By the time Maria Blaha reached the emergency room at Memorial Regional Medical Center in Mechanicsville on Sunday night, she had been living for three weeks with the symptoms of COVID-19, the disease caused by the coronavirus.
Her fever was consistently high, draining her energy. She coughed constantly and sometimes out of control. Her breathing was labored.
“Breathing feels like it’s drowning you,” she whispered in a telephone interview on Tuesday.
The emergency room doctor who saw her on Sunday night concluded that she was “fully symptomatic” of COVID-19, Blaha wrote in a wrenching post on her Facebook page on Monday.
And then the hospital sent her home without testing her for a disease that already has killed more than 3,800 people in the United States.
It was the second time she had visited a Richmond-area hospital at her doctor’s recommendation and the second time she had been turned away without a test to confirm whether she had the disease.
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As a result, her 80-year-old father, Ron Blaha, now acting as her primary caregiver, could not get tested either, even though she relies on him to bring her food and medical supplies.
“Our system is broken” wrote Maria Blaha, 51, an artist living on a houseboat in a Richmond marina on the James River.
Her doctor and nurse practitioner at Crossen Family Practice in Henrico County will not publicly confirm that Blaha is their patient, although she has authorized them to discuss her case with the Richmond Times-Dispatch.
However, they say the failure to make tests for COVID-19 broadly available is fueling the spread of the disease, which as of Tuesday morning had resulted in 1,250 confirmed cases and 27 deaths in Virginia alone, according to the Virginia Department of Health. Later Tuesday, the Richmond City Health District reported the city’s first COVID-19 deaths, two men in their 70s.
The state health department said Tuesday that 13,401 have been tested for the virus in Virginia, and 165 people have been hospitalized.
“We will not get a handle on the epidemiology of this thing until we start testing everyone, but there are no tests,” said Keith Crossen, whom Blaha said has been her physician for 28 years.
A spokeswoman for Bon Secours, a nonprofit health care organization that owns five hospitals in the Richmond region, including Memorial Regional, said all of its hospitals are following guidelines issued by the Centers for Disease Control and Prevention and the Virginia Department of Health.
“While we are unable to comment on specific patient cases due to our responsibility towards patient privacy, Bon Secours’ discharge policy is a comprehensive process that ensures a patient meets all clinical requirements to continue recovery outside of an in-patient setting and considers their needs after a hospital stay,” spokeswoman Jenna Green said in a statement to The Times-Dispatch.
The state health department, citing “limited availability of tests,” lists four priority groups for COVID-19 testing at the Virginia Division of Consolidated Laboratories:
- health care workers or first responders with fever or symptoms of lower respiratory illness;
- any “potential cluster of unknown respiratory illness where influenza has been ruled out,” especially in health care facilities;
- any person hospitalized with fever or symptoms of lower respiratory illness; and
- anyone working in a “congregate setting,” such as a nursing home, assisted living facility, group home, homeless shelter and prison, jail or detention center.
As a result, the first time Blaha and her father went for evaluation, they went to St. Mary’s Hospital, also A Bon Secours facility, where she said they sat in a tent with a member of the hospital staff who was being tested because he had a cough.
“They didn’t test us,” she said.
The hospital staff prescribed an antibiotic for a potential bacterial pneumonia infection, she said. That didn’t work, so her doctor prescribed a different antibiotic, which also did not break the fever or eliminate the cough.
Her fever was consistently high and her breathing increasingly labored, said Wendy Hendrick, a family nurse practitioner at Crossen’s practice. “She would cough and couldn’t catch her breath.”
The nurse practitioner decided on Sunday night to send Blaha to the emergency room. Blaha’s family called Henrico Emergency Medical Services, which she complimented for maneuvering through a marina to take her off her boat and transport her to Memorial Regional in Hanover County.
“She had all of the classic symptoms [of COVID-19],” Hendrick said, “so she does have a highly suspicious case, in my view.”
Blaha wrote in her Facebook post on Monday that the emergency room physician concluded that her lungs were compromised with COVID-19 pneumonia.
“ I, based on your symptomology, believe you are a COVID-19 survivor,” Blaha quoted the doctor as saying. “But this is not New York, you have an excellent support system and can continue to manage at home, if your symptoms get worse come back. ”
Hendrick, the nurse practitioner, said she was “really disappointed” by the outcome, but said hospitals are trying to manage patients in isolated home settings unless they require emergency treatment such as a ventilator to breathe.
“They are cognizant of overwhelming the system,” she said.
Green, the spokeswoman for Bon Secours, said, “Our decisions are based on safeguarding the health of our patients, associates and the communities we serve.”
Blaha acknowledged that hospitals have a limited ability to treat the virus, beyond putting patients on ventilators.
“They don’t have anything else to give you,” she said. “It’s really how strong is the human body just to fight this off.”
But a consequence of not testing Blaha makes it even harder to test her father, who lives with his wife in a separate boat at the marina, to determine if he has the disease without showing symptoms.
“It’s critical to decrease the spread of the virus,” Hendrick said. “They’re not symptomatic, but they could be shedding the virus.”
Crossen’s wife, Margaret, has overseen a move of the medical practice out of Henrico Doctors’ Hospital into a remote location because of the pandemic. The practice now relies on telehealth to reach patients.
“The tests aren’t there,” she said. “Virginia was woefully unprepared.”