District Service Board paramedics test more than 200 patients for COVID-19 at home

The Manitoulin Expositor

By Warren Schlote - May 6, 2020

Two Manitoulin-Sudbury DSB paramedics demonstrate the process of getting swabbed at a home appointment. If you suspect you may have COVID-19, call one of Manitoulin Health Centre’s assessment lines and the health care worker will determine whether you should be tested at home or at a designated screening site.

Officials explain the process and its significance

MANITOULIN – A new service from the Manitoulin-Sudbury District Services Board (DSB) has three teams of paramedics deployed throughout its service area to offer home testing for COVID-19, an important service that allows patients to remain safely where they live and reduces the testing load at hospital-based assessment centres.

The mobile testing service was first discussed on March 9 when Public Health Sudbury and Districts Medical Officer of Health Dr. Penny Sutcliffe partnered with Ontario Health and community partners to identify alternative methods of COVID-19 testing.

She identified that leveraging the community paramedic system would provide useful support during this time, a system pioneered by the County of Renfrew Paramedic Service.

“The last thing we want to do is bring someone who might have (COVID-19) into a health care facility and expose them to other people who are at risk or unwell, as well as health workers and the community as a whole,” said Rob Smith, chief of paramedic services at the DSB.

Planning began on March 9 and lasted until March 23, followed by three days of training (because this is a medically delegated act, meaning physicians have directed non-physicians to carry out a medical service). One of the DSB’s team

members was part of the medical team that helped test the first plane-load of repatriated Canadians earlier this year at CFB Trenton, so they were able to aid the education.

On March 25, the first service team began working with the Espanola hospital to provide mobile tests in the LaCloche area, from the Township of Sables-Spanish Rivers to Greater Sudbury on the mainland. Requests soon followed from Sudbury East (which includes areas such as Killarney, Markstay-Warren and St. Charles) and then the District of Manitoulin.

“If you think about Sudbury East especially, they don’t have a hospital system. Health Sciences North in Sudbury is their main referral hospital,” said Mr. Smith. “We’d be making them travel over 100 kilometres to get a (COVID-19) test done when we can leverage having paramedics in our communities to help do that.”

This especially impacts the at-risk population, including seniors, those with compromised immune systems and marginalized people with low incomes who cannot as easily drive long distances for testing.

“There are communities on Manitoulin Island that are isolating together as a community, so this stops them from forcing people or requiring people to leave that community for testing,” added Mr. Smith.

There are 142 full- and part-time paramedics within the DSB. The DSB asked every staff member about their interest in becoming a designated COVID-19 mobile test provider.

Filling the slate of six staffers proved to be difficult, albeit for a positive reason.

“That’s something I’m extremely proud of and it made it a difficult decision because so many people said they were willing,” said Mr. Smith. “We have a really strong group of personnel who will step forward and assist. They see what’s going on right now and they’ve stepped up to say, ‘how can I help?’”

The paramedics work in pairs of two. One paramedic dons all necessary personal protective equipment (PPE), but only what is necessary to safely complete the job, completes a screening of the patient and, if deemed to be appropriate, will conduct the test.

The other paramedic stands at a social distance and acts as a safety officer.

“Their role is to make sure that the exact same process is used in exactly the same way over and over, and to ensure that we don’t see any PPE breaches or protocol breaches, thereby keeping our medics and the patients safe,” said Mr. Smith.

The teams work eight-hour days from Monday to Friday, beginning at a staggered time between 8 and 10 am and working as late as 6 pm. Each of the three regions of the DSB has its own dedicated team.

Paramedic testing appointments are booked through the same process as calling one of the in-person assessment centres at Manitoulin Health Centre. If the hospital employee deems the individual would be best served by a home visit, they will arrange the appointment through the DSB.

“Paramedics can provide service, ensure that it’s done in an extremely safe manner and that they can do it in a manner that limits any risk of exposure for the patient or anyone else in the community,” said Mr. Smith.

By only having one of the two testers don full PPE, the service is able to conserve its supplies while maintaining safety. Mr. Smith said provincial sources and other agency partners have been very helpful in securing these items and the DSB has a four-and-a-half-week supply on hand.

Last week, the DSB hit the milestone of having tested 200 patients through its service. The responses have been quite positive to date.

“Patients are happy that they can have this service within their own homes without having to travel long distances, especially if they’re not feeling well. The feedback from our community partners like municipalities and the health care sector has all been extremely positive, too,” said Mr. Smith.

All of this testing carries a cost. DSB CAO Fern Dominelli said the hourly rate for a paramedic can reach levels close to $39 per hour for a 42-hour week, meaning a weekly staffing cost for the six individuals could be close to $10,000. Then, there’s the cost of supplies and ambulance expenses.

Ontario paramedics were also recently classified under the category of health care workers who will receive pay bonuses for their efforts in controlling COVID-19.

“There is a cost to this but we think that at the end of the day, this will prevent the spread of COVID,” said Mr. Dominelli. “We are providing a valuable service, especially for seniors who might be afraid or unable to leave their home.”

Despite taking six paramedics off their regularly assigned duties to be COVID-19 testers, Mr. Smith said the DSB has been able to maintain its existing paramedic service levels.

This may be partly due to people being reluctant to visit health care providers because of pandemic fears. Several Ontario hospitals and paramedic services have reported downturns in their patient volumes; however, Mr. Smith said those volumes have not dropped significantly for this DSB.

Mr. Dominelli and Mr. Smith both stressed that anyone who needs medical help should seek it, regardless of any worries they may have.

As Ontario begins to plan its economic re-opening alongside other provinces, health experts warn that the best way to ensure success is through increased testing. Otherwise, models show that a second spike in cases—possibly worse than this first peak—could easily occur.

That additional testing is something the DSB has been discussing to determine how it may be able to help.

“As business starts going back to normal and we’re figuring out what that means, it could mean more testing. We’re meeting the level of community need at present, but if more testing is needed we will have to revisit it,” said Mr. Dominelli.