HJAR Jul/Aug 2020

HEALTHCARE JOURNAL OF ARKANSAS I  JUL / AUG 2020 37 Nathaniel Smith, MD, MPH Director and State Health Officer Arkansas Department of Health pressure in the chest, new confusion or inability to arouse, and bluish lips or face. Patients who are mildly ill should stay home and contact their physician by telephone for guidance. The disease may worsen in the second week after infection. Patients who have severe symptoms, such as difficulty breathing, should seek immediate care. Encourage older patients and people who have underlying medical conditions, or are immunocompromised, to contact their physician early, even those who are mildly ill. Physicians should use their judgment to determine if a patient has signs and symptoms compatible with COVID-19, and whether the patient should be tested. Most confirmed cases have developed fever and/ or symptoms of acute respiratory illness such as cough and difficulty breathing. The ADH does not advise testing asymptomatic patients a second time unless they are immunocompromised. After 10 days of isolation they can be considered to be recovered without a test of cure, as long as they have been without fever for at least three days and their symptoms are improving. Physicians should also not use antibody testing to diagnose COVID-19 because the test may not turn positive until after a person is well, or almost well. That means the physician and patient would learn of the patient’s positive status too late, and they would miss that period of time when they should have been isolating. Testing guidance and screening locations can be found at https://www.healthy.arkansas . gov/programs-services/topics/covid-19- guidance-for-getting-tested. More testing sites are opening across the state, including at theADH’s Local Health Units, where tests are being offered to anyone with or without symptoms who lives in, or has traveled to an area experiencing active transmission. Anyone who wants to be tested at a Local Health Unit should call ahead for an appointment. There is no out-of-pocket cost for the tests, but insurance may be billed for patients who have it. The quicker a person with COVID-19 is identified, the faster they can be isolated to prevent spreading the disease to others. In April, Governor Asa Hutchinson created the Governor’s COVID-19 Testing Working Group to examine the state’s supply of testing equipment, and make recommendations to expand the capacity and performance of testing in the state. Members of the Governor’s COVID-19 Testing Working Group are: Dr. Nathaniel Smith, ADH; Dr. Glen Baker, ADH; Dr. Naveen Patil, ADH; Dr. Katie Seely, ADH; Dr. Jennifer Hunt, UAMS; Dr. Jose Romero, ADH, UAMS, Arkansas Children’s; Dr. Atul Kothari, ADH, UAMS; Mr. Robin Mitchell, Arkansas Children’s; and Dr. Bobby Boyanton, Arkansas Children’s. Contact tracing is a standard public health