By Crystal Harrell
The Coachella Valley continues to persevere through the ongoing battle against the spread of the coronavirus, slowly resuming operations of previously closed businesses and opening more testing facilities. One such clinic that has been treating patients stricken with COVID-19 is the Palm Springs-based Desert AIDS Project.
Established in 1984, the Desert AIDS Project (DAP) is a Federally Qualified Health Center that offers a combination of medical, dental, counseling, and social services, in addition to housing other health and wellness services like support groups, alternative therapies, and an in-house pharmacy and lab.
The COVID-19 Triage Clinic was opened in March of this year as an influx of cases began spreading across the country. The clinic now sees on average of 40 COVID-related appointments/treatments on a daily basis.
“I remind our team that we were made for these times. When DAP was founded, there were no HIV medications for over a decade, yet through compassion, creativity and commitment, we
saved lives. Now is the time to pay all those lessons forward and open our doors and hearts wider,” stated DAP CEO David Brinkman.
Brinkman contracted the virus and has been suffering symptoms of COVID-19 for eight weeks and counting, despite his strong immune system. He had already been working from his home office for a while when he got his test results 48 hours after taking a test. Brinkman initially thought the fatigue he was experiencing was from exhaustion, and the tightness in his chest from anxiety.
The CEO’s focus is now on decreasing the loss of lives in the desert community by decreasing the number of new positive cases. The clinic is prepared to continue fighting the coronavirus and expand care, but Brinkman insists that it is going to take community support.
“It’s in the very DNA of the DAP to respond quickly to a public health crisis using
science and medicine to create a humanitarian response. We are using our tested roadmaps from the HIV and HCV epidemics to respond to COVID-19,” said Brinkman.
Dr. Christopher Foltz is an infectious disease physician who started and leads the COVID-19 Triage Clinic at DAP. He has been on staff since 2007, and while the medical community put an emphasis on hospitals and how to prepare them as the outbreak began, there was little planning about how the outpatient world and places like DAP would contribute.
“That’s how it all came together. Asking, how can we provide this much needed service to offload our hospitals, but also continue to operate our normal clinics with little or no interruption?” explained Foltz.
The DAP is now testing, treating, following up with hospitalized COVID patients, and providing urgent care to those in quarantine. The handling of treatment for someone who tests positive for the virus involves staying in touch with the patient.
The protocol is as follows: After someone tests positive for COVID-19 with a nasal swab, they usually get the full results in about 48 hours. The DAP calls the patient right away with the news and they do a symptom assessment, which gives an indication as to how the patient is doing.
If they are stable or improving, home care and over-the-counter medications are usually recommended. The DAP monitors patients over the phone to assist in their recovery and progress.
If symptoms worsen, however, the DAP arranges for a follow-up appointment in the clinic.
They also submit positive test results to the Riverside County Public Health Department, which helps to track the progress of the pandemic locally and ensure the sick are counted and advocated for.
The Riverside County Public Health Department typically will contact the patient in about seven business days to discuss testing, symptoms, and the duration of quarantine.
DAP clients who have tested positive for COVID-19 return to the clinic wearing masks after they quarantine for follow-up care, primary care, and any follow-up testing. They will need to prove they are cleared to return to work or provide blood donations.
“It’s not just about COVID-19. We make sure coming to the COVID-19 Clinic means getting treated for any non-COVID-19 respiratory infections,” said Foltz.
Treatment provided for other upper and lower respiratory infections at DAP’s COVID-19 Clinic includes oxygen therapy for patients who have lower than normal levels, nebulizer treatments to open airways and address shortness of breath, IV fluids for dehydration, strep throat testing and treatment, and community acquired pneumonia treatment, among many others.
“After working last weekend at an area hospital to provide support, I saw again the intensity and focus it takes to work with the sickest of the sick COVID-19 patients in a hospital setting… I feel an urgent need to alleviate hospital staff from being overwhelmed. As we have seen in other countries, you can go from normal to unstable in the blink of an eye. Having alternative options for testing and treatment, even if at a less acute level, is a necessary component of managing the COVID-19 crisis,” revealed Foltz.
Dr. Foltz also contracted the virus, experiencing mild symptoms and has since then fully recovered. To make sure he was fully free of COVID-19, Foltz put himself through five more nasopharyngeal swabs to prove he was no longer infectious or shedding. After 20 days from his original positive test, he was finally negative.
Once he tested negative, he attempted to donate plasma to help the cause. Patients who have recovered from COVID-19 may have immune-boosting antibodies in their plasma, with the plasma then referred to as “COVID-19 convalescent plasma,” and could be used to treat critically ill COVID-19 patients. The treatment is not proven, but may have some impact in preliminary studies.
Foltz was denied the ability to donate due to an FDA regulation put in place during the AIDS crisis that prevents gay men from donating blood.
“Frustration doesn’t even begin to explain the complexities of this… I applied for plasma donation only to find out that I was rejected because of the FDA regulations stating men who sleep with men can essentially not be donors for twelve months… Here I had the opportunity to potentially save a life and I was made to feel like something was intrinsically wrong with my blood. The other option was to lie about my medical and personal history, but the ethical physician in me just couldn’t do that. I was angry on so many levels,” stated Foltz.
Despite the difficulties and uncertainties surrounding the treatment and containment of the coronavirus, Foltz remains hopeful that things will change in the future, and is optimistic that there is science now to change FDA regulations.
“If anything good can come out of this health crisis, I hope the FDA will end this harmful ban… Seeing the resilience of healthcare workers and their continuing to work despite this risk makes it very rewarding to be in such a group,” said Foltz.
The COVID-19 Triage Clinic offers antibody testing and diagnostic (swab) testing.
An appointment is required to access COVID-19 testing at DAP by calling (760) 992-0407 between 9am and 4pm Monday through Friday.
Visit the cdc.gov website to learn more about the CDC Steps to Stay Safe during the pandemic, and https://www.desertaidsproject.org to see what other services the clinic offers.