The Testing Problem

Questions answered in this post:

  1. Who should get tested for COVID-19?
  2. When should I get tested if at all?
  3. Why not get tested?

Just get tested and find out. Sounds easy but it’s not.

To develop testing for a virus is not a simple manner.  You first have to identify and sequence the virus and create the test.  You then have to turn that into something that can be mass produced.  You then have to manufacture the equipment and get it to the appropriate locations.  You have to make enough testing kits and scale up production and distribution.  You have to calibrate the testing on site to make sure it gives accurate results – you can’t have it giving false negatives. 

All week we had patients who were unlikely to have the infection, but we couldn’t get them cleared because it was taking up to 7 days to get results back.  This was clogging up our ICUs and depleting our supplies of protective equipment.  We had rumors that on site testing was in the lab but that it was going to take a week to get it calibrated.  So what was I to do?

This morning I called the occupational health at my hospital to ask to get tested but there was a problem.  There were no more testing kits.  No what?

I did what everyone else was recommended to do.  I called my doctor.  Well, in this case, I video chatted a physician assistant in Washington D.C. through a new urgent care telemedicine platform.  As an aside, this is probably going to be the future of healthcare.  It was easy and effective.  The PA was very nice and helpful, but it took another 4 hours of multiple calls, texts, and emails with her and other people around town just to find a place to get tested.  It was essential that I get tested, not for myself, but for the people I may have unwittingly exposed at the hospital.

Finally, I was able to get help from the director of the ER at my hospital and got my testing done.

Now I wait.

I have locked myself in my basement.  Nobody in, nobody out until I get the results.

My experience is the reason why you should NOT get tested unless you meet the recommendations of the CDC.  These are the reasons:

  1. The tests need to be reserved for people who are hospitalized  so we can rule out those who are not infected and save our protective equipment for the people who are at risk.
  2. It is essential that healthcare workers have access to tests.  If they can’t rapidly be ruled in or out for the disease it could exacerbate the crisis by having a lack of doctors and nurses to care for patients.
  3. If people flood the doctor’s offices or ERs they can overwhelm them and also spread the virus more readily in an environment where people are more susceptible.
  4. Finding out you are positive does not change what you do.  You have to isolate yourself and avoid contact as much as possible.  You should do this whether you test positive or not so the test doesn’t help you.

What you should do if you think you have the disease is call your doctor or find an urgent care center that does remote visits.  If you qualify, get tested.  If you don’t, but still think you have the virus, just assume that you are infected. Isolate yourself and tell anyone around you that you’ve got the bug.

As of now, I don’t feel so sick and may not be infected.  I’ll let you know the results when I get them.  Stay well!

For a great explanation of why it is so difficult to get tested in the United States, listen to this podcast from NPR “The Test Shortage” keeping in mind that it reflects the reality form 3/19/20

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