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FARMINGTON — San Juan Regional Medical Center administered “over 100” COVID-19 assessment tests during the facility's external drive-thru testing, according to Marketing Manager Roberta Rogers.

The test itself is referred to as a nasopharyngeal swab, which is a flexible swab that is inserted into the nose of a patient and pushed to the upper part of the throat, behind the nose, where viral specimens are collected.

The swab is then sent to the New Mexico Department of Health where, it’s analyzed. A diagnosis is then sent back to the medical center.

There have been 17 confirmed cases of coronavirus in San Juan County and 191 in New Mexico, according to the New Mexico Department of Health. The New Mexico Department of Health reported three new cases in San Juan County on March 27 and a total of 55 new cases in the state.

During a Facebook live video, Chief Medical Officer Dr. Robert Underwood said cases are prioritized if the patient is a San Juan Regional Medical Center employee who shows symptoms or who has been exposed to the coronavirus. In-patient tests are also prioritized, Underwood said. But if a patient isn't a priority case, it could take five to six days to get test results.

One person asked Underwood about President Donald Trump stating that there are enough tests for everyone to get a test.

Underwood said even if there were enough tests tubes and swabs for each person in the United States, the laboratory equipment that runs the tests has limited capacity. He said some of the early tests took four hours to run. 

"Tests may be available, swabs may be available, doesn't mean we actually have the machines that can run the tests in a timely way," Underwood said.

Rogers stated that the cost of taking the test is “similar to the cost of an urgent care visit.”

Public Relations Coordinator for San Juan Regional Medical Center, Laura Werbner, said that people who have symptoms, but don't think they can afford a test, "will not be turned away, we care for everyone in our community regardless of their ability to pay and will let them through the assessment line."  

COVID-19 testing: Insurance, Medicaid, Medicare

In response to Gov. Michelle Lujan Grisham's declaration of a public health emergency, New Mexico's Superintendent of Insurance Russell Toal issued two emergency orders that prohibit health insurers from imposing cost sharing, copays, coinsurance and deductibles for COVID-19, pneumonia and influenza related testing and health care. 

The first rule only applies to insurance plans that cover major medical expenses. The order states that insurance plans with limited coverage need to "notify their members whether and to what extent their policies cover testing and health care services related to COVID-19. Additionally, if an insurer only offers limited coverage, they must notify their members of available full coverage options." 

The second order requires health insurance plans with limited coverage to give their members information on where they can go to apply for full coverage, like programs for those with low-incomes.

The order states that "The Superintendent of Insurance does not have jurisdiction over large employers who “self-insure,” including the State of New Mexico through its state employee health plan," but that the governor would direct the state's General Services Department’s Risk Management Division to waive all cost sharing requirements for testing and treatment for COVID-19, pneumonia and influenza from the State Employee Health Plan. 

The governor also encouraged employers across the state with employee insurance plans to also waive the costs of COVID-19 testing. 

"Individuals who are uninsured and do not have access to Medicaid, Medicare or employer health coverage should have the opportunity to enroll in a comprehensive health insurance plan through the health insurance exchanges," Lujan Grisham said in a statement attached to a press release about the orders. "I call on President Trump and HHS Secretary Azar to issue an emergency order creating a Special Enrollment Period for all people who are eligible to obtain coverage through the health insurance exchanges, such as beWellnm.” 

When reached for a statement regarding the price of their COVID-19 test, Mercy Regional Medical Center in Durango sent the following statement: "We have determined that anyone who meets testing criteria for COVID-19, but is uninsured, will not be billed for the testing by Centura – Mercy Regional Medical Center. If a patient comes in with insurance, we will bill insurance as we would for any other emergency department claim. However, as Colorado Governor Polis has already declared a State of Emergency for Colorado, insurance companies have been told to waive patient co-pays and deductibles. So insured patients should not see a bill for these services."

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Confirmed cases

San Juan Regional Medical Center announced the first case of coronavirus in San Juan County on March 21. As of the afternoon of March 26, there were 14 positive cases in San Juan County. There were 69 total cases being reported on the Navajo Nation on March 25. By 7 p.m. on March 26 that number rose from 69 to 71.

Go to our free coronavirus liveblog for updates on those numbers or visit the blog via at www.daily-times.com.

Rogers said that only people displaying symptoms of the coronavirus like fever, cough, body aches, sore throat, runny nose and any other flu or cold-like symptoms, will be given a test by San Juan Regional. People not displaying symptoms will not be given a test.

The overall number or percentage of asymptomatic carriers of COVID-19, or people carrying the virus who do not show any symptoms, is unknown at the time, but a recent U.S. Centers for Disease Control and Prevention report found that 46.5% of the 712 passengers on the Diamond Princess cruise ship who tested positive for the virus showed no symptoms.

Rogers said about 20% of people who came to the assessment site presented possible symptoms of the virus.

Rogers said that the medical center has 14 intensive care unit beds ready, with plans to convert other rooms to ICU beds if needed. Rogers went on to say that the medical center has a “highly variable” number of medical ventilators that “fluctuates daily based on patient care needs.”

Medical ventilators are life support systems that get oxygen into the lungs of a patient to help them breath. Severe cases of the coronavirus can cause pneumonia and other respiratory illnesses that require patients to need a medical ventilator.

There are approximately only 160,000 ventilators in the United States. It’s projected that the country will need an estimated 960,000 medical ventilators to treat patients during the coronavirus pandemic.   

People with mild symptoms are asked to not enter the hospital before contacting them. Unless patients have serious symptoms, they should not go to the emergency department.

People with mild symptoms are asked to drive to the medical center’s drive-thru assessment area at Parking Lot K of the medical center’s campus located on West Pinon Street, next to San Juan Health Partners Midwifery and Women’s Health, where assessments will take place on March 27, March 30, April 1 and April 3. All assessments will take place from 10:00 a.m. to 2:00 p.m. Assessment times for the following week will be announced on the medical center's website at sanjuanregional.com, and on their Facebook page at facebook.com/sanjuanregionalmedicalcenter.

Consumers who believe they have been unfairly billed for testing or treatment of COVID19, are asked to call the OSI Managed Health Care Bureau at 1-855-427-5674.

Sam Ribakoff is a visual journalist for The Daily Times. He can be reached at 505-333-5283 or via email at sribakoff@daily-times.com.

Reporter Hannah Grover contributed to this story.

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