A MESSAGE FROM HATTIESBURG CLINIC CHIEF MEDICAL INFORMATION OFFICER, BRYAN N. BATSON, MD
JUNE 19, 2020
WHY PRE-OPERATIVE TESTING IS AN IMPORTANT STEP IN OUR PATIENTS’ CARE CHIEF MEDICAL INFORMATION OFFICER, BRYAN N. BATSON, MD
We understand this remains an uncertain time for everyone. As Hattiesburg Clinic continues to monitor the COVID-19 pandemic and make important decisions about how we care for our patients, we want our community to understand that our first priority in making these decisions is the safety of our patients, physicians and employees.
We continue to work with multiple sources including the Centers for Disease Control and Prevention (CDC) and Mississippi State Department of Health (MSDH). Additionally, as we make important decisions about our policies and procedures regarding COVID, we review the local disease patterns and guidelines as well as vast amounts of internal data on over 12,000 patients who have been tested for COVID throughout Hattiesburg Clinic. As we have cautiously increased the number of services and elective procedures, there are several pieces of information that we want our patients to be aware of as they receive care:
- In a study published online last month by a trusted medical journal, The Lancet, of 1128 patients who underwent surgery, death occurred in 25% of patients who had elective surgery while also having COVID at the time of their procedure. This research points out the critical importance of identifying COVID in patients prior to them having non-emergent surgery and delaying the procedure if possible.
- As of June 18, 2020, there had been 981 patients diagnosed with COVID at Hattiesburg Clinic. Approximately 11% of them – or 108 patients – were completely asymptomatic.This high percentage of COVID patients with no symptoms has been reported throughout the world, and it helps explain why this virus spreads so easily. It also emphasizes the importance of why we must perform additional testing for patients prior to surgery (also called “pre-operative testing”) to identify patients with COVID as we cannot rely on symptoms alone to identify those who have the infection.
- Through the pre-operative screening done thus far at Hattiesburg Clinic, we have found over 20 patients who were scheduled for elective surgery to be positive for COVID-19. The overwhelming majority of these patients had minimal or no symptoms. These are not national statistics. These individuals are mothers, fathers, grandparents or children right here in our hometown – and we take the responsibility for these and all of our patients’ lives very seriously.
- At Hattiesburg Clinic, we have been able to perform COVID antibody testing since April.With most infections, our bodies make antibodies when fighting an infection – like COVID-19; an antibody test looks for antibodies in the blood. While this type of testing is not recommended as the sole method for diagnosing COVID-19, that guidance is partly related to the Federal Drug Administration’s (FDA) caution statements about the reliability of some of the “fraudulent” (fake) antibody tests that were rapidly developed early in the pandemic. Hattiesburg Clinic is using a test called the SARS CoV-2 IgG antibody test on the Abbott Architect i2000 instrument, authorized by the FDA under Emergency Use Authorization. Additionally, multiple studies have shown that antibodies to COVID-19 rise as early as 2 days into the infection. Why is this important? Coupling these facts with reports that the RNA nasal swab, which is part of the initial COVID testing process, may have a false negative rate as high as 20% nationally, antibody testing has proven helpful in getting a more complete picture of a patient’s COVID status, which helps us make better decisions for the patient.
We understand that undergoing additional tests prior to having a procedure is neither comfortable nor convenient. However, please know that Hattiesburg Clinic continues to work diligently to provide you the best advice possible during these uncertain times, and our recommendations will most likely change in the future as additional local and national data emerges. Your health is our primary mission, and your safety is our goal. We recognize that not all providers in our area are requiring these steps, but we sincerely believe that taking these added measures is the most responsible path to providing you with the safest health care possible.
As always, thank you for trusting Hattiesburg Clinic.
Bryan N. Batson, MD
Chief Medical Information Officer
Hattiesburg Clinic, PA
 Archer, J. E., Odeh, A., Ereidge, S., Salem, H. K., Jones, G. P., & Gardner, A. (May 29, 2020). Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: An international cohort study. The Lancet, 1-12.
Shah, A., & Shuren, J. (May 4, 2020). Insight into FDA’s Revised Policy on Antibody Tests: Prioritizing Access and Accuracy.