Swabbers on the front line

Three of the team of swabbers that perform the COVID-19 testing at Androscoggin Valley Hospital (from the left): Janet Reynolds, certified medical assistant, AVH Surgical Associates; Ann O'Sullivan, RN, AVH Medical-Surgical Unit; and Alexis Marcou, RN, BSN, AVH Medical-Surgical Unit. (COURTESY PHOTO)

BERLIN — They are the Swab Squad at Androscoggin Valley Hospital — the dedicated team of health-care workers who do the COVID-19 testing. The swabbers conduct the testing, handle the specimens and notify clients of the results.

Chief Nursing Officer and VP of Patient Care Services Brian O’Hearn said the work the team does goes beyond identifying positive cases of the coronavirus. He said their work helps health-care officials and community leaders identify trends and develop strategies to address them.

“It allowed us to stay, in many cases, one or two steps ahead of outbreaks,” O’Hearn said, calling their work invaluable.

Director of Inpatient Services Karen Smith, who heads up the team, said all of the swabbers volunteered to be part of the effort. She said the hospital sent around a survey, asking for members of the nursing staff willing to work on the testing team. Some felt them could not because of family considerations. But nine were selected from those who were willing.

“They’re a great team,” said Smith. “People working from different departments that never really knew each other are working alongside each other to try to fight the COVID pandemic.”

Smith notes the testing comes with a degree of risk for the team. While they wear masks and protective gear, the job requires they come into contact with positive cases. With winter weather, conditions can be a little chilly. The swabbers work out of a construction trailer staged outside the front of the hospital to allow people to drive up to be tested away from patients and the rest of staff. The trailer is heated and has a portico but swabbers are in and out of the cold as they do the nasal swabs while patients remain in their vehicles.

People call for COVID-19 testing for a variety of reasons. Some are work- or travel-related while others are people who have been exposed to someone with the virus or have symptoms. For those exposed to someone with the coronavirus, the ideal window for testing is three to five days after exposure.

The testing process is easy for the patient. They sign up and will get a phone call with their appointment and then they drive up. Smith said there is a quick screening, their swab is taken and they drive away. Within two hours, they get a phone call reporting their results.

For the vast majority of patients, they will receive one of two rapid tests AVH uses. Both require just a quick swab of the nose, nothing invasive. The entire process takes about 10 minutes for patients.

“We’re no longer doing what they call the brain tickler,” said Smith, referring to the intrusive nasopharyngeal swabs that drew complaints across the country when first used. She said those are only used on doctor’s orders in special cases.

Smith said most of the patients who come are very willing to be tested. She said many say it is better to get tested then to have COVID and not realize it.

“I've never really had anybody sitting in the car saying “No, I won't be tested,” she said.

On any given day, Smith said there are three working in the COVID hut at a time. There is a lead nurse and two others. One does the paperwork, one does the swab and one reads the results. When they started the outside testing this summer, Smith said they swabbed from 9:30 a.m. to 12:30 p.m. and did about 20 tests per day. Now as positive cases have increased in the city, they are doing at least 50 tests a day and the hut is open longer.

Smith said they opened the COVID hut up one weekend to do testing when there was a spike in the valley. She said some of the swabbers heard and came in on their day off. She said the line of cars was down the hill and they ended up testing 125 people that day. Staff in the hospital worked shorthanded to send extra help to them to handle the demand.

“They're all chipping in and wanting to fight the fight together as a team. I think that moment brought tears to my eyes,” Smith said.

It can be unsettling for a patient when they are notified that their test came back positive.

“The phone calls can be very emotional. You know, my 5-month-old, I'm exposing my 5-month-old. What should I do? There's a lot of questions and answers,” said Smith.

“When this all started, we never expected that it would be going this long. But it didn't take more than three, four months when we realize we're in it for the long haul,” said O’Hearn.

When they started testing, he said the state was doing contact tracing. But as the volume of cases increased, the state was not able to keep up and O’Hearn said the hospital stepped up to do the tracing. While protecting confidentially, he said the testing results are reported at the COVID-19 group meetings. The group, which contains representatives from health-care organizations, schools, nursing homes, municipalities and prisons, discusses hot spots and trends and look for evidence of community spread. The information is used in making decisions like whether schools should move to remote learning.

A recent article in The Boston Globe newspaper said the onset of COVID-19 vaccines only increases the need for testing. Initially, the vaccines are being reserved for health-care workers and residents of long-term care facilities.

The vaccine is not expected to be available to the general population, which accounts for most of the spread, for three or four months.

Furthermore, it is unclear whether the vaccines will stop people from transmitting the virus or act only to protect the individual vaccinated. In the meantime, the virus is surging across much of the country, attributed to holiday travel and gatherings. At the same time, people are urged to continue to wear masks, wash their hands frequently and social distance.

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