Nicole Moore has been sick with symptoms associated with the novel coronavirus for two and a half weeks. She’s requested COVID-19 tests from three separate physicians, and has been told three times that she can’t be tested because she isn’t over 65 years old and doesn’t have a compromised immune system.
Moore reached out to us Friday, wanting to share her story of struggling to find out whether she has coronavirus. She’s far from alone.
Moore lives with her husband and three children and is doing her best to isolate, though her living situation makes complete separation an impossibility.
She’s one of countless Americans who may want to be tested but can’t because of stringent guidelines. Meanwhile, at minimum, tens of thousands of those who did get tested are awaiting test results amid a testing backlog. On Friday, National Public Radio reported that Quest Diagnostics, one of the private testing labs processing COVID-19 tests, “has a backlog of at least 115,000 coronavirus tests.” Quest’s facility in San Juan Capistrano, California got quickly overwhelmed with tests when testing became available at private labs, NPR reported.
“The last place I went was High Lakes Urgent Care. They told me they had 60 or so people with the same symptoms walking into urgent care over the past two days with the same exact concerns,” Moore said.
Meanwhile, Moore has been given expensive tests to rule out every possibility except COVID-19, and now she’ll be stuck paying the bill: It’s the beginning of April and her $2500-per-month insurance plan has a high deductible.
I pay a lot for health insurance. It is my right to know if I have this disease or not. – Nicole Moore
Moore said the first doctor she saw in mid-March at West Bend Family Medicine told her she probably has seasonal allergies, after she experienced shortness of breath, headaches and radiating pain down her neck and back. Her doctor ordered X-rays for her shoulder and neck. Moore couldn’t sleep because of painful joints and trouble breathing. The doctor told her to go to the emergency room if she started feeling bad.
Then Moore said she heard Summit Medical Group was offering telemedicine appointments. She made an appointment, and the doctor told her over Skype to monitor her pulse and oxygen saturation (with a pulse oximeter, available online). Once again, providers told her they couldn’t test her unless she was 65 years old and had a compromised immune system.
The last stop was High Lakes Urgent Care, where Moore said the doctor explained the same story she’d heard before about testing. She said the doctor added that Moore presented with the classic symptoms of COVID-19 that the doctor had been seeing at their clinic for the past few days. In order to rule out other possibilities, they ordered an EKG, two blood samples and a chest X-ray.
Moore was told to assume she had COVID-19, to put on a mask and stay home.
“I pay a lot for health insurance,” Moore said. “It is my right to know if I have this disease or not. I see these statistics… Deschutes County only has ‘two’* people [with COVID-19]… that’s a bunch of garbage. That’s what I’m concerned about most. People won’t be prepared because we don’t have the numbers. It lets our guard down.” (*Deschutes County had 36 reported cases as of Friday, according to the Oregon Health Authority, with 412 people in the county testing negative, according to OHA figures.)
High Lakes Urgent Care Responds
Becca Mataya, director of primary care at High Lakes primary care clinics in Bend, said there are multiple reasons her staff can’t test at a high level.
“Testing supplies are extremely limited. We only get 20 kits from commercial labs a week. Their manufacturers don’t send [the labs] very many. For example, the test kits require viral media tubs, and the company that manufactures most of them in the world is located in Italy.”
Italy is one of the epicenters of the coronavirus pandemic, with 120,000 positive cases and 14,681 deaths as of April 3.
When a provider does decide to test a patient for COVID-19, test results do not come back for one to two weeks, Mataya said.
We would love to test everyone from a public health perspective. We’ve been pushing the Oregon Health Authority to set up a community drive thru, but in Oregon, there isn’t the capacity. – Becca Mataya, director of primary care, High Lakes Urgent Care
Mataya explained that all providers in the area are setting a high bar for testing because they want to save the tests for the highest-risk population. She said that all the health care organizations in Central Oregon have a weekly call, on Wednesdays, to collaborate on personal protective equipment. Providers share their stock of PPE inventory numbers with the group, and larger clinics share information with smaller clinics about how to set up their accounts with commercial labs.
“We would love to test everyone from a public health perspective. We’ve been working with the Deschutes County Health Department to set up a community drive thru, but in Central Oregon, there isn’t the capacity,” Mataya said.
Telemedicine has been working successfully at High Lakes to help manage potential coronavirus cases, Mataya said. After the CARES Act was passed by the federal government last week, more telehealth privacy requirements were waived, enabling doctors to use other platforms to meet with their patients online, including FaceTime and Skype.
“We’re still able to get a lot of information this way,” Mataya said. “I’ve witnessed doctors counting respiratory rates, talking patients through how to take their own pulse, asking them to take their temperature. If they need to be seen in person, [the provider] will direct them to urgent care.”
Testing at St. Charles Medical Center
Lisa Goodman, the public information officer for St. Charles Health System told the Source that—to date—the hospital has sent 811 specimens to the University of Washington. The labs then return the results within 48 hours. Of these tests, 666 were negative, 29 were positive and 116 are still pending. St. Charles Health System has facilities in Bend, Prineville, Redmond, Sisters, Madras and La Pine—multiple cities, encompassing multiple counties, including Crook, Deschutes and Jefferson counties.
The hospital’s providers make the final decision about who will receive testing, Goodman said.
“We are now collecting specimens not just for patients who fall in clearly identified high-risk groups, but also health care workers, first responders and anyone who is experiencing ‘worsening symptoms’ as judged by their provider,” Goodman said.
Goodman could not provide a solid number for how many tests the hospital can conduct a day. She also acknowledged that the OHA’s testing numbers are a few days behind the hospital’s reported testing numbers, which accounts for the large discrepancy between each organization’s testing totals to date.
“Ultimately, we could send out hundreds of tests a day, but being able to do so would be dependent upon how many tests the University of Washington lab could reasonably handle and we can’t answer what that number is,” she said.
This article appears in Mar 25 – May 20, 2020.
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First it was the 7 year old, aches and fever on Mar 15th, like 24hr flu but there were hours where her pulse was in the 130s, respiration 32x/min and motrin made her vomit, I kept in contact with pediatric hotline all day and they advised me to get her to urgent care. Mon morning and she seemed better, the congestion starting in me, my head hurt, incredibly fatigued and gastro symptoms. We both tested negative for flu, had a flu shot, there was nothing else they could do. By Tues I had the fever and tylenol wouldn’t break it, I could eat but wasn’t hungry, my body was badly stiff and sore, tired but I couldn’t sleep, I have never felt the lymph nodes in my neck so inflamed, and it was like someone was sitting on my chest for days…all that lasted to Thursday. That night my oxygen was hovering around 86-89% and every time I fell asleep fluid would pool deep in my throat and gag me awake. No it’s no allergies and I have never felt like this before. VA triage sent me to ER on March 20th, they check oxygen and for infection but can’t test for covid, I am a suspected case, “please go back to quarantine at home.” I feel like a burden to the health system, like I have done something wrong by showing up at ER, an outcast. Next phase was like “walking pneumonia” for over a week, everyone in our home had at least mild symptoms of the persistent cough. My daughter would cough until she vomited and we sat to watch a family movie last night that was hard to hear over the coughing of myself and the kids. Telehealth says No zPak, no motrin, no albuterol…elderberry and guaifenesin for kids and add on benzonatate for me. I obey. Day 22 of isolation, cough feels chronic with slow improvement. The sickness returned all week in lessening waves, a good day then a bad. When will there be an antibody test? Do we have immunity? Is there long term damage to my lungs?
In all likelihood you should all recover just fine. Drink plenty of fluids, especially water, and rest as much as possible. If symptoms get too horrible go to St. Charles ER. Not everyone can be tested for the virus, because there are a limited number of test kits. Plus it really doesn’t matter in the big picture. The important thing is to get help if necessary; and follow the advice of your physician.
NurseNooch, well said. Our family are masters of hydration, and that, along with rest and healthy food/lifestyle have been key to us pushing through this. That advice is going to keep people out of the hospital that can recover at home.
Truth be told, we are tough as nails. Of course we will get through this! And in all likelyhood we will be just fine long-term. But no one knows the long-term of this right now, so I am not going to operate on blind certainty. Pursuing answers to my three questions, with all understanding that we don’t have answers yet to those three questions, should be at the forefront of beating this virus.
In no way am I stomping my feet for test results– the time for that helpful knowledge has passed for our family. But has it passed for others? For the thousands of Central Oregonians out running “essential” errands in crowded lines separated by 6 foot personal bubbles, know that the local numbers do not reflect the extent of cases in our community. The virus is here. Don’t panic, but ask yourself if you really need that item from Walmart or Coscto to survive the next few weeks.
To our doctors and nurses: I remember what it felt like to be a new Marine when 9/11 happened. The whole world went still in that moment, I was staring at the tidal wave that was about to hit. I had signed up for the military voluntarily, as a career choice. In an instant, I had no choice but to except that I would be sent to a war and that I could die in that war. I worked logistics for surgical shock trauma platoons and mortuary affairs, I saw the toll of mass casualty on our hospital teams and volunteered morticians. I escorted two Marines and five Army soldiers home from Iraq to Dover, I had to grow up fast in my 20s. This virus thrives in a body teeming with stress and cortisol. Healthcare workers should be prioritized for testing. We need solutions for the burnout and isolation you will feel. Our community needs to stay home for you.
*accept not except below…
We are testing in Central Oregon with a drive thru location
http://www.telemedicinecentraloregon.com/
I survived COVID-19
COVID-19 is different, potent and, for me, unnerving compared to the flu. This was my experience:
Day 1: Wednesday, March 25: symptoms of 99.6° fever, body aches, chills and a bit of coughing.
Days 2, 3, & 4: Symptoms: fever of 100.1°, tight chest (actually felt like someone was sitting on my upper chest) dry cough, dizzy, very tired with several hours of naps; yet, no runny nose.
Day 5: Dry cough and heavy feeling in lungs persists. Fever of 99.6°, less body aches and energy slightly improved.
Day 6: Less coughing, lungs do not feel as heavy. Fever is slightly lower.
Day 7: Wednesday, April 1st: Finally no fever, no heavy chest. Still exhausted.
Days 8, 9 & 10: A bit more energy each day. I can read a book without falling asleep.
Day 11: Sunday, April 5th: I do not have not normal strength, otherwise feel close to normal.
I was lucky. Lucky my wife was such a great nurse/chef. Random luck that my body responded and recovered. Many other fit 62 year olds do not have the same luck. Lucky I had a large separate bedroom / bathroom to spend 10 days by myself. Lucky I did not have a job on which I was dependent.
I will begin to crawl my way back to a normal life this week.
The CDC protocol states I am ready to return to life when:
• At least 3 days (72 hours) have passed since resolution symptoms; and,
• At least 7 days have passed since symptoms first appeared
I pass. Ready to return.
Oh, my how I wish I could have been tested, especially test now to confirm I am negative. Alas, no. I advised my county health department and I did not get test. Deschutes County reports under 40 cases, probably under reported.
I am a physician living in central Oregon but licensed in another state. I have assumed that the lack of testing means that reported cases are off by a factor of ten (an order of magnitude). This is supported by the data about asymptomatic and presymptomatic transmission. But that is an underestimate: Deschutes 55 cases may be more like 1000-1500 rather than the 500 I have assumed. The importance of this is in our individual assessment of risk of exposure and u derstanding of pervasiveness of Coronavirus in our community.
The criteria for the test that OHA Has promulgated leaves out a 61 year old with heart disease, a 58 yo with kidney disease, etc, all individuals with higher risk for severe illness.
It demonstrates the disaster of mismanagement of testing for this illness that transcends Oregon as it falls on the federal government leadership. Fortunately responsible governors have chosen to work together, but even for Oregonians this is a lot of self reliance to ask of us.