Coronavirus : Who Should Get Tested? | COVID-19
Coronavirus | COVID-19 YouTube Video Playlist:
The decision of who should get tested for coronavirus aka COVID-19 is not an easy one.
The main reason is that as of right now, there aren’t many tests available. Last time I checked the CDC, that number is around 80,000 or so. Probably more by the time you watch this video because they are ramping up production.
When reporters asked President Trump about testing, their response was…
“Anyone in this country who needs a Coronavirus test can get a test”
Well, that’s not true.
Because I can tell you from first-hand experience, If I want to do COVID-19 test someone, it first has to be approved by the state DOH. And this is the case with thousands of other doctors in this country.
Why is this the case?
Because there are so many tests available.
Yes, there are more and more tests being made.
But there still are not enough.
You see, South Korea was prepared before the coronavirus hit them.
When they saw the COVID-19 outbreak start in December 2019 in Wuhan, they immediately got the RNA genetic code of the virus from China, and a private company in South Korea started working on developing the PCR test before it even hit South Korea. That’s why they were able to test so many people so quickly. And that also why their case fatality rate was so low because they were testing so many people, not just the sickest people.
But the USA has had more than 2 months to prepare, but we were not prepared. And we do not have enough tests. There are 4 reasons for that.
1. Our current administration drastically reduced our public health infrastructure, and two years ago, the CDC stopped funding epidemic prevention activities in 39 countries, including China…. At that time, former CDC director Dr. Tom Frieden said the move “would significantly increase the chance an epidemic will spread without our knowledge and endanger lives in our country and around the world”…well, looks like he nailed that prediction
2. There are so few tests is that there were malfunctions in the test kits, which lead to delays in manufacturing
3. About 5 weeks ago we could have used the WHO’s test but that was rejected for whatever reason
4. In the beginning, unlike South Korea, we did not have private companies making testing kits
But we can’t rewrite the past. So in the here and the now, moving forward, we have to be selective in who we test.
The CDC says it’s the physician’s clinical judgment on who we test. But that’s only partially true, because like I said, I still need approval from the state Dept of Health in order to test someone. And this has already happened to me several times.
And that is a common frustration among all of us doctors on the front lines.
The way most physicians are deciding on who to test falls into one of the following 4 scenarios:
If that person had a fever and/or lower respiratory tract symptoms such as cough and SOB, who have had any of the following in the prior 14 days:
1. Close contact with a confirmed or suspected case of Coronavirus, including in a health care setting. Close contact includes being within approximately six feet of a patient for a prolonged period of time.
2. Residence in or travel to hotspot areas, meaning where widespread community transmission has been reported (China, South Korea, Japan, Iran, and most of Europe [especially Italy]. Within the US, this would especially mean NYC, state of Washington, Colorado, California, and others.
3. Potential exposure through attendance at events or spending time in specific settings where coronavirus cases have been reported.
4. Those with severe lower respiratory tract illness when an alternative diagnosis cannot be identified, even if there has been no clear exposure. So this would include things like low oxygen levels, abnormal findings on CXR or CT scan of the lungs, or patients who are clinically unstable.
Dr. Mike Hansen, MD
Internal Medicine | Pulmonary Disease | Critical Care Medicine
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