Washington community develops rural coronavirus testing model

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Rural communities fear resource shortages if COVID-19 strikes

Rural communities across the U.S. fear medical resource shortages if COVID-19 strikes, Alicia Acuna reports.

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An island community in Washington State has developed a coronavirus testing and tracing model that they believe could be replicated in rural and tribal areas nationwide.

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The Vashon Island community, with help from the medical reserve corps and a swath of volunteers, developed a testing system in which residents self-test with nasal swabs from the security of their own cars. The set-up also eliminates the need for extensive personal protective equipment, testing organizers said.

Vashon Island is reportedly located over an hour away from the nearest emergency room, vulnerable to an easily overwhelmed ambulance system, and lacks acute care facilities. Rural communities across America face similar issues as well.

“While rural areas are typically under-resourced and disadvantaged as it comes to health and health care, a model like this shows that rural places can be particularly nimble and flexible,” Carrie Henning-Smith, the deputy director of the University of Minnesota’s Rural Health Research Center, told the New York Times. 

The testing model came about after Vashon resident Dr. Jim Bristow’s wife reportedly developed gastrointestinal issues and endless bouts of coughing with no testing options in sight.

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The island community coins the coronavirus response plan and model the "Rural Test & Trace Toolkit."

"We have no acute care or hospital care," the toolkit's website states. "When faced with these challenges, we developed and deployed a testing strategy that allowed our community to launch a successful testing site in less than three weeks using local resources, a volunteer workforce and without resources from our country's public health system that was already stretched thin."

The website said that the strategy is based on three principles: 1) that informed patients can self-collect nasal swab specimens for testing; 2) that exposure of volunteer health care workers to SARS-CoV2 must be minimized; and 3) PPE use can be minimized during testing by isolating patients and workers from each other throughout the testing process.

Residents are instructed on how to swab their noses via written instructions given before they arrive to test sites and again immediately before they administer the test. The sample is then put into a biohazard bag, and the resident drives to the drop off point to deposit it in a cooler before leaving the premise.

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A portion of Vashon volunteers were trained on contact tracing as well, which will ensue should positive cases arise.

“It’s not rocket science and with the right supervision you can train basically anyone to do it,” Bristow told the New York Times. 

In developing the testing model, Bristow told the news outlet that he recruited the help of Seattle E.R. physician, Dr. John Osborn, who leads Vashon's medical reserve corps. They believe other remote areas could come to rely on the same help.

"We believe that rural communities can and should accept responsibility for protecting their communities now," the toolkit's website stated. "We suggest engaging and marshaling local resources while communicating your intentions upward. If your community or area has a Medical Reserve Corp, begin by talking to them -- they may already be organizing."

Bristow’s wife recovered and as of Saturday, the island community had not experienced a positive case in more than two weeks despite four other coronavirus cases previously reported to the Washington Department of Health.