NJ DOCTOR TURNS VAN INTO MOBILE COVID TESTING CLINIC – MetroFocus PBS

Author: News Media
May 20, 2020

Jack Ford, Metro Focus PBS 5/20/2020

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POP-UP CLINIC SEES BETWEEN 100-150 PEOPLE PER DAY IN LOW-INCOME COMMUNITIES

PATIENTS CAN BE TESTED FOR VIRUS AND ANTIBODIES

DATA PROVIDED TO LOCAL HEALTH OFFICIALS TO BOOST TRACING EFFORTS

The pandemic has brought about countless stories of tragedy, loss and hardship. But there have been some inspiring stories as well about selflessness, sacrifice, about caring for others. Dr. Alexander Salerno is a physician who for decades has provided care for the underserved in New Jersey. He was so frustrated by the difficulties he saw in getting testing for this underserved population that he literally took matters into his own hands – and into his own wallet – and created a pop-up clinic that would travel to different locations to see over 100 people a day. Dr. Salerno joins us to discuss his efforts to get low-income communities access to testing, as part of our Chasing the Dream initiative on poverty and opportunity in America.

Interview Transceipt:

WELCOME TO ‘METRO FOCUS’ FOR WEEKS, AS WE’VE COMBATTED THE CORONAVIRUS PAN DEM, WE’VE BEEN BESIEGED BY STORIES OF GREAT LOSS AND TRAGEDY.

BUT THERE HAVE BEEN INSPIRING STORIES TOO ABOUT SELFLESSNESS, SACRIFICE, ABOUT PEOPLE WHO ABRAHAM LINCOLN CALLED THE BETTER ANGELS OF OUR NATURE.

DR. SALERNO IS AN INTERNAL MEDICAL SPECIALIST AND PRIMARY CARE PHYSICIAN WHO HAS PROVIDED CARE FOR THE UNDERSERVED.

BECAME SO DITCH KLTY BY TESTING FOR THE UNDERSERVED POPULATION, THAT HE DECIDED TO TAKE THINGS IN TO HIS OWN HANDS AND CREATE A POP-UP THAT WOULD TRAVEL TO DIFFERENT LOCATIONS AND TEST LITERALLY HUNDREDS OF PEOPLE A DAY.

PEOPLE WHO WOULD NEVER SEE THE INSIDE OF A TEST LAB.

OUR CONVERSATION:

PART OF OUR TASTING THE DREAM INITIATIVE ON POVERTY AND OPPORTUNITY IN AMERICA.

WELCOME.

THANK YOU SO MUCH FOR JOINING US.

THANK YOU, MR. FORD.

LET ME ASK YOU TO GIVE US A SENSE OF THIS FRUSTRATION.

THAT EVOLVED HERE.

AS I MENTIONED, FOR DECADES YOU’VE BEEN PROVIDING CARE AND TREATMENT FOR MEMBERS OF THE UNDERSERVED POPULATION.

WHAT WAS IT THAT MADE YOU FINALLY SAY I HAVE TO DO SOMETHING?

IT STARTED WHEN THE WHOLE PANDEMIC BEGAN.

MY FRUSTRATIONS HAVE EVOLVED FROM NOT BEING ABLE TO GET PPEs FROM MY STAFF TO NOT BEING ABLE TO GET TESTING KITS.

THE BIGGEST CHALLENGE IN EARLY MARCH AND TO THE END OF MARCH WAS HAVING TO RATION WHO CAN GET TESTED AND WHO CAN UNDER GET TESTED.

THAT WAS NOT ANYTHING I WAS RAISED IN THAT I HAVE TO RATION CARE.

AND SO, WITHOUT THE SWABS, WE COULDN’T DO A TESTING SPECIMEN.

BUT THEN WE GOT SWABS.

AND WE GOT LOTS OF THEM AND WE WERE ABLE TO TEST AND WHEN WE STARTED TESTING, WE CREATED POP-UP TENTS AT OUR DIFFERENT LOCATIONS, DEPARTMENT OF HEALTH WAS SENDING FOLKS BECAUSE DIDN’T SEEM LIKE ANYONE WAS TESTING.

IF YOU NEED TESTING, IT SEEMED ODD YOU NEED TO GET EMERGENCY TO BE TESTED.

AND WAIT IN A FOUR-HOUR MILE LINE TO GET TESTED AND THAT JUST ADDS TO THE ALREADY FRUSTRATING.

A LOT OF PEOPLE REMAIN FRUSTRATED ABOUT IT.

HOW DID THE IDEA EVOLVE TO CREATE THESE POP-UP LOCATIONS.

THE IDEA CAME BECAUSE I THOUGHT OF AN ICE CREAM TRUCK.

AND AT BASKETBALL COURTS AND PUBLIC POOLS AND IN GENERAL.

SO, IT’S PART OF THE FOCUS, ARE TRUCKS.

SO, NOW WE’RE NOT GOING TO HAVE, UNFORTUNATELY, IT LOOKS LIKE, ICE CREAM TRUCKS AND FOOD VENDING TRUCKS.

SO, I WAS LIKE WHY DON’T I FILL THE VOID AND BRING THE TESTING TRUCK.

BECAUSE IT’S NOT LIKE BRICK AND MORTARS, IF YOU BUILD IT, IT WILL COME.

SO, I BOUGHT A USED SPRINTER VAN AND RETROFITTED IT.

AND WITHIN ABOUT TWO WEEKS WE WENT ON THE ROAD AND THIS IS OUR SECOND WEEK ON THE ROAD.

I GREW UP PART OF MY YOUTH IN JERSEY CITY.

SO, I REMEMBER VIVIDLY THE SOUND OF THE ICE CREAM TRUCK COMING DOWN THE STREET AND HOW IT WAS THE HIGHLIGHT OF YOUR DAY, OBVIOUSLY.

SO TOO, SEE THAT PARALLEL FOR YOU SAYING IT WORKS IN THE URBAN AREAS TO PROVIDE RELIEF IN ICE CREAM, WHY CAN’T WE USE IT OTHERWISE.

LET ME ASK YOU A QUESTION.

WE’VE HEARD SO MUCH ABOUT ADDITIONAL LAYERS OF FRUSTRATION CAUSED BY BUREAUCRACY AND RULES AND REGULATIONS THAT HAD TO BE FOLLOWED.

DID YOU RUN INTO ANY PROBLEMS OF I’M GOING TO TAKE THIS ON THE ROAD AND GET TO AS MANY PEOPLE AS I CAN?

NO.

BUT THERE IS SOMETHING TO WHAT YOU’RE SAYING ABOUT THE BUREAUCRACY.

AND ANALYSIS TO ANALYSIS WITH A LOT OF GOVERNMENT OFFICIALS.

IT’S LIKE LAYERS OF AN ONION.

THE MORE YOU PEAL, THE MORE YOU CRY.

SO, WITH CERTAIN AREAS, I HIT A LOT OF BUREAUCRACY.

AND OTHER AREAS, I DID NOT.

THE CITY OF ORANGE DID GREAT.

IT WAS A PHONE CALL, AND WITHIN THREE DAYS, WE WERE UP AND RUNNING.

AS YOU CAN SEE, THERE’S BEEN A LOT OF RELAXING OF GOVERNMENT, YOU KNOW, GOVERNING PRINCIPALS.

LIKE HIPPA HAS BEEN RELAXED QUITE A BIT.

AND TELEMEDICINE HAS EXPANDED BUT A LOT OF FOLKS DON’T HAVE SMART PHONES OR COMPUTERS.

SO, YOU CAN DO TELEMEDICINE BY JUST THE PHONE.

SO, WE HAVE EASED A LOT OF THINGS, AT LEAST FEDERALLY, IT SEEMS.

AND INSURANCE COMPANIES, THEY EASED UP THE IDEA OF YOU CAN ONLY SEE YOUR PRIMARY CARE DOCTOR.

YOU DON’T HAVE TO CHANGE YOUR DOCTOR TO GET TESTED AT OUR VAN.

SO, THE FEDERAL GOVERNMENT HAS EVOLVED TO ALLOW THIS CREATIVE ENDEAVOR.

BUT SOMETIMES AS WE GET FURTHER DOWN IN THE FOOD CHAIN THINGS GET COMPLICATED.

WE’RE TALKING TO DR. SALERNO WHO HAS LITERALLY BROUGHT COVID-19 TESTING TO PEOPLE WHO OTHERWISE WOULD NOT HAVE HAD THE OPPORTUNITY TO HAVE THE TESTS DONE.

EXPLAIN TO US WHAT YOU DO WHEN YOU GET THERE, WHAT DO YOU FIND?

SO, HE DETERMINES, ALONG WITH CITY COUNSEL AND SENIOR HOUSE OFFICIALS THE BEST PLACES TO PUT THE VAN.

FOR A FEW DAYS T WAS IN THE POLICE PARKING LOT AND THEN IT WENT TO WHERE IT IS CURRENTLY IN A TRIANGLE COURT YARD BETWEEN BUILDINGS.

NEXT WEEK WE’RE GOING TO ANOTHER LOCATION.

HE KNOWS WHERE THE PEOPLE ARE AND WHERE WE CAN REACH THE PEOPLE.

SO, I’M RELYING ON CITY OFFICIALS.

SO, ORDINARILY, IF YOU AND I WERE HAVING THIS CONVERSATION BEFORE AND NOT IN OUR LIVING ROOMS AND I WAS NOT DOING THE RECORDING HERE AND WE HAD EDITORS AND PRODUCERS, WE WOULD BE WEAVING IN PICTURES OF WHERE YOU ARE AND WHAT YOU’RE DOING.

SO, CREATE THE PICTURE FOR US, IF YOU WILL AND WHAT IT LOOKS LIKE AND WHEN THE PATIENTS GET THERE, WHAT THEY DO.

SO, WE ARRIVE ON THE STREET CORNER WITH POLICE SUPPORT.

THEY BLOCK OFF THE AREA TO ALLOW SAFETY.

A LOT OF THESE PATIENTS ARE THE ELDERLY.

SO, YOU DON’T HAVE TO WORRY ABOUT CARS GOING IN AND OUT OF THE BLOCKS.

SO, THE VAN BECOMES A THREE-ROOM CLINIC.

ONE ROOM FOR REGISTRATION, ONE FOR PHLEBOTOMY.

AND THE OTHER ROOM IS WHERE WE SWAB, DO A PHYSICAL EXAM, GET THE PATIENT HISTORY AND DO ALL THE VITAL SIGNS, INCLUDING PULSE, OXYGEN LEVEL.

AND THEN TAKE THE REGISTRATION PROCESS TAKES A LITTLE BIT BECAUSE WE’RE DOING TRACING.

SO, WE REALLY WANT TO KNOW WHAT’S YOUR AGE, RACE.

WHAT MEDICATIONS ARE YOU ON BECAUSE WE HAVE TO FIGURE THIS OUT.

THERE’S GOT TO BE A COMMON DENOMINATOR WHETHER SOME PEOPLE DO POORLY.

SO, THERE ARE DEMOGRAPHICS WE HAVE TO DO AS WELL.

HONESTLY, THE SWAB AND BLOOD WORK TAKE MAYBE 30 SECONDS TO A MINUTE TO DO.

AND WITHIN 48 HOURS TO 72 HOURS, WE CONTACT THE PATIENT WITH THEIR RESULTS.

AND THIS ADDED STEP.

IN THE DEPARTMENT OF HEALTH THEY ONLY REPORT POSITIVE TEST RESULTS.

THEY DON’T REPORT NEGATIVES OR ANTIBODIES.

THAT’S IMPORTANT TRACING TO KNOW WHO YOUR NAIVE CITIZENS, THE PAST EXPOSED WITH ANTIBODIES AND YOUR ACTIVE CITIZENS WE GATHER THE INFORMATION AND LITERALLY HAND DELIVER IT TO THE DEPARTMENT OF HEALTH OF ORANGE SO THEY CAN START DOING THEIR TRACINGS BECAUSE WE DO KNOW THERE’S A FACE TWO COMING.

SO, WE HAVE TO TAKE THIS INFORMATION WE’RE GATHERING NOW AND ISOLATE THE RIGHT PEOPLE WHO NEED TO BE ISOLATED DOWN THE ROAD.

GIVE ME AN IDEA OF HOW MANY PATIENTS YOU’VE BEEN ABLE TO SEE ON EACH DAY IN TERMS OF THE TESTING PROCESS.

SO, WE CAN SEE AND WE SEE ABOUT 150 A DAY AT THE MINI VAN OR THE VAN, I SHOULD SAY.

AT OUR OFFICE SITES IN EAST ORANGE, ORANGE AND NEWARK.

WE SEE A HUNDRED, MAYBE A LITTLE MORE A DAY.

AND THEN 40 TO 50 PATIENTS IN THE OUTSIDE TENTS.

I THINK IT’S IMPORTANT TO NOTE THESE ARE SIGNIFICANT EXPENDITURES YOU’VE CHOSEN TO MAKE ON YOUR OWN.

WHY?

THERE’S NO OTHER WAY TO DO IT.

WHEN THIS WHOLE VIRUS BROKE OUT IN END OF FEBRUARY, EARLY MARCH, WE HAVE A STAFF OF 106 EMPLOYEES.

MY FIRST PROMISE TO STAFF WAS TO PROTECT THEM.

SO, LIKE MOST OF THE COUNTRY, WE WERE LATE IN GETTING THE PPEs.

SO, THEY WERE THE BIGGEST CHALLENGE.

SO, THAT WAS THE FIRST PART.

CAN’T AFFORD TO BE SICK AND CAN’T AFFORD TO SHUT DOWN.

IT’S GREAT BUT DOESN’T WORK IN EVERY AREA.

TELEMEDICINE IS NOT AN OPTION.

SO, WE STILL HAVE TO BE OPEN AND CREATE A SAFE ENVIRONMENT.

SO, THE NEXT THING I DID WAS I HAD OUR CLEANING CREWS WORK EVERY 30 MINUTES ON THE HOUR LITERALLY WIPING DOWN EVERYTHING.

SO THEY WOULD WEAR A MASK AND PROTECTIVE GLOVES.

AND THE VAN PART, AGAIN T CAME OUT OF THE FACT NOT EVERYONE COULD GET TO US.

I’VE BEEN IN PRACTICE 20 YEARS AND WE’VE BEEN DOING HOUSE CALLS FOR THE LONGEST TIME FOR THE INNER CITY SENIORS.

SO, THIS IS MY NEIGHBORHOOD SO TO SPEAK.

I THINK ABRAHAM LINCOLN WOULD BE QUITE PROUD OF YOU AND YOUR STAFF.

SO, I WANT TO THANK YOU AGAIN.

I HOPE WE CAN TALK AGAIN DOWN THE ROAD HERE ABOUT THE BIGGER PICTURE.

BUT THANK YOU SO MUCH AND YOUR STAFF FOR THE GREAT WORK YOU DO.