Eleven cases. Six of which are in the ICU. And 40 more patients under observation.
All at Holy Name Medical Center in Teaneck.
It’s why Holy Name CEO Mike Maron thinks all the attention the coronavirus has been getting in New Jersey — from the school closings, banning of public gatherings, suspensions of pro sports leagues and even the fights over toilet paper and bottled water — is not enough. Not even close.
“There is absolute reason to be extremely cautious, to be very concerned,” he said.
Maron and his staff are working around the clock under the most trying of conditions. The vitally important single-use N95 masks that are needed to care for patients who have been identified — you know, the ones the state is running out of? Holy Name went through 795 of them. Just on Friday. By 7 p.m.
Maron said the past week has been unlike any other in his more than four-decade career.
“I can fall back on my cholera experiences in Haiti, which was devastating, considering the lack of basic medical supplies after the earthquake — and then the other things that came here, everything from MERS and SARS, and even when we ramped up for Ebola — this is unprecedented,” he said.
“I can tell you, it’s real.”
New York state is introducing drive-through testing, following the lead of Washington, California, Texas, Colorado and others. Seven states had introduced it going into the weekend. Plenty more — including New Jersey — are either considering it or getting ready to introduce it.
This concerns Maron. And it’s a concern he has shared with Murphy and Bergen County Executive Jim Tedesco.
The tests are so new — and have so little history behind them — that Maron said he’s been told they are 90% accurate at best. And that’s for patients presenting with the known symptoms: fever, respiratory issues, gastrointestinal distress. For those who aren’t, Maron said, the accuracy is much lower.
“Here’s the concerns around lab testing that people need to know,” he said. “One, every sample has to be garnered under strict conditions. So, the sample taker has to be gowned in full PPE equipment. Precautions have got to be taken. You can’t just put up a test and have people show up. Gathering samples is not like swabbing for the flu. So, that slows down the number of people you can effectively swab.
“The second is that all these companies all use different assays to determine the RNA sensitivity to the test. And, because the (Food & Drug Administration) let people fast-track because we need to make more available, we don’t know for sure. I’ve had this conversation with the virologists at LabCorp, and they told me, ‘We don’t know the sensitivity of the test.’
“So, if you’re symptomatic, meaning you have a fever and cough, and I swab you and send that sample in, the accuracy of that is 90%. There’s a 10% chance it’s wrong, which is a pretty big window. This is opposed to the flu test, which is 99.999% positive. We’ve had enough testing on those and they have refined that the processes that they know for sure.
“This is complicated. It’s complex science. And, the best we can tell, it’s only 90% accurate. And there is no evidence whatsoever to indicate it’s otherwise.”
Maron said he’s explained this to elected officials.
“I said, ‘Governor, you do not want to do this,’” he said. “You’re going to give people a very false sense of security thinking they can drive through and get swabbed and say, ‘Oh, it’s negative. I’m clear.’
“That’s not good. That’s irresponsible.”
“What we’ve seen in the patients who ultimately are positive is that things can turn very rapidly. We had a patient that we were thinking about releasing — he seemingly was recovering — and then, two days later, he was put in the ICU. The flu isn’t like that. People need to know this.”
Things are progressing that quickly, he said.
And Maron needs to only look at one of his colleagues to see it.
“One of my employees, who is a beloved guy here, got it in the community and came in,” he said. “We had him in our ER in isolation. We were monitoring him, and the decision was: ‘He seems to be doing a little bit better. We think we’re going to discharge him home under self-isolation and monitor him from there.’ But we wanted to wait another hour or two because we were just seeing a little indication that something’s not right.
“In that two hours, he decompensated so fast. He is one of the ones in the ICU on a ventilator. He’s fighting for his life. It goes that quick.
“That’s what people aren’t seeing. The flu doesn’t do that to you. These people are going from being moderately OK to being on a vent. And the next thing that happens is they start to decompensate, and then you get into organ failure.”