(Updated 3/17/20, by Jeremy Gabrysch, MD)
At Remedy, we’re getting peppered daily with questions about testing for covid-19 coronavirus.
“Do you have tests?”
“Can I be tested?”
“Who should be tested?”
This is a rapidly evolving situation, and I’m going to break this down for you.
“Do you have tests for coronavirus?”
In the beginning of this outbreak, testing could only be done by public laboratories such as the CDC and the state health departments. As things progressed, commercial labs (like Quest and LabCorp) were able to offer a test. A few things to know about the test though.
- The turnaround is long, somewhere between 3 and 5 days. When we test you for flu or strep, we are typically using what we call a “point-of-care” test. These are rapid tests that result in 5-15 minutes, right there on the spot. (With Remedy, you can get this test in the comfort of your own home!) This coronavirus test is not a point-of-care test.
- Some of these private labs are only running the actual test in a few places in the country. For example, if Quest is only running the COVID PCR at one facility in California, the turnaround time is largely affected by this. The sample has to get out there from wherever it started.
- When test facilities are few, the labs have to limit the number of samples they can accept. They have a fixed capacity. One of the ways to do that is to limit the number of testing kits they send out. In Austin, for example, Quest only distributed to any one clinic group FIVE TEST KITS per location.
With a limited number of tests, we simply can’t test everyone who wants to be tested. The situation is getting better. We are hearing every day of other labs coming online with their test.
“Who should be tested for coronavirus?”
Currently the CDC is only recommending testing for the following people – those with fatigue, body aches, worsening symptoms, fever, cough, and shortness of breath, AND:
- You have been in close contact (within 6 feet) of a known confirmed COVID-19 patient in the past 14 days.
- Within the past 14 days, you have travelled from any area with sustained community transmission of COVID-19. This could be within the US and other countries.
- You have risk factors that put you at a higher risk for a poorer outcome. This includes:
- Older adults (age ≥ 65 years)
- Individuals with chronic medical conditions and/or an immunocompromised state (e.g., diabetes, heart disease, receiving immunosuppressive medications, chronic lung disease, chronic kidney disease).
If you’re sick enough to be hospitalized, and the reason cannot be otherwise determined (influenza, bacterial pneumonia), then you would be tested for COVID-19.
What this means is that most people who are not sick enough to be hospitalized do not need to be tested at this time.
“If I won’t be tested anyway, what can I do?”
You should stay home if you are sick, and stay at least six feet away from other people. Wear a mask, cover your cough and sneeze, and wash your hands frequently! Whatever you do, don’t go out. With social distancing, even healthy people are supposed to stay home. But if you are sick, you even more so! Stay home, so in the event that you have COVID-19, you will not spread the disease to others, especially the most vulnerable among us.
“Can I get tested for strep or flu to see if that might be going on?”
With Remedy, if we think it could be strep or flu, we are currently “treating empirically.” What does that mean? We will see you via video visit, and if there is a reasonable suspicion that the cause is strep, flu, or pneumonia, we will treat you for those.
“What do I look out for to know if I’m worsening?”
If you are concerned that you are worsening, schedule a video visit through a telemedicine service. Your employer may offer this, or use Remedy! Your provider can evaluate you over video. In some cases, you may just need reassurance. If the medical provider thinks you need to be evaluated in-person, they may recommend a clinic visit, or in Remedy’s case, a house call. If you are experiencing severe shortness of breath, you should go to the ER.
“Ok, let me try this again. What if I REALLY want to be tested?”
At Remedy, we really want to test you, too! And just because we can’t right now, there’s good news! Help is on the way! More labs have committed to testing more of the population and we hear there will be more places to test … including with us! We’ll keep you posted.