This is a wild ride, where are we going?

And at this point, you might be wondering, where are we going anyway?

In this era of uncertainty, there are some things we do know: 

• We’re not going to eradicate coronavirus

• And we’re a long way from a vaccine

We also know: We’re all in this together.

As a society we’ll to learn how to live with the coronavirus disease.

Our role in getting us there, and our number one priority, is to manage how best to test, identify infected people, encourage and support isolation and to contact trace. We’ll continue to partner with San Miguel County Public Health in these efforts.

Below is what our staff at the Telluride Regional Medical Center has been working on for the short-term, mid-term and long-term coronavirus response:

The criteria for who we test is still nevertheless limited by supplies, and the testing capacity of labs.

We’re currently testing patients who are symptomatic (fever, cough, shortness of breath) or who are in a high risk category and have had exposure to someone with a confirmed case of COVID-19.

We’re also testing patients who are essential service workers with a known contact to someone confirmed with coronavirus.

If you fit the above criteria, call the medical center, we can assess your situation and discuss a plan for visiting the outdoor respiratory clinic and/or how to best manage your symptoms at home and self-isolate.

Best case scenario is for the San Miguel County / United Biomedical Inc. partnership to complete the mass antibody testing and provide results in a clinically timely fashion.

With timely results Public Health could pair with PCR tests and utilize “contact tracing” to the maximum effect. We’d also see where the community on the whole stands with regard to prevalence and immunity at a point in time.

Another ideal scenario: Rapid and reliable IgG/IgM (antibody) tests that could be given at the medical center with results provided within 15 minutes. We’d then pair results with a PCR test for validation.

The challenge here is reliable and rapid tests, at this point, are only available for hospitals, specifically state and large hospitals that belong to broad health care systems and offer “high complexity labs.”

Our clinic hosts a “moderate complexity lab,” which limits the type and kind of tests that we’re able to perform.

This lack of access is something all rural clinics and small health care providers are facing.

We believe it’s reasonable that within 3 – 6 months, our BioFire Diagnostics System — which we currently use to scan stool for dozens of pathogens — could be outfitted with a respiratory panel to rapidly test for COVID-19. We’re in close contact with the BioFire team who are working tirelessly to develop the technology.

This rapid PCR test for COVID-19 would also test for other respiratory illnesses (like RSV, flu, HMPV, etc.) providing point-of-care results within an hour.

The tests are expensive (up to $2000) and may not be covered by Medicaid or Medicare — though there’s reason to hope private insurance would cover coronavirus tests. (We like to imagine a scenario where the community is able to create a safety net for those who need the test, but can’t afford it.)

The long-term goal would include pairing the rapid PCR test results with an antibody test, like those as described above so we can differentiate infection rates over time.