The 2019-novel coronavirus (2019-nCoV) was first identified in Wuhan China in early December, 2019, and named COVID-19 by the World Health Organization (WHO) on January 12, 2020. The first US COVID-19 case was identified in an urgent care clinic in Snohomish County, WA [1,2,3]. On March 10, 2020, the World Health Organization declared a global pandemic due to COVID-19 .
Patients with COVID-19 symptoms rapidly started to appear in US hospital emergency departments (ED), and these departments needed to quickly develop strategies to respond to this sudden influx of acutely ill and worried well patients. At the University of California-San Diego, two EDs tested for COVID-19 and reported their results during the first 10 days of screening in March, 2020. High-risk patients, as defined by the Centers for Disease Control (fever, cough, shortness of breath and travel to an endemic area, healthcare worker with exposure), were offered screening. Of the 283 tests ordered, 10% were COVID-19 positive .
As cases of COVID-19 grew exponentially, ED volumes in our region also rapidly increased, and concern was raised that hospitals would not be able to provide care for these patients. We sought out strategies to decompress the volume of low acuity patients in the ED by screening them outside of the hospital [6, 7]. Such screening took place in Africa during the Ebola crisis of 2014–2016. One hospital, Redemption Hospital (Liberia), created an out-of-hospital screening program to decrease patients entering the hospital and identify patients at risk for Ebola [8, 9].
Early in the COVID-19 pandemic, providers in Korea created drive-through (DT) 2019-nCoV testing centers. This was implemented in a remote, large parking lot. The cars followed a designated sequence to allow examination, specimen collection, and instruction. This DT testing method was introduced at Kyungpook National University Chilgok Hospital, Daegu, Korea, on February 23, 2020, and later expanded to at least an additional 68 testing centers .
There is currently a dearth of literature evaluating the safety and outcomes of out-of-hospital testing for COVID-19 as a means to decompress the healthcare system and provide large scale epidemiological screening. For this reason, the objective of this investigation was to describe testing and clinical outcomes of patients evaluated by a hospital system-based DT screening strategy early in the 2020 COVID-19 pandemic.