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Do I have COVID-19? Maybe. But like many Georgians, I've found it impossible to get a test.
Atlanta Magazine
Sat Mar 28, 2020
Category: Health News
Area: Atlanta
Since my husband, Jim, and I returned from a trip overseas on Monday, March 16, we've followed the instructions CDC workers distributed on our plane: avoiding others, checking our temperatures, keeping an eye out for the major symptoms of coronavirus infection - fever, coughing, and shortness of breath.
We both felt great, but having read about the risk of asymptomatically infecting others, we skipped visiting our daughter in Atlanta when we returned and headed back to our home in Athens, which went under a shelter in place edict earlier than most cities in Georgia. Self-isolating was relatively easy. We continued the maniacal handwashing we practiced during our trip and took our city-approved outdoor walks through vacant downtown blocks, empty quads on campus, and the wide streets in our neighborhood.
Saturday night, I woke up coughing. On Sunday, I started wheezing. During Monday's third video conference call, talking got tougher; I found myself gasping between words.
On Tuesday, struggling to speak easily, I followed my insurance company's instructions and checked in with my doctor electronically. I reminded her I'd recently returned from overseas and also reminded her of a significant detail from my medical history: a few years ago, I had a pulmonary embolism, or blood clot in my lung, which caused significant damage and required months of recovery. Should I get tested for COVID-19?
"As you know, testing is hard," she wrote. It would be impossible to have a test at her office. "It is the pollen season. That could explain some of the symptoms." Well, not really. I didn't have any regular allergy symptoms like a runny nose or eyes. I had a dry cough and shortness of breath. She advised me to keep an eye on things. I wrote back again, reminding her of something else in my chart. Last month, a biopsy revealed basal cell skin cancer on my scalp. (Nothing too serious. "If you're going to have skin cancer, that's the kind you want," the dermatologist assured me.) I was scheduled for outpatient treatment at the end of the month. Should I cancel, I wondered? The last thing I want is to be one of those people who infect healthcare workers. "If your symptoms are very much better you can proceed," my doctor wrote.
That night, my coughing got worse. I could not complete a full sentence or draw a complete breath. In the morning, I checked in with my insurance company again, this time completing an 'e-visit' about COVID-19 which was kind of like the most horrible BuzzFeed quiz ever. Rather than being told I belong in Slytherin, I was directed to call a nursing advice line. Another round of questions. "Go to the emergency room in the next 30 minutes to two hours," the nurse said. "You need to get tested. Have someone drive you."
Jim and I drove to the ER. At the door, a half-dozen robed and masked screeners stopped us for more questioning. They handed me a mask and sent me to triage.
"I'm just here because I drove her," Jim said. He mentioned that he, also, had traveled and he, also, had constricted breathing. "Oh, you should be tested, too," a staffer said, and sent him to triage as well.
I've never seen such a quiet ER. No blaring TVs. No family members crowding the lobby. No nurses gossiping at the front desk. Just a handful of us, spread out, adjusting to the clammy sensation of breathing with a mask covering most of your face.
In an exam room, more questions with the doctor. "You could have COVID-19," he said. "Probably." But he explained because there are so few tests available in Georgia, hospitals are only allowed to administer them to patients who need to be admitted. He said the restrictions on testing are frustrating. "I want to test to see how bad it is in the community," he said. "I want to test the medical staff here." But he can't, because there aren't enough tests to go around - something that has been known for weeks.
My medical history gave him reason to screen me for possible admission, so he ordered an X-ray and bloodwork. If anything looked serious and I might need to be admitted, then I'd receive a COVID-19 test.
An hour or so later, the results showed that I had some kind of respiratory infection but no testing flags red enough to put me in the hospital. I was given discharge papers including a sheet labeled 'Viral syndrome and Coronavirus (COVID-19) instructions' that cover home treatment for COVID-19. Just in case.
The doctor circled the number of the Georgia Department of Public Health on the bottom of one page and suggested I try to get a test at one of the drive-thru testing centers in this area. I left with prescriptions for an inhaler and serious cough medicine, along with instructions to return if I started running a high fever.
I thanked him for working during this tough time, and for all that the ER staff was doing.
"It's not bad now," the doctor said. "But it will be bad in a week or two when things in Georgia escalate."
I noticed he wore a basic pleated mask, like a dental assistant wears, not one that attaches around the nose and mouth. The nurse wore a mask that looked like it might have been reused or the wrong size; rubber bands were stapled to it in the place of the original elastic straps.
On March 9, the number of reported COVID-19 cases in Georgia was 17. Wednesday, when I went to the ER, Athens-Clarke County where I lived reported its first COVID-19-related death and the number of Georgia cases was 1,387. Today, the number is 2,001. The Georgia Department of Public Health is updating these tallies twice daily along with the total number of tests, which currently is 9,865. That's out of a population of 10.2 million.
Despite now having the highest number of COVID-19 cases in the world, the U.S. has dragged its heels on testing, falling well behind other countries. But testing - not just the very sick but also the slightly ill and the asymptomatic - is one reason why Germany, which has one of the highest number of cases, also has one of the lowest fatality rates and was able to get ahead of the disease.
The screening protocols here are tinged with xenophobia. The fact is, I was put to the head of the screening line through my insurance company's telemedicine system because I'd traveled overseas. But, if instead of traveling to Austria, I'd spent my spring break week in New York City or New Orleans or on the beach in Florida, I'd be at equal or higher risk, but not flagged by medical bureaucracy.
When I got home from the ER, it took several tries to get through to the Georgia Department of Public Health, then 15 minutes of voicemail prompts and waiting on hold to reach an adviser. I went through my symptoms and told her I'd just left the ER where the doctor told me to call them. She told me she had to check with her supervisor and asked me to hold. She forgot to put me on mute.
"I've got someone here who's at high-risk." I overheard her saying against the noisy backdrop of a call center. "I don't want to be the person who gives bad news." I heard the supervisor explain she needed to tell me there weren't enough tests and it wasn't advisable for me to have one.
"Thanks for holding," she said. I didn't have the heart to tell her I hadn't really been on hold. "I hate to be the person with bad news," she went on. "But there is a limit on tests and you don't qualify as high-risk." If things got worse, she said, I should call back. Or go back to the ER.
So, right now, I'm coughing, gasping a little, but still not running a fever. The inhaler helps. When I called to put my skin-cancer procedure on hold and explained that I couldn't live with the idea of accidentally infecting anyone, the nurse thanked me. No problem, I answered. Cancer is one thing, but the guilt over possibly harming healthcare workers is something else.
I'm not a person who likes to talk about medical stuff. I hate shows like E.R. and House. A lot of what is in this post will be news to my friends.
But earlier this month, before Dr. Anthony Fauci became a household name, he testified in a congressional hearing and called the U.S. lag in testing a 'failing.' Over the past weeks, celebrities and professional athletes have been tested, but a rollout of widespread testing, considered essential epidemiological knowledge for tracking and containing a pandemic, simply has not happened. On March 9, on a visit to the CDC in Atlanta, President Trump said: "They have the tests. And the tests are beautiful. Anybody that needs a test gets a test."
I need a test. My husband needs a test. Thousands of Georgians need tests. And we're not getting them.
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