Feverish Americans Sweat It as Virus Testing Expands Slowly

Soon after spending the day in a Seattle suburb where coronavirus spread, Linda Backstrom began feeling sick herself.

Her twin sons fell ill, too, as did her husband, who has multiple sclerosis. They had fever, sore throats and aches. But when she called a hotline run by the Pierce County health department, Backstrom was told her family didn’t qualify for testing because no one had traveled to an affected country, had direct contact with an infected person or developed pneumonia.

“I don’t think I have the coronavirus,” said Backstrom, 58. “But, as a citizen, I’m wondering why this government doesn’t have access to testing. It doesn’t make any sense.”

Coronavirus struck at the height of regular flu season. It has killed at least nine Americans and also has fed a mounting frustration and even panic among feverish, sniffly citizens — most of whom likely don’t have the novel virus. People want to get assessed, jamming hotlines, creating competition for scarce tests and prompting jealous comparisons to other countries where testing has been ubiquitous.

The fervor is compounding what experts and some officials say is a legitimate concern: that U.S. testing capacity, set back by initial problems with a government-developed test, lags far behind a potential pandemic.

National Disgrace

“The lack of test kits is a national disgrace,” San Francisco Mayor London Breed wrote in a letter to Vice President Mike Pence on Tuesday. “We will not be able to contain, treat, or mitigate the effects of the virus if we cannot diagnose infection.”

San Francisco has been provided just 250 kits to date, which the city is putting to use in its own lab, she said. Each can test about 350 people, according to the Association of Public Health Laboratories.

At a briefing late Tuesday, Pence said that the federal government would make testing available to everyone. “Any American can be tested with no restrictions, subject to doctor’s orders,” he said.

But it was unclear where those tests would come from, or how Pence’s promise jibed with earlier statements from health officials.

U.S. Food and Drug Administration Commissioner Stephen Hahn told Congress earlier Tuesday that he expects to have the capacity to run about a million tests by the end of the week. The Centers for Disease Control and Prevention has also said it plans have six cities running coronavirus tests on people with flu-like symptoms, with hopes of further surveillance in all 50 states.

In South Korea, health authorities are now testing around 10,000 people a day. But in the U.S., tests are scarce even as cases are confirmed across the country, including seven in King County alone on Tuesday — and one in North Carolina linked to the outbreak there.

Peter Jay Hotez, professor and dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, said coronavirus testing hasn’t kept up with the outbreak’s rapidly changing nature.

Exclusive Club

“The criteria are ridiculously narrow and no longer reflect the reality of coronavirus in the U.S.,” he said.

Hotez said that testing should be expanded at the very least to anyone who comes into contact with vulnerable groups, specifically older people, those with chronic diseases and health-care providers.

“If you have a perfect world, you’d have the ability to get tested for flu and coronavirus at the same time in a rapid test” that could be administered in a doctor’s office and return results within minutes, compared with hours now, he said.

The symptoms of other diseases — including the common cold and flu viruses common in winter months — are easily mistaken for the coronavirus, and federal officials said they can’t waste tests on speculative cases or just for reassurance.

“The chances that a person with a fever and a cough has coronavirus is very low,” Anne Schuchat, principal deputy director of the CDC, testified in Washington on Tuesday. “Not everyone needs a test. We don’t want to go through all our tests on low-risk situations, and not be able to address the care and contacts that are going to be critical.”

But for those who feel at risk, those assurances fall flat. John Eads’s wife, Carol, works as a school aide in Colorado, and after falling ill weeks ago was diagnosed with pneumonia. Even so, she was unable to get the coronavirus test, John Eads said. She returned to work this week after taking antibiotics, but her husband still frets.

“We would like to have the test, and I know doctors at the hospital and everywhere else would be willing to give the test, but we’re dependent on the health department. Are you kidding me?” he said. “Our concern is this thing might be out in the wild, and everybody’s getting infected.”

Test Anxiety

Testing can loom large “in a situation like this, where it’s not crystal clear just how worried people should be,” said Andrew Diamond, chief medical officer of primary-care clinic chain One Medical. (The affiliated administrative company is publicly traded San Francisco-based 1Life Healthcare Inc.) “So an absence of information can exacerbate that worry, even if it’s unfounded.”

One Medical’s membership-based model, which has locations in affected areas like Seattle, San Diego and Manhattan, has sent “many dozens” of its about 400,000 members for testing, though no cases have been confirmed.

For most sick people, the coronavirus test won’t change much in the short term, Diamond said: Patients who don’t need hospital care should stay home, avoid exposing other people, practice good hygiene and talk to their doctors.

“Knowing is important from a public-health standpoint, but not so much from a personal-health standpoint,” he said.

— With assistance by Robert Langreth, and David R Baker

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