I woke up at 3 a.m. and my throat was burning.
Ordinarily, I’d rinse my nose with a neti pot, drink a cup of tea, and fall back asleep; I have allergies and am prone to sinus infections. But this was September 2020, and it seemed like every sniffle, rash, or pain could be a COVID-19 symptom.
Achy and fatigued later that morning, I started to feel like “patient zero.” When was the last time my parents had visited? Which friends had I seen that week? Had I infected the cashier at the grocery store? Or the pizza delivery guy? I was supposed to travel in a few days. Should I stay home?
“There’s a real crisis of anxiety right now,” said Kent Bream, MD, an associate professor of Clinical Family Medicine and Community Health in the Perelman School of Medicine at the University of Pennsylvania.
One step to quelling my fears? A test.
Though only one piece of the effort to stem infections — prevention through vigilant use of masks, handwashing, social distancing, and an eventual vaccine are also key — COVID testing it is a cornerstone of arming people with information they can act on. If you test positive, there are important ways you can help your loved ones — and your entire community — to stop the spread through isolation and contract tracing.
Bream, who also serves as medical director of the Sayre Health Center in Cobbs Creek, says the availability of COVID testing is an indispensable step toward protecting the physical and mental health of Philadelphians. “We need testing to tell people that it’s OK to go for a walk, to send their kid to school, to be able to visit a relative. We’re creating a pathway to confidence.”
Penn Medicine has played a critical role in Philadelphia’s testing ecosystem during the pandemic. In a three-part blog series, we’ll give you three, 24-hour snapshots of how to get tested for COVID-19 at Penn Medicine, what happens to that test once it’s collected, and how positive cases are traced to stop the spread of the virus.
Where to Get a COVID Test at Penn Medicine
Penn Medicine is responsible for a vast swath of Pennsylvania’s COVID testing. To date, the health system has performed and processed nearly 238,000 tests — about 3,000 per day, on average — which accounts for roughly 9 percent of all testing in Pennsylvania, according to David Roth, MD, PhD, chair of Pathology and Laboratory Medicine.
Contributing to that number are pre-procedural tests. In order to keep patients and staff safe in Penn Medicine hospitals, patients who have an upcoming surgery or procedure, like a colonoscopy, may receive a COVID-19 test, even if they do not have coronavirus symptoms. Likewise, mothers-to-be coming to deliver their babies are tested, as well as all other patients admitted to the hospital including those who are admitted via emergency department for any reason.
Additionally, Penn helps to operate two community testing sites in the city:
- West Philadelphia: 4040 Market Street (indoor site newly located from the previous 41st and Market Street parking lot). Call 267-414-2303.
- Sayre Health Center (in partnership with Penn Medicine): 227 S. 59th Street (drive/walk-through). Call 215-474-4444.
The testing sites at 4040 Market, as well as at Sayre Health, are both open to the community, and nearly 33,000 tests have been administered there so far.
You should call to schedule an appointment, but you do not need a doctor’s referral or to be a Penn patient to receive a test there. At Sayre, you also don’t need to be experiencing any symptoms, and there, you can get your flu shot, along with a COVID test.
For Penn Medicine patients, COVID testing is also offered at Pennsylvania Hospital with a doctor’s referral: 711 Delancey Street (drive-through) and 721 Delancey Street (indoor walk-through).
The Families First Coronavirus Response Act ensures that COVID-19 testing is free to anyone in the U.S., nationwide, including people without insurance.
After seeing a dip in COVID cases from June through September, daily infections are on the rise again in Philadelphia. And that uptick, paired with an approaching flu season, means that testing will continue to be a critical component to controlling the spread of the coronavirus.
Calling Penn Medicine OnDemand
My own first step to getting tested was contacting a physician. As a Penn Medicine patient, I had access to Penn Medicine OnDemand, the health system’s telehealth urgent care practice. I logged on to MyPennMedicine and looked for an available time slot for a video appointment with a nurse practitioner. There were dozens — including one in the next half hour. I booked it.
Thirty minutes later, a kind nurse practitioner was asking about my symptoms and writing an order for me to get a test. I called the number she gave me for the Penn Medicine COVID Testing Hotline and made an appointment to visit Penn’s West Philly testing site later that morning.
Though not required, it is recommended that Philadelphians who want to get tested for COVID-19 first speak to a doctor. Since Penn Medicine OnDemand operates 24/7, the service — and telemedicine more broadly — has been a critical access-point to health care over the past six months, according to OnDemand Medical Director Krisda Chaiyachati, MD, MPH. “With cases on the rise again, we are laser-focused on getting people tested and quarantined,” Chaiyachati said.
Time for a COVID Nasal Swab
When I arrived at Penn’s West Philadelphia testing site, which was constructed within a weekend to get up and running by mid-March, there was a small but steady line of cars wrapping around the lot, and one other person in the walk-up line.
I was tested in September, however, beginning in November, in anticipation of colder weather, the outdoor drive-through/walk-up site at 41st and Market was relocated to the lobby of the building at 4040 Market Street. There is free parking available next to the building.
I told the nurse at check-in that I had an appointment and waited for about five minutes. Another nurse wearing personal protective equipment called me over to the bus stop that had been converted into a testing “room.”
“It might tickle, but it’s not bad,” she said. “And you’ll have your results in 24 hours.”
Luckily for me, Penn is no longer collecting samples through a nasopharyngal swab — which required a clinician to insert a long swab all the way back to the nasal cavity. Now, instead, nurses get just a few shallow swirls along the tip of each nostril, which, according to the Centers for Disease Control and Prevention, can be just as effective a test as the deeper swabs.
The entire process took about 10 minutes from start to finish. As I walked home, I wondered what would be in store for the months ahead, when the weather would turn cold, flu season would arrive, and cases might surge again. I asked Robert Challender, chief operating officer and corporate director of laboratory services at Penn about how Penn Medicine was considering addressing these factors.
Challender said that the health system is hard at work making comprehensive plans to support continued testing for Penn Medicine patients, staff members, and an influx of university students in the spring, while still continuing to serve the community.
The health system has prepared to dramatically expand its testing capacity to accommodate the thousands of undergraduate students returning to campus in January, who will be tested twice per week. To ensure easy access to testing, Penn will be utilizing a saliva-based testing system (which has slightly lower sensitivity than the standard PCR test, but is easier to administer) for students at eight sites across campus. Plans are underway to ramp up test processing capacity by converting a campus anatomy lab and to open a facility at Penn Medicine Rittenhouse later this winter.
After my own test, all I had left to do was quarantine myself at home while I waited the next day for my results and for as long as I had symptoms, in an effort to protect others from any illness that I may have contracted — COVID or not.
I started to wonder what had happened to the DNA that had been swabbed from my nose. Whose hands was it in? And what would they find?
Read more in part two of this series on the Penn Medicine News Blog.