When Kristina Donnay took it upon herself in April to provide coronavirus testing in Maricopa, she didn’t anticipate working weeks on end in the office without a day off.
Nor did she expect the public backlash visited upon her practice, the Maricopa Wellness Center, for conducting tests at a time several health providers and national drug store chains in the city were taking a pass.
“I needed to step up to the plate. I was shocked other facilities in Maricopa did not,” Donnay said. “We need more testing in the city. We need to see we are a hotspot in the city.”
Her practice, which opened in April 2019, was perhaps a less-than-obvious choice to jump into the COVID-19 testing fray.
The Maricopa Wellness Center is not a primary care provider, but a med spa, a hybrid of an aesthetic medical center and day spa that provides nonsurgical aesthetic medical services – Botox injections, chemical peels, hormone injections and the like – under the supervision of a licensed medical practitioner. Donnay is medical director and co-owner of the practice.
But she saw a need and assumed the “huge undertaking” to set up as a testing facility.
“We are truly trying to do our best to help the community,” she said. “I didn’t feel like I had a choice not to offer it.”
“She really has so much compassion and concern for the community of Maricopa,” said Tascha Spears, Pinal County’s new health services director.
The center started testing after Gov. Doug Ducey’s stay at home order expired and the practice reopened for medically necessary services.
In April and May, Donnay and her staff of four were conducting 1-3 tests weekly.
That number grew to 4-5 tests a week during the first three weeks of June.
And then the lid blew off the pot on June 24.
ON THE FRONTLINES
Donnay ended up on the frontlines of the pandemic after a rare illness took her down in March. Suspicious it could be coronavirus, she looked around to get a test. As sick as she was, she spent a good part of three days on the phone. Pinal County didn’t have enough tests and Maricopa County wouldn’t test her because she is not a resident. She was told to go to the ER, but she knew that wasn’t the proper way.
“It was a terrible situation and I thought, oh man, I hope nobody else has to go through this, too,” she recalled. “I thought, I have the access to LabCorp and Sonora Quest and I’ll just make sure that I have some type of testing available.”
She figured her practice would be a “back-up,” that another entity in the city, perhaps more equipped for the task, would offer testing, but none did.
Maricopa Wellness Center closed 10 days before the state mandate because Donnay could see what was happening. During the shutdown, she worked diligently to procure testing kits, hearing “no” many times because her practice was not a primary care provider and did not accept insurance. She persisted.
“I just continued to say I need this,” she said. “I just refused to take no for an answer.”
Eventually, working through her contacts, she was successful. Today, she works with Lab Corp, which turns around the results a bit more quickly.
That single-mindedness to do what is best for the patient was at the heart of creating the practice.
Donnay grew up in Scottsdale but had strong ties to Maricopa before moving here five years ago.
In 2000, her father, Bill Day, came to set up trash service for a sparkling new development called Rancho El Dorado about to start building houses, he recalled. Day, who said his wife and son moved from Scottsdale three years later, talked fondly of his memories from that time.
“I was a senior in high school, and I was like ‘You guys are crazy,” Donnay interjected.
A mother of two, she is a certified family nurse practitioner. She earned her master’s degree from Grand Canyon University a decade ago and has worked in women’s health and forensics.
She was working with sexual assault victims in early 2018 when she approached her father to ask if he wanted to go into business.
Day knew something about business start-ups. He has been an entrepreneur since buying his first business – a dog-grooming pet store in Glendale – in the late 1970s. His wife also started and managed businesses as well.
He had recently invested in another business when his daughter posed a partnership. “I look at her and go ‘no,’ but what is it? She threw out the idea of a practice here in Maricopa.”
Donnay had begun thinking about a venture after a family member had a stem-cell injection in the knee at a “terrible practice.”
“They were being sold the world and it just looked like bad medicine,” she said.
With her forensic background and research-based approach to medicine, she thought she could do better. With her father’s help.
“It concerned me that this was happening,” she said, “so we thought we would do that here in Maricopa, provide that service but on an ethical level.”
‘WE’RE TEACHING ONE ANOTHER’
Daughter and father started with an initial focus on aesthetic treatments, but the practice has evolved into a full-service med spa. Once committed, Donnay took about a year to train full-time with a focus on treating patients safely. Her father attended all the training as well, though he is not certified to perform treatments. It opened in April 2019.
Day serves as office manager for the practice when he’s not working his day job overseeing landfill and transfer station sales in the Phoenix market for Waste Management.
“We’re teaching one another” the other side of the business, said Donnay who, with her husband, Chris, co-own the practice with her parents. It recently received the “Small Business of the Year” award from the Maricopa Chamber of Commerce.
Her father was an early arrival in the city, but today it is also home to Donnay, her brother, her in-laws as well as an uncle and cousin.
“That was one of the reasons why we wanted to start the business here in Maricopa,” Day said of family. “I love the town. I’ve seen it grow. I’ve always wanted to be part of the community, be able to help people. This has worked out great for us.”
Perhaps it was only natural that Donnay and her family would end up here, with many fond memories collected over the years.
“I mean even before I lived here, I was coming here with my parents for the Fourth of July at Pacana Park,” she said. “Oh my gosh, those were amazing. We thought that was wonderful, like what a great new addition to the city. And then the salsa festivals
“So even though I haven’t lived here as long, we’ve been enjoying the small-town feel since they’ve moved here.”
THE CORONAVIRUS CRUSH
In mid-July, in her office, Donnay flicked week-by-week through her online appointment calendar to show the COVID-19 testing appointments. Through the first three weeks of June, they barely registered, less than five a week.
And then she reached the week of July 21. Monday and Tuesday were normal, but on Wednesday the 24th the calendar grew thick with testing appointments.
By the time, Donnay and her team left the office that day, three hours after the normal 5 p.m. closing time, they had performed 42 tests.
“We were hit hard. We weren’t prepared,” she said. “It was chaos. My staff was so amazing. It has not let up since.”
Through the better part of July, the office performed from 30-45 tests daily.
“I feel like I’ve gotten my sea legs a little bit better in the past couple of weeks,” she said. “When we were hit that first day we weren’t as organized as we are right now. We didn’t have our groove on it. We felt like we were kind of pushed into the deep end.”
Now, patients come in the morning for their aesthetic treatments and in the afternoon for their COVID-19 tests. In between, the office undergoes an extensive disinfecting protocol.
“I’m separating the healthy and the sick,” she said.
To this day, Donnay said she is unsure what triggered the local rush to get tested on June 24.
But the news was not good that day in Arizona, which was emerging as a coronavirus hotspot along with several other states, including Florida and Texas. The Arizona Department of Health Services reported a then-record number of COVID-19 deaths in a single day – 79 – even though they didn’t all happen on the same day.
A day earlier, hospitalizations had started to climb in the South and West. In Arizona, hospital beds were reportedly filling up with virus patients. Health officials reported that 88% of adult intensive care units and nearly as many inpatient beds were being used. They were the highest percentages in nearly three months.
The country’s top epidemiologist had just testified before a House panel on Capitol Hill and delivered a sobering assessment.
“The next couple of weeks are going to be critical in our ability to address those surges we are seeing in Florida, Texas, Arizona and other states,” said Dr. Anthony Fauci, the longtime director of the National Institute of Allergy and Infectious Diseases.
“The virus is not going to disappear,” he warned.
All of which added up, at least, to more public awareness that Arizona was rapidly becoming a hot spot for the virus, weeks after the state began to reopen.
Donnay has been working overtime and gone without a day off since that crazy Wednesday. She has been in the office every day, including July 4 as she contacted patients to give them their test results. She has called to give results, only to find out the patient had already died. (On July 13, the office had 150 COVID-related inquiries.)
Meeting the demand for tests has been demanding on Donnay and her family, including a daughter, 5, and a son, 2.
She wanted to work for herself to have more time with her family. But the past two months she and her staff have worked many hours, “more hours than I did even as a floor nurse,” she said.
“It’s definitely been difficult on my kids.”
AN UNEXPECTED BACKLASH
Maricopa Wellness Center charges a $100 office visit fee for the testing, which includes a molecular test to diagnose a SARS-CoV-2 infection and a rapid serology (blood) test to detect antibodies that indicate previous exposure to the virus. Those two tests are conducted via a nasalpharyngeal swab and fingerstick, respectively.
The antibody test results are ready in about 15 minutes, while the nasal specimen is sent off to the lab with results typically available in 3-9 days.
The cost includes the testing kits, processing and further labs if needed.
She said the practice has been transparent with the fee as a provider that does not accept insurance, though patients can submit to their insurance for possible reimbursement.
But that didn’t prevent an onslaught of negative comments from people stopping in the office, calling in to rant or posting on social media. Donnay and staff were told they were “terrible people” with a “special place in hell” awaiting them. She was called a “drug lord” and accused of “profiting off the pandemic.”
Donnay doesn’t take the criticism personally but admits there were days when she and other staffers were in tears as they turned out the lights.
In a Facebook post on July 24, she mentioned the “nasty comments made about us for charging an office visit fee for the rapid antibodies test. I have some serious issues with this.” She noted that to provide testing she has to buy the antibody tests, pay staff, purchase PPE, pay rent and utilities.
“Every day my staff is putting themselves at risk to be the only place in town to offer testing,” she added.
Early in her career, as a triage nurse at the 4th Avenue Jail in Phoenix, she learned people do not like to have their autonomy taken from them. She sees the anger expressed by some as “people trying to get control back (in their lives) during the pandemic.”
“It’s not directed at us,” she said.
Spears was on the job at the Pinal County Public Health Department for less than a week in early July when she reached out to Donnay, a former forensic colleague. The county wanted to offer a testing blitz in Maricopa, and she knew Donnay was the only provider in the city.
“I had no doubts about her,” Spears said. “We’re just grateful as a health provider here that she recognizes the need for testing. Pinal County Public Health just applauds her efforts.”
‘THE STATE IS AT A CRITICAL POINT’
On July 18, Donnay’s team, with help from Spears, health department staffers and the National Guard, swabbed more than 375 people at three drive-thru stations at Copper Sky. The vehicles lined up early, some three hours before for the 8 a.m. event, but the wait dissipated within a couple hours on a day when temperatures reached 108 degrees. The event was ended several hours early after one staffer suffered heat stroke and three others had heat exhaustion.
Donnay said she was hoping to conduct about 500 tests but surmised that people thought the wait would be worse.
“I think people were very hesitant, thinking the lines would be through the roof,” Donnay said at the event, in her surgical gown, mask and gloves.
Donnay was hoping to schedule additional testing blitzes for August.
And while testing is vitally important in gaining the upper hand on the virus, she said people need to do their part.
Acknowledging face masks have become political, she said their role in preventing the spread of the virus has not been emphasized enough.
“You wear one to protect others,” a concept ingrained in healthcare workers during their education and training, she said. “From a medical standpoint, the masks have always been important.”
She sees face masks as similar to smoking being prohibited in public buildings. Such bans are not in place for the health of the smoker’s lungs, but for others subjected to secondhand smoke.
“It’s the same with face masks.”
“The state is at a critical point,” she said. “We are taking it day by day.”
Her message: Wash hands. Stay home. Wear a mask. Get tested.
And don’t take chances by not doing those simple things.
“It’s not worth it.”
This story appears in the August issue of InMaricopa.