeks. Once we got started, word got out that it was a place to come to get tested. From that, an entourage of lab and testing equipment came my way. We first worked with LabCorp, then Quest Diagnostics before they were backlogged, then a California lab called WestPac.

[As of April 14,] I’ve tested 119 patients. Of those, 11 have tested positive. We’ve established four locations throughout the area, and initially handled payments as we would for any other urgent care visits. Now, of course, the government has made testing more readily available, and made sure it’s all free.

What inspired you to set up the testing centers, and how has the testing gone?

Nobody else is in our area doing this, and underserved communities are getting hit hard, for sure. Now that so many people have been exposed to the virus, we’re starting to get at least two or three positive tests every day now. Before that it was sporadic. We’re going to see more people as the virus enters its peak.

Right now though, not a whole lot of people are coming out and getting tested, because nobody’s pushing them to go, or they don’t know where they can go.

Additionally, for those who test positive and are quarantined, we send food. We know they can’t get out so we’ve been sending them a daily meal or a week’s supply of some needed items. We try to keep them going until they’re past the stage of being contagious.

How have you been getting PPE?

It’s been very difficult to get. I had to buy start buying it on my own from China. One of the things that happens in an underserved community is, frankly, the government funding is dwindled down to nearly nothing.

Most of the equipment I’m buying is a personal investment, and that includes what we call the ‘jumpsuits,’ washable goggles, shoe covers and the N95 masks. I make sure everyone working for me inside the clinics has fresh N95 masks, and then a mask underneath, to provide security when they’re seeing patients for general urgent care needs.

For everybody in the tents, on the other hand, we’re cycling gear out every time we see a patient. That means immediately disrobing afterwards, and getting ready for the next one by spraying down the tent.

It’s virtually impossible to get all of this PPE in the U.S. right now. The people we usually get our daily gear from just don’t have it.

How have you and your staff handled this difficult, front line work?

One of my personnel tested positive. Then two more got sick but tested negative. We debriefed at that point to make sure everyone was OK and confident with what we were doing, because their families are scared.

They all said ‘doc, we’re ready to give it all we’ve got.’

Related reading:

Hero Next Door: DO establishes network of urgent care centers for underserved

COVID-19 updates: Underserved communities hit hard by pandemic