As novel coronavirus continues to spread throughout Los Angeles, medical professionals have been keeping an eye on Skid Row.
Dr. Marc Eckstein, Professor of Emergency Medicine at Keck School of Medicine of USC and Medical Director of the Los Angeles Fire Department, tells Inside the Issues “testing this population is extremely challenging.”
Last week, L.A. County partners teamed up with non-governmental agencies to assist the fire department with its first-ever mobile testing unit on Skid Row at 6th and Gladys Street, near Gladys Street Park.
“The entire street was shut down. Basically this was people who can walk up, register, and get tested in real time,” he said. “We confirmed their identification, got them registered. We created a barcode for them, handed them a test kit.”
Dr. Eckstein said the fire department paramedics tested all patients, even if they were asymptomatic.
“[We used] a piece of plexiglass surrounded by wood with two holes cut out so our members can basically put their hands through the holes in the plexiglass, walk the client through how to do the self-swab, hand them the kit, provide the instructions, and collect the specimen, to really minimize their exposure,” he said.
After the self-swab, patients were evaluated by a health care professional.
“The client went down to the end to get evaluated by our paramedics, to get a history, get an exam, get a set of vital signs, check their oxygen saturation and blood glucose. And those individuals who were deemed to be most at-risk, most vulnerable, were then offered to be transferred to what’s called Tier 2 Housing,” he said.
The fire department converted some ambulances into “COVID transport vehicles.” Up to five individuals at a time were taken from this mobile testing unit to hotels and placed in individual rooms. These hotels will also provide supportive care.
“It was very gratifying to see not only the number of homeless individuals that showed up to be tested, but a high percentage of individuals who were offered placement in Tier 2 Housing availed themselves of that opportunity,” he said.
Dr. Eckstein said the results from the mobile testing unit at 6th and Gladys Street were shocking.
“We tested about 250 individuals over the course of a few days, and we only had two individuals test positive, which is really striking,” he said.
Still, several individuals on Skid Row had already tested positive for COVID-19. Prior to the testing performed by the fire department, Dr. Eckstein said missions and shelters had begun their own tests.
"And not surprisingly, there was a huge number of individuals who tested positive. The hotspot was the Union Rescue Mission on Skid Row," he said.
Reverend Andy Bales, CEO of Union Rescue Mission, told Inside the Issues they are the only mission that performs Universal Testing - weekly tests on everyone who stays at the shelter.
"Our Mission, which has 100 positive cases, our [sic] of a once 1000 person population, with nearly 75% reportedly with no symptoms," Bales said. "It is far too early to indicate in any way that someone is safer on the streets alone in a tent."
Dr. Ecksteain said it's not suprising that congreate living conditions, such as residing in shelter, would result in higher numbers, but he was shocked to discover those tested by the fire department, resulted in lower cases of positive test results.
“We know the concern of people living in congregate housing, particularly some of the conditions and medical conditions that the homeless individuals have, so it wasn’t really a surprise to really anybody that we had a high number of individuals who tested positive in the Mission,” he said.
Dr. Eckstein suspects that the individuals who walked over to get tested at the mobile testing unit near Gladys Street Park last week live alone in tents.
“Although they live in horrific conditions with great needs in terms of proper hygiene and so forth, I don’t think they’re cohabitating and have the same exposure they would in the congregate living of a shelter,” he said. “Now I don’t want people to refuse offers to take congregate shelter, but right now, the Tier 2 Housing we’re offering is individual hotel rooms.”
Even if someone tests negative for novel coronavirus, Dr. Eckstein says he or she still needs to practice proper social distancing.
“If we test someone today, all we know is within a reasonable degree of certainty that they do or they don't have evidence of the virus at that point in time, but if they’re not vigilant about social distancing and stay at home orders, they may very well go and get exposed right after they get tested,” he said. “Getting tested in no way means people should let up their vigilance to remain safe at home, social distancing, and so forth. It’s just a static data point in time so you have a reasonable degree of certainty that you did or did not carry the virus when you were tested.”
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