Improved Across the Board Access to SARS-CoV-2 Laboratory Testing in an Integrated Medical System; the Veteran Affairs Medical Center (VAMC) Experience

Abstract

Introduction/Objective Due to the spread of SARS-CoV-2 - the causative pathogenbehind COVID-19, a significant impact on society includingsignificant death, morbidity, strain on the nation's medicalsystems, and an economic shutdown of many sectors has cometo pass. While society has been affected by this virus, it has alsobeen documented in the mainstream news that this pandemichas disproportionately affected non-white minority groups, and that access to testing for vulnerable populations have beenlimited. Similarly, previously published epidemiological data byZuvekas et al. show that populations with health insurance, higher socioeconomic class, and white in race have receivedsignificantly better access to private health care resources. Asveterans represent a vulnerable population, as part of qualityassurance, testing data was reviewed to verify that this trend was not also affecting the VAMC. Methods As part of a quality assurance/quality improvement project, aretrospective manual review of all SARS-CoV- 2 RT-PCR testsperformed at the VAMC from March 11th, 2020 to April 13th,2020. These tests were reviewed with in the computerizedmedical record system to determine the age, gender, and ethnicity of the patients. The demographic data from this search was compared with the population statistics of the majormetropolitan city that the VAMC is located in. Results Out of 571 patients who were tested for SARS-CoV-2, 264 (46%)had an ethnic African-Americans background, 135 (24%) had anethnic Caucasian or white background, 8 had an ethnic Hispanicbackground, 3 had an ethnic native Hawaiian or other PacificIslander background, 2 had an ethnic Asian background (0.4%), and 1 had an ethnic American Indian or Alaskan Nativebackground. The rest had left ethnicity unanswered or was unknown/declined to state. The majority of those tested were males (392 or 69%). Ages of patients tested ranged from 24 to98 years of age. The ethnic distribution of those tested was likethe ethnic distribution with in the city where the VAMC was located. Conclusion Quality healthcare to the entire population also means thathealthcare should be accessible to all members who require it.The VAMC offers broad access for testing to all its patients of allethnicities. This demonstrates, in the changing healthcarelandscape, one of the many advantages of the Veteran Affairssystem.