Alfonso del Granado, administrator of Covenant High Plains Surgery Center in Lubbock, Texas, is a proponent of preoperatively testing ASC patients for COVID-19.
He shared his thoughts on the topic with Becker's ASC Review. Note: Responses were lightly edited for style and clarity.
Question: How is your ASC handling preoperative COVID-19 testing?
Alfonso del Granado: Thanks to our hospital partner, we are able to send to their lab all of our patients for COVID-19 testing, where they use the Abbott ID Now rapid polymerase chain reaction test. Although we can get results in one to two hours, due to the high volume, [the lab prefers] not to do same-day testing if possible, so most of our patients are tested within 24 to 48 hours [of their procedure]. Seventy-two hours is our maximum window with a Friday test for a Monday procedure. Patients are instructed to self-isolate immediately after the test is performed.
Q: How does preoperative COVID-19 testing benefit your surgery center in terms of safety and efficiency?
AG: While there has been some controversy regarding this particular test, the lowest-reported false negatives have been around 50 percent. That is still a significant improvement, and it falls into the all-of-the-above strategy that we employ. The patient questionnaire, masking at all times, use of N95 for clinical and patient-facing workers, social distancing of the staff, leaving the operating room to allow for a full room air change — all of these measures combined reduce our risk by 98 percent.
Q: What is your perspective on the accuracy of COVID-19 test results? Is the possibility of false negatives/false positives a big concern for your center?
AG: Anybody would love a 100 percent accurate test, but it's just not possible in our environment. The current controversy seems to stem from a number of studies demonstrating a false negative rate of about 50 percent rather than the previously reported 30 percent. The variation results in about a 1 percent difference, from 99 percent down to 98 percent, when all of the other safety measures are factored in. Unfortunately, given very large numbers of patients and personnel, as well as the increasing population prevalence, this actually makes a real difference in the likelihood that one or more of our staff or physicians will be infected. Worse, an infection has the potential to shut down our entire center for two weeks. And finally, let's not forget that this is still a deadly disease — we could not live with the thought that a patient, staff member, physician or someone in their family were to suffer the worst possible outcome because we did not take reasonable measures to help keep everyone safe.
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