Local hospitals are restricting visitors and postponing elective surgeries as they prepare for a possible surge in COVID-19 cases.

The moves come as Washington’s coronavirus outbreak tops 900 cases and the state closes all schools, cancels large events and locks down businesses reliant on customer visits such as restaurants and bars.

All Providence Health Care locations in Eastern Washington, including Sacred Heart Medical Center and Holy Family Hospital, will not allow visitors until further notice, with limited exceptions for maternity, pediatric and end-of-life patients.

All MultiCare locations, including Deaconess Hospital and Valley Hospital and Medical Center, are suspending non-emergency elective surgeries through at least March 22 in order to preserve personal protective equipment supplies needed to treat patients with COVID-19.

The tightening of hospital policies in Eastern Washington comes amidst a growing number of cases confirmed in the state, mainly in Western Washington, each day. On Monday, the state Department of Health reported 904 confirmed cases of the novel coronavirus in 18 counties statewide. So far, 11,582 people have been tested statewide.

Of the 48 people who have died in the state due to COVID-19, the majority were older than 60 or had underlying health conditions. Several confirmed cases in the Seattle area are tied to about a dozen long-term care facilities, including Life Care Center in Kirkland, where 29 former residents have died due to the virus.

Gatherings of more than 50 people are prohibited in Washington state after Gov. Jay Inslee amended statewide orders intended to slow the spread of the respiratory virus. Restaurants, coffee shops, bars, gyms, theaters and salons will be closed starting Tuesday, through the end of March. Separately the federal Centers for Disease Control and Prevention launched a 15-day guidance that discourages gatherings of more than 10 people and asks U.S. residents to avoid discretionary travel.

Local testing still limited

The virus has spread to six counties east of the Cascades, with 15 confirmed cases, but health care providers in Spokane are still experiencing challenges with the availability of testing, which continues to hamper efforts to see how widespread the novel coronavirus is in the community.

“This testing is an essential piece for us to get a sense of the prevalence of COVID-19 in our community,” Spokane County Health Officer Bob Lutz said at a news conference Monday.

The region’s primary health care providers acknowledged that they are not able to test a wide swath of people despite loosened guidelines.

“We are gearing up and doing our best, but on this day, there’s not a lot of testing,” Dr. David Ward, acting medical director for Kaiser Permanente Spokane, said Monday.

This is due to a national shortage of the materials needed to conduct the test, Ward said.

No local health care providers in Eastern Washington actually have test kits for COVID-19, and they rely on the University of Washington lab and State Public Health Lab in Shoreline as well as commercial labs, such as LabCorps and Quest Diagnostics. If a person is swabbed for COVID-19, the samples are sent to one of those labs with a turnaround time of about three days at best for results, Lutz said.

LabCorps is testing COVID-19 samples at labs in North Carolina and New Jersey. Quest is testing COVID-19 samples in San Juan Capistrano, Calif. Both companies expect to ramp up and expand their capacity to test this week, but the lag has forced local health care providers to continue prioritizing testing for high-risk patients and reinforced the message to the community to “stay home.”

“If you are ill and can get treated at home, if you have a fever and cough, you should be staying home and contacting your medical care providers via home, not necessarily coming in to be tested, as of today,” Ward said. “This is an incredibly fluid conversation that will change day by day as we understand what resources our community has.”

The majority of lab testing capacity in the United States is in the private sector, U.S. Surgeon General Jerome Adams, told reporters Monday, and state labs have limited capabilities.

“Testing has not gone as we would have liked so far, but we are at a crucial turning point,” Adams told reporters. “And over the next week you will see an increase of testing.”

LabCorp and Quest expect to have much broader testing capacity by the end of the week. LabCorp expects to conduct 10,000 tests per day by the end of this week and 20,000 tests per day by the end of the month. Quest also expects to conduct 10,000 tests a day by the end of this week and 20,000 tests a day by the end of the month. The University of Washington lab can test about 2,000 samples per day, currently.

The surgeon general said the next two weeks are critical to determining if the United States can slow the spread of infection like South Korea or watch it climb as it has in Italy.

One possible key to South Korea’s success in curtailing the number of cases that resulted in deaths is testing, Lutz told reporters Monday. As ProPublica reported, South Korea had tested more than 248,000 people as of late last week, curbing its mortality rate significantly compared to other countries. So far, there are 75 deaths reported in South Korea due to COVID-19.

Meanwhile, in the United States, two major lab companies hope to get to a capacity of 40,000 tests a day by the end of March. Public health labs and the CDC labs together have run slightly more than 25,000 tests since January. There are 68 deaths, so far, due to COVID-19 in the United States.

Local health care providers get ready

Spokane officials said Monday that Providence is at the forefront of plans to open a drive-through assessment site at the Spokane County Interstate Fairgrounds where people can be evaluated by health care providers for symptoms Details were still scant on the tentative plans to open the site perhaps as early as Thursday.

When asked for further details, a Providence spokeswoman said in a statement that the medical, public health and EMS community is coming together to create a COVID-19 screening resource. They expect to release further details on the resource Tuesday or Wednesday.

A primary goal of the site would be to ease the burden on the 9-1-1 system, ambulances and hospital emergency departments. Mike Lopez, integrated medical services manager for Spokane Fire Department, described the planned site as “a place where people could go if they’ve exhausted the virtual doctor’s visits.” When pressed by the Spokane City Council at its meeting Monday night, Lopez said patients would need an “informal referral.”

Lopez emphasized that the Fairgrounds site should not be labeled a COVID-19 testing site, with the supply of tests for the novel coronavirus limited. “We quickly came to the realization that doing a testing clinic is virtually impossible and sets the community up for failure.” Lopez said.

Local health care providers are emphasizing virtual care for all patients in the Spokane area, especially for those patients with symptoms suggestingCOVID-19, including high fever, cough and difficulty breathing.

MultiCare is offering free virtual visits for those experiencing symptoms. Additionally, MultiCare officials plan to dedicate two Rockwood clinics to patients with specific respiratory symptoms who will be separated from other patients. Officials encouraged patients to call ahead so they can be evaluated and either sent to a specific clinic for their symptoms, or adivised by a doctor of how to treat themselves at home.

Elective surgeries at MultiCare hospitals in the Inland Northwest have been postponed, David O’Brien, chief executive of MultiCare in the Inland Northwest, to conserve essential supplies.

“We are doing this to preserve personal protective equipment, things like masks, face shields and other things we use to keep our staff safe,” O’Brien said Monday. “There’s a national shortage of this form of protection, and we’re making sure we conserve as much as we can as the number of coronavirus cases begins to increase.”

Both Providence and MultiCare hospitals have restricted visitation in order to help prevent the spread of COVID-19. Providence has restricted all visitors, with a few exceptions, and MultiCare is only allowing two visitors per patient. No children under the age of 14 can visit a patient.

“I don’t think coming to the hospital is probably the best place to social distance yourself, so please be patient with us,” said Peg Currie, chief operating officer at Providence. “We all need to be cognizant that we are all in this together, and staying home will reduce the number of cross-contaminated patients in our community, so please, please think about that.”

Kaiser Permanente clinics in the Spokane area will go to virtual-only care starting Wednesday, with doctors and nurses on-call 24/7 to provide virtual check-ups and care to their patients. If a person does need emergent or urgent face-to-face medical care, they will be directed to one clinical site in Spokane.

CHAS clinics also are conserving the personal protective equipment at some of their dental clinics and redirecting it to the clinics that will treat patients with respiratory symptoms. Patients with upper respiratory symptoms are being redirected to separate waiting areas or clinics, said Dr. Deborah Wiser, chief clinical officer. CHAS pharmacies have increased mail-order delivery and are encouraging the method.

Spokesman-Review reporter Adam Shanks contributed to this story.