MUSC Health biweekly COVID-19 report (January 19)

CHARLESTON, S.C. (Jan. 19, 2021) – At MUSC Health, the safety of patients, families, care team members, students, faculty and staff remains the number one priority. The MUSC Public Affairs and Media Relations (PAMR) department issues regular COVID-19 updates on Monday and Thursday of each week. Please read the report in its entirety; information can change quickly. 

The Path Forward / Recovery

COVID-19 VACCINATION UPDATE

Vaccine Q and A: Dr. Danielle Scheurer talks all things vaccine.

MUSC Health is aligned with CDC and SCDHEC recommendations for distribution of COVID-19 vaccines. As supply becomes more readily available, MUSC Health will next offer the Pfizer vaccine to community essential workers in early 2021. The community is encouraged to monitor muschealth.org for COVID-19 vaccine availability criteria, updates and FAQs.

Our goal at MUSC is to get COVID-19 vaccinations into arms. MUSC Health is currently administering vaccines to those individuals who qualify for Phase 1a, which includes health care personnel providing direct medical care in any setting, health care personnel providing indirect medical care, workers exposed to bodily fluids, and residents and staff of all long-term care facilities. Phase 1a also includes South Carolina residents age 70 or older, regardless of health status or preexisting conditions. 

Eligible individuals should visit https://muschealth.org/vaccine-1a to make an appointment. View information and a video with directions on how to schedule a vaccination appointment.

All individuals in Phase 1a will need to sign an attestation to their vaccine status and may need to present credentials/proof to verify they qualify to receive vaccination.  Patients who will not attest to their status or who are not able to present credentials (e.g., driver’s license for the 70+ group or employer badge, medical license, picture of license, or other proof for Phase 1a group) will not be vaccinated and asked to return with proof at their earliest convenience.  

MUSC Health is asking for clinical and non-clinical volunteers to help expedite the vaccination roll-out. Interested individuals should email volunteer@musc.edu.

The MUSC Health team continues to work hard and around the clock on this complex and important distribution process.

• Total number of COVID-19 vaccinations received: 45,425 
  • Percent MUSC Health employees vaccinated across MUSC divisions:
    • Charleston – 88.91%
    • Florence – 63.77%
    • Lancaster – 59.01%
    • System Average  – 83.43%

• MUSC Health is receiving the Pfizer vaccine exclusively at this time, due to sub-zero freezing storage capacity.  
  • Shipments have been arriving approximately once a week and are administered as quickly as possible while also monitoring closely supply dynamics. 
    • Our process was designed to allow for a day’s worth of doses to remain “in-hand” in case a shipment arrived late, to ensure no vaccination appointments have to be canceled or rescheduled.
    • The first shipment was a day late, so the plan to keep a day’s worth of vaccine in-hand was confirmed as a sound approach.
    • MUSC Health has opened evening and weekend clinics to accommodate health care worker schedules and to accelerate completion of Phase 1a.

OUTPATIENT COVID-19 TREATMENT  

Early Treatment

MUSC Health works to expand access to monoclonal antibody infusions to treat COVID-19 after seeing good results in the first batch of patients in late 2020.

MUSC Health is now accepting community health care provider referrals for their patients to receive treatment at MUSC’s COVID-19 Infusion suite in Charleston. The site administers monoclonal antibody treatment to patients who meet the symptom onset and eligibility requirement of the Emergency Use Authorization (EUA). Community providers may learn more about referring patients for this treatment by visiting this page. 

FOR UPDATED DATA

The MUSC COVID-19 Epidemiology Intelligence Project is a digital dashboard that provides leading indicators related to the COVID-19 epidemic to enable informed decisions. Current situation assessments for MUSC Health – Charleston (Charleston, Berkeley and Dorchester counties), MUSC Health Florence, and MUSC Health Lancaster divisions are available on this site. 

HELPFUL WEB LINKS FOR THE GENERAL PUBLIC 

General information 

Information about testing options

MUSC Virtual Urgent Care

COVID-19 vaccination

MUSC Health diagnostic saliva-based COVID-19 testing

MUSC Health is prioritizing diagnostic COVID-19 saliva testing for symptomatic patients (by appointment only) at select locations in the Charleston, Florence and Lancaster communities. Results will be available in MyChart in less than 24 hours (per internal data reports). The test is not a “rapid” point-of-care test and results must be processed within a clinical laboratory. The cost of the test will be billed to insurance carriers. Based on the recent CARES Act, insured or uninsured patients will not have an outstanding balance for this test.

High levels of accuracy were reported for MUSC Health saliva tests, thanks to continued interdisciplinary collaboration and expertise sharing among clinical care and bench research teams. It is important to make sure individuals understand the details related to saliva testing:

• NP swabbing and saliva-based testing will continue in parallel at MUSC and take about the same amount of time to process; one method does not replace another. 
• The current saliva test has lower sensitivity in asymptomatic individuals, and MUSC Health continues to work on improvements to the saliva test assays to improve test performance for these patients.  
• PCR-based saliva testing is not necessarily faster in terms of time to process results within the lab, nor is it less expensive to process than NP swab testing. 
• Saliva is not an acceptable specimen type for any other respiratory virus except SARS-CoV-2. If there is potential to test for any other respiratory viruses, a NP swab is the only acceptable specimen type.
• Collection volume required for testing is 2 ml of saliva and patients should not eat, drink, or smoke for 30 minutes prior to saliva collection. 

Status of MUSC COVID-19 diagnostic testing

At this time, MUSC Health is not experiencing significant issues which would delay either the scheduling of a test or delivering the results of tests to patients. Individuals who are symptomatic or have had a significant exposure to someone with COVID-19 should seek testing. 

Our goal is to maintain the quality, timeliness and volume of testing needed by our state and community. As the current wave of COVID-19 infections develops, it is possible that one or all of these challenges may reduce our test volume capability. This could result in temporary changes to the testing paradigm in order to conserve tests for those requiring hospitalization, health care workers, and first responders. This would allow MUSC Health to focus testing on patients who need it the most. No changes have been made at this time. We will provide timely notification to the public if any changes occur and ask for understanding and patience as we respond as best we can to external factors beyond our system’s control that may arise.   

MUSC COVID-19 mobile diagnostic testing 

Rural and underserved communities experience disparities in access to COVID-19 screening, testing, prevention and treatment in South Carolina and nationally. MUSC Health, in partnership with the state legislature, is rotating mobile screening and collection sites in rural and underserved areas throughout the state. Tents will be set up outside in designated locations to collect COVID-19 respiratory specimens from both walk-up and drive-through patients. Prescreening is not required and the cost is free to patients. Patients will be contacted within two days with the results of their test, if not sooner. Patients are asked to bring photo identification and an insurance card if they have one. Insurance is not required to be seen, however, the CARES Act does require MUSC to bill insurance providers if patients do have insurance. Patients may email drivethruresults@musc.edu if they have questions regarding their results. If they do not have an email address, they may call 843-985-8888.

Sites may close early or operate with reduced hours if weather conditions become unsafe for care team members or if volume exceeds site safety capacity. 

NORTH CHARLESTON: The Charleston International Airport and MUSC Health have collaborated to offer a mobile COVID-19 diagnostic testing site. The site will open on Tuesday, Jan. 19, Thursday, Jan. 21, Friday, Jan. 22, Monday, Jan. 25, Tuesday, Jan. 26 and Thursday Jan. 28 from 2:30 p.m. to 5:30 p.m. and is located on the 4th floor of the airport’s Daily Parking Garage, 5500 International Blvd., North Charleston, S.C. 29418.“Rapid’ nasopharyngeal swab testing is now available at this site, with results available via email within 30 minutes of the test. 

An additional site will open on Thursday, Jan. 21 from 12 p.m. to 4 p.m. at the North Charleston Performing Arts Center, 5001 Coliseum Dr., North Charleston, S.C. 29418.

(Information related to Healthy Me — Healthy SC free mobile testing sites for each week can be found here.)

In reporting on these important developments for these local communities, individuals (elected officials, community leaders, city employees, etc.) and media outlets are asked to adhere to these basic rules while engaging with these locations during operational hours:

1. NO FILMING OR PHOTOGRAPHY INSIDE THE SITE while patients are present and during the stated “open” hours for any given site. This is to protect patient privacy. We also request that no real-time aerial, close-up/identifying or magnified lens use while patients are present.

2. We ask that every effort be made to follow all security protocols for the site so that patients, care team members and media professionals stay safe. Those who cannot follow these protocols will be asked to leave the area as appropriate. 

3. We ask that all MUSC Health team member interviews related to this topic take place when the site is not in operation (before opening, during an individual’s lunch break or after closing via phone or Zoom at a later time) so that our team can focus on safety, patient care and making sure that things are going as smoothly as possible. All interviews should be coordinated through MUSC PR offices and are dependent on site location and care team member availability. 

MUSC Health antibody testing

MUSC Health is offering voluntary COVID-19 serologic testing through musc.care. Results will be available in MyChart within 48-72 hours. Testing is available at select locations in the Charleston, Florence, and Lancaster divisions and by appointment only.  Repeat testing, for those who test negative, will be offered no more than every 30 days for qualified candidates. The cost of the test will be billed to insurance carriers. Based on the recent CARES Act, insured patients will not have an outstanding balance for this test.

The serology test is a blood test that looks for the presence of antibodies, which are specific /proteins made in response to infections. Antibodies can be found in the blood and in other tissues of those who are tested after an infection. The antibodies detected by this test indicate that a person had an antibody response to SARS-CoV-2 (the virus that causes COVID-19), whether symptoms developed from the infection or the infected person was asymptomatic. These antibodies may help provide protection from future infection as well as identify those still at risk. 

MUSC Health is committed to offering the best tests available. It is important to make sure individuals and the media understand what the test results mean.

• A positive result means that there is a high chance that an individual had a previous COVID-19 infection.
• Positive results do not establish proof of long-lasting immunity for any future COVID-19 infection. It is likely that an individual may have some immunity, but we do not yet know the level of immunity or how individual characteristics might influence this immunity.
• Therefore, positive results should NOT be considered a reason for individuals to stop protecting themselves from COVID-19 (at work or home) in terms of social distancing practices when possible, good health hygiene, use of PPE in high-risk environments, etc.

For populations, the test helps measure how much COVID-19 is occurring locally by comparing how many people have antibodies now versus later, as COVID-19 becomes more common in South Carolina. For individuals, it is difficult to make firm conclusions and work-home decisions based on a single antibody test. However, it is important to start testing now, knowing that tests will improve over time. In addition, our knowledge will improve on which antibodies protect people from getting COVID-19, and how long these antibodies are likely to last in the body. As we are able to document who has had prior exposure to COVID-19, we will be able to understand whether individuals are at risk for developing a second infection and its severity.

MUSC COVID-19 follow-up story ideas:

Low School Spread

Some experts feared in-person school during pandemic would cause surge in cases. Data show that hasn’t happened in Charleston County.

COVID Survey

Almost 100 people have signed up so far for an MUSC survey that could help Charleston as it tries to bring COVID-19 under control.

Overdose Epidemic

Drug overdoses are up during COVID-19 at MUSC Health and across the country. A self-described addict, now sober, shares her perspective.

Basic stats / COVID-19 positive cases 

Previously reported data points, such as the number of telehealth screenings, total number of specimens collected at various mobile sites, or the number of COVID-19 positive MUSC care team members are available upon request. Information related to vaccinations is at the top of this release.

• Total number of COVID-19 community screening tests completed by MUSC Health-Charleston: 267,936

(MUSC Health system-wide: 311,066) 

• Total Number of COVID-19 positive greater Charleston community screening tests: 24,767

(MUSC Health system-wide: 29,954) 

• It is important to understand, and to avoid duplication in reporting, that these cases are reported to, and included in, the DHEC statewide COVID-19 numbers.
• The majority of these individuals may not require hospitalization in a South Carolina hospital. 

• Number of COVID-19 inpatients currently in the hospital (MUSC Health-Charleston): 48
  • MUSC Health monitors this number to determine that we have current and future capacity in terms of health care providers, supplies, ventilators and PPE. Please see the IHME graph here. These numbers are consistent with the modeling and expectation that MUSC Health will have appropriate resources to manage these patients. 
  • Of the 48 patients currently in the MUSC Health-Charleston location, 16 are in MUSC Health COVID-19 intensive care, with 12 of the 48 total inpatients currently receiving ventilator care for disease progression.

MUSC Health can use recently vacated, critical care space in the old Children’s Hospital, now known as University Hospital Extension, as well as ICU space in Ashley River Tower as patient volumes increase. 

For a current list of supply requests, please visit this page.  

For specific information about MUSC Health Florence or Marion Medical Centers, please contact Kim Geiger at geigerki@musc.edu. For information about MUSC Health Chester or Lancaster Medical Centers, please contact Ashley Shannon at shannona@musc.edu.

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About MUSC

Founded in 1824 in Charleston, MUSC is the oldest medical school in the South as well as the state’s only integrated academic health sciences center with a unique charge to serve the state through education, research and patient care. Each year, MUSC educates and trains more than 3,000 students and nearly 800 residents in six colleges: Dental Medicine, Graduate Studies, Health Professions, Medicine, Nursing and Pharmacy. The state’s leader in obtaining biomedical research funds, in fiscal year 2019, MUSC set a new high, bringing in more than $284 million. For information on academic programs, visit musc.edu.

As the clinical health system of the Medical University of South Carolina, MUSC Health is dedicated to delivering the highest quality patient care available while training generations of competent, compassionate health care providers to serve the people of South Carolina and beyond. Comprising some 1,600 beds, more than 100 outreach sites, the MUSC College of Medicine, the physicians’ practice plan and nearly 325 telehealth locations, MUSC Health owns and operates eight hospitals situated in Charleston, Chester, Florence, Lancaster and Marion counties. In 2020, for the sixth consecutive year, U.S. News & World Report named MUSC Health the No. 1 hospital in South Carolina. To learn more about clinical patient services, visit muschealth.org.

MUSC and its affiliates have collective annual budgets of $3.2 billion. The more than 17,000 MUSC team members include world-class faculty, physicians, specialty providers and scientists who deliver groundbreaking education, research, technology and patient care.