Multiple cities have started door-to-door coronavirus screenings and testing in an effort to identify those who are infected and help severely ill people get treated.
It's a small part of a larger effort to test more Americans for coronavirus in order to get a handle on how widely it has spread and prevent another wave of infections as some parts of the economy slowly reopen.
Emergency medical technicians employed by the New Orleans-based company Ready Responders are working in New York City, New Orleans, Reno, Las Vegas and Washington, D.C., and plan to begin working in Los Angeles later this month.
In New York City, a pilot program with the company has been going on for about two weeks and is focused on eight public housing locations. It's meant to complement six new community testing sites that are also prioritizing New Yorkers who live in public housing.
The goal is to make sure residents understand the symptoms of COVID-19, and that they have access to coronavirus testing quickly and easily even if they don't have access to a car or a regular primary care physician.
"We wanted as many New Yorkers to be tested as possible," said Olivia Lapeyolerie, a spokesperson for New York Mayor Bill DeBlasio's office.
Mayelyn Rojas was assigned to distribute fliers, talk to residents about symptoms and do coronavirus tests this week at the Edenwald Houses in the Bronx.
"It's been pretty hectic," the 24-year-old EMT said, smiling behind her mask. "I'm doing a lot of COVID calls. It's insane how often these calls are coming and they're just, like, 'No one's tested us before.'"
Rojas and other EMTs carry the protective equipment and materials, including nasal swabs, that they need to administer coronavirus tests. If a resident says they have one or more symptoms of COVID-19, or they think they were exposed to someone with the disease, the EMT sets up a telemedicine call with a doctor or nurse practitioner, who decides whether to order a coronavirus test.
When a patient needs a test, an EMT is dispatched to the person's apartment to take the sample right there in the living room. At the end of each day, the samples are mailed to a commercial lab and patients receive their results by text or on an online portal in two to three days.
Rojas says a lot of people with essential jobs are asking to be tested — a hospital administrator with a scratchy throat, a janitor with a fever, a maintenance worker feeling under the weather.
She has also noticed a rapid increase in demand for COVID-19 tests.
"Since they found out that we're now testing at home, the calls are non-stop," she said Thursday. She had run out of test kits earlier in the day and needed to go pick up more. At this rate, she estimates she's on track to do at least 25 tests each week.
It's a drop in the bucket — New York Mayor Bill DeBlasio said this week that about 13,000 tests are being conducted every day in the city, and epidemiologists warn that even that number is far lower than it needs to be in order to safely allow most people to leave their homes.
But at-home testing and screening allows medical providers to identify and treat people who likely would not have been tested or treated otherwise, including people who have serious cases of COVID-19.
Judy Vidal, 24, works part-time as an EMT for Ready Responders in New York City, and primarily works in Queens, a borough with some of the highest per-capita infection rates in the country. She says she has encountered people who have severe symptoms — shortness of breath, fever. In those cases, clinicians recommend that patients call 911, so they can be treated at a hospital, and it can fall to the EMT to help the family take that difficult step.
"They're not sure. 'Should I go? Should I not?' People are afraid," Vidal said.
Sometimes family members suggest that a sick person should wait one more day to go to the hospital. She said she tries to explain how people with COVID-19 can rapidly deteriorate.
"A day could be life or death," she said. "We just have to persuade these patients to take that step, and their family too. Especially if we're talking about grandma or grandpa — we know that your parents are gonna be at the hospital by themselves. They're gonna feel lonely; it's going to feel strange. But the silver lining is your mom is going to come back.
"But actually that's the hard thing. We can't promise that their relative is going to come back, because we don't know."
SCOTT SIMON, HOST:
Some cities are taking a new approach to testing people for the coronavirus. EMTs are going door to door to offer the test to people in their homes. NPR's Rebecca Hersher's been talking to some of the EMTs who are doing this in New York's public housing. And she joins us now. Rebecca, thanks for being with us.
REBECCA HERSHER, BYLINE: Hi. Thanks so much.
SIMON: The idea sounds promising. Does it seem to work?
HERSHER: Well, it's still early. These programs are still ramping up now in just about half a dozen cities. And New York City is one of them. One of the issues there is that people have been dying in their homes, which suggests that they are not being tested, and they're not being treated. And so the city is having EMTs go door to door. And I talked to one of the EMTs, 24-year-old Mayelyn Rojas, while she was working this week in the Bronx.
MAYELYN ROJAS: It's been pretty hectic, pretty busy doing a lot of COVID calls. Yeah.
HERSHER: Here's how she says her days go. She has personal protective equipment and a bunch of flyers with the symptoms of COVID-19. She knocks on a door, hands over a flyer, and then asks does anyone here have these symptoms?
ROJAS: Yesterday, I was actually handing out flyers for a good portion of the day, going door to door. And it's about over a hundred apartments. And the amount of people is, like, unknown in every building.
HERSHER: Because some apartments are one person. Some have large families. And then if someone does have symptoms, she can set up a telemedicine appointment with a doctor or a nurse practitioner who can decide whether to order a COVID-19 test. And if they do, she can do it right there. And at the end of the day, she drops off all the samples she's collected at UPS. And they get shipped off to a commercial lab, which sends back results in a couple days.
SIMON: Becky, you mentioned that New York City has a high number - shockingly high number of people dying at home. This is how they're trying to deal with that?
HERSHER: Yeah. And, you know, the ultimate goal here is to find people who are not seeking out medical treatment or testing on their own, maybe because they don't know how to do that, maybe because they're afraid to leave the house. And another EMT I talked to - her name is Judy Vidal. She said even when it's clear that a person is quite ill - and she's seen this - sometimes, they feel scared about the idea of even going to a hospital.
JUDY VIDAL: They're not sure. It's like, oh, should I go? Should I not? People are afraid, like, oh, it has to be severe severe. But a day could be life or death.
HERSHER: And she sees part of her job as talking family members into having this person go to the hospital. And she explains that people with COVID-19 can get critically ill without much warning.
VIDAL: We have to persuade these patients to take that step and their family, too, especially if we're talking about grandma and grandpa. We know that your parents are going to be at the hospital by themselves. It's going to feel lonely. It's going to feel strange. But, you know, the silver lining is that they'll come back. And we know we can't promise - that's the hard thing. We can't promise that their relative's going to come back because, you know, we don't know.
SIMON: Rebecca, how does this program, this effort fit into the larger push in New York to try to test more people?
HERSHER: You know, it's a relatively small piece, but it's important. It's hard to scale because it takes a long time to do each of these tests. Often, they take an hour or more. But it's really important because it's allowing cities to more proactively test people who wouldn't do it on their own.
SIMON: Rebecca Hersher of NPR's Science Desk, thanks so much for being with us.
HERSHER: Thanks so much. Transcript provided by NPR, Copyright NPR.