Marshall Medical Centers has administered 131 COVID-19 tests, as of Wednesday morning, March 25.

In a statement, Marshall Medical Centers Pulmonologist, Dr. Christopher Manganaris helped explain how the testing process works.

To be tested, a person must meet certain criteria, which is based on federal guidelines to ensure those most at risk receive testing. Criteria includes:

• The patient is symptomatic with, at minimum, measured or subjective fever or cough or shortness of breath.

• The patient is hospitalized. 

• The patient is immunocompromised or has co-morbidities.

• The patient age 65 years or older.

• The patient is a healthcare worker.

• The patient is associated with a long-term healthcare facility.

Individuals with no symptoms should not be tested. Testing is also not recommended for persons with mild symptoms. Manganaris said everyone is encouraged to stay home, practice home care, and call their doctor or the hospital if symptoms worsen.

When tested, a long Q-tip is inserted through the person’s nose in order to reach the “nasopharyngeal region” where cells are collected. This is the area where the respiratory tract meets the back of your mouth, which is the area where the virus attaches itself, latches on and starts replicating.  The test is not painful and should take 10 seconds or less.

Manganaris said after the test is taken, it is sent to outside labs.

“Right now, specimens are being sent to one of three outside testing labs, depending on what day of the week the test is collected, current turnaround times and how quickly results are needed (for more urgent patients),” Manganaris said. “The labs all use a reverse-transcriptase polymerase chain reaction (RT-PCR) in testing the specimen.”

The RT-PCR technique rapidly identifies the presence of viral RNA in the swabs from the noses of potentially infected people. RT-PCR uses short stretches of DNA, called primers, which bind tightly and specially only to matching sequences in SAR-CoV-2 RNA.  An enzyme, called reverse transcriptase then converts the viral RNA into complementary DNA, and, as the reaction continues, an enzyme, called polymerase is used to generate billions of DNA copes that can be detected by fluorescently tagged molecules called probes.  

If the patient tests positive for COVID-19 and is clinically stable, not oxygen-deficient or significantly short of breath, the patient will be sent home to self-quarantine for 14 days until symptom free for at least 72 hours.  If the patient tests positive for COVID 19 and is oxygen-deficient or significantly short of breath, the patient will be admitted to the hospital and treated appropriately.  If the patient improves clinically during the hospitalization then they will be discharged home to finish out their quarantine.

Turnaround time for test results can range from 48 hours to 3-4 days depending on the case. For example, if an older person with chronic illness is tested at same time as a young, considerably healthy person, the older person’s results would take first priority. Also, labs across state are reportedly flooded with cases, so that also causes delays in the ADPH’s reporting.

Patients should also be aware of the following changes:

The Marshall Imaging Center is open only to PET/CT scans. Screening protocols are in place. No visitors are permitted. 

• The Marshall Wound Healing Center is open. Screening protocols are in place. No visitors are permitted. 

• Marshall Rheumatology – Patients are asked to please call before appointments; 256-894-6700.

• Marshall Sleep Disorders Center is closed through April 4 with plans to re-open on April 5. 

• Northeast Alabama Vein and Vascular Specialist – business as usual. Screening protocols are in place. No visitors are permitted. 

• Marshall Cancer Care Center is open. Screening protocols are in place. No visitors are permitted. Exceptions will be made for extraordinary circumstances.

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