Cars crowded along 59th Street and wrapped around the block on the first day that Sayre Health Center opened its COVID drive/walk-through testing site in the Cobbs Creek section of West Philadelphia.
Despite the long line, Sayre Medical Director Kent Bream, MD, greeted each of the 121 men, women, and children patiently, with a joke and a laugh. The patients cracked a smile in return. They seemed to share a common emotion: relief.
Each person was not only tested for COVID-19, but also screened for anxiety and depression. The services tapped into a need that had been hard to come by as the outbreak spread across Philadelphia the past two months.
“It’s a really empowering thing to have access to care. Whether the result of the test is positive or negative, having access is an intervention in itself,” said Bream, who is also an associate professor of Clinical Family Medicine and Community Health in the Perelman School of Medicine. “On our very first day, our patients were telling us, ‘We needed this.’”
Though COVID-19 affects people from all backgrounds, the pandemic has also highlighted profound racial and socioeconomic inequities in health care. In Philadelphia, more than half of coronavirus deaths are among African Americans, even though they make up 40 percent of the city’s population. African Americans are dying at a rate more than 30 percent higher than white patients, according to city data.
Experts have pointed to social conditions, structural inequities, and other factors that have elevated African Americans’ risk of contracting COVID-19. One example Bream noted is that in Cobbs Creek — which is primarily African American — people are more likely to live in multi-family homes or apartment buildings, or they may be transient, making social distancing difficult.
Black and Hispanic individuals are also likelier to face barriers accessing testing and care. For instance, research shows that many do not have primary care physicians, so they cannot easily obtain a referral to a testing site, or they may not own a vehicle to travel to a drive-through site. A history of unethical experiments on minority populations— like the Tuskegee syphilis experiment — has also sowed seeds of mistrust or fear of the medical field, experts have noted.
The Dr. Bernett L. Johnson Jr. Sayre Health Center, which is a Federally Qualified Health Center, and Penn Medicine have sought to address this gap by offering COVID testing in a high-risk neighborhood — without barriers or bureaucracy.
“Many of the patients we’re testing have never been seen at our center before. But still, there is a sense of community, since we have been a part of this neighborhood for 15 years,” Bream said. “You may have graduated high school with the person greeting you at the site. Or maybe you attend church with the registration staff.”
In 2006, Bernett L. Johnson, Jr., MD, a former chief medical officer at the Hospital of the University of Pennsylvania, opened Sayre Health Center as a way to link resources between the health system and its surrounding community. As COVID-19 hit the Philadelphia area, University of Pennsylvania Health System CEO Kevin B. Mahoney realized there was a racial gap in access to testing. He turned to Bream to find out how Penn Medicine could help to expand the longtime partnership with Sayre to provide testing capacity.
“Sayre has 26 employees and two physicians. We were hearing from patients that there was demand for testing in the neighborhood, but we could not figure out how we could meet that demand,” Bream said.
Following discussion with Penn Medicine Chief Quality Officer Pat Sullivan, PhD, the concept of a drive/walk-through testing site went from idea to reality. Penn deployed seven nurses, doctors, and physician assistants, as well as Penn Police, to bring the makeshift site to life. Nida Al-Ramahi, MHA, a Penn Medicine administrative fellow, led the operation, pulling from her experience leading Penn’s other drive-through COVID site in West Philadelphia.
“We’re seeing really big volumes, similar to the West Philly site. But morale is really high, and this has once again showcased the importance of teamwork. The bond that the staff has here is what keeps everyone going,” Al-Ramahi said.
During the first week of operating the Sayre Health testing site, the staff performed testing on 906 patients, more than 88 percent of whom identified as African American and two percent of whom identified as Hispanic. This week, the number of Spanish-speaking patients from Upper Darby has increased, as patients have learned that Bream is bilingual.
Despite the surge in patients, Al-Ramahi said the site runs like clockwork, as patients are intended to spend no more than 50 seconds at each of the three different stations.
The site is run so efficiently in fact, that Bream saw that he had an opportunity to expand the services on offer: Using a 5-minute window available while patients wait between test ordering and swabbing, they now receive screening for anxiety and depression. The model follows a principle of integrated mental and physical health care, which Penn’s Psychiatry Department has begun to emphasize in outpatient and inpatient settings.
If a patient expresses sadness, fears, or anxieties, the health care team can perform what is known as a “brief intervention,” and, if needed, provide referral or resources for help, such as the phone number for the COVID-19 Social Needs Response Team (267-785-2019). This has allowed Sayre to care for the dual epidemics of COVID and mental health issues.
“As people self-isolate, these kind of small but meaningful interpersonal interactions have been missing,” Bream said. “Being here gives people a small sense that both we and they can control what’s happening. The feeling of disempowerment can be managed.”
The Sayre Health Center Coronavirus Testing Site entrance is located in the parking lot behind Sayre High School at 227 S. 59th Street, Philadelphia.
Patients are strongly encouraged to pre-register by calling 215-474-4444. On-site registration may incur long wait times.
Registration call line hours: 8 am to 5 pm, Monday through Friday
Testing hours: 10 am to 3 pm, Monday-Wednesday and Friday; 12 pm to 3 pm, Thursday