What country places sharp limits on testing for the new Coronavirus? Which country requires testing specimens to be sent to a single location, up to thousands of miles away? Which country requires doctors to discuss cases with a state health department chief before a test can even be ordered? Which country is essentially claiming “all is well,” because no one is detecting spread?. If you don’t look, you don’t know. If your country demands substantial prior authorization paperwork before you can order a test, the test isn’t ordered. No evidence of spread must mean there is no outbreak, right? Problem solved!
For the past month, we have criticized China for such behavior. Unfortunately, this is exactly the scene in the United States.
This flowchart is from the CDC. It is also being distributed by state health departments. Notice something critical: The only way you get tested is if you EITHER came from China or had known exposure to Coronavirus AND are pretty darn sick. That’s it. You won’t get tested otherwise.
Consider this: A huge number of new infections in the world are now in people who had no known contact with someone from China or someone with Coronavirus. Yet, by decree, these people will never get tested in our country. Is everyone comfortable with that?
I’m not a big fan of Twitter. It is hard to distinguish fact from fiction on the site. On the other hand, there are certain people to follow who have valuable insight. If you want to scare yourself, go on Twitter and follow Laurie Garrett (https://twitter.com/Laurie_Garrett). She seems to know her stuff and her warnings over the past month have been very accurate.
There are also other messages appearing on Twitter which are coming from doctors who are facing the same issue we are seeing in our office. Like many, our region is in a serious Influenza A outbreak. The majority of severe cases did not get a flu shot. In fact, the good news is the flu shot was pretty good this year.
But, we are also seeing something a little worrisome: Only a third of these cases are testing positive on Influenza nasal swabs. Perhaps this is simply the limit of the test. Maybe our sampling is not so great. Perhaps, however, it is not the flu. Perhaps, we are looking at something bad and we don’t know it.
Would we know the difference between Influenza versus Coronavirus on the basis of physical exam and other generic lab work? Of course not!
Our area of Northern Virginia is populated with commuters to and from Washington, D.C. This area is full of people from all countries, riding in packed trains for up to hours at a time in close contact, coughing on each other. How can we possibly avoid the epidemic?
The time frame with Coronavirus between exposure, mild sickness, bad sickness and maybe death appears to be many weeks. That means this thing can remain invisible for up to a month while it widens its circle of infection. We can delude ourselves for quite a while.
Because…. We’re not looking.