You want a coronavirus test -- here's why your doctor probably won't give you one

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The U.S. has lagged behind other advanced nations in testing for the coronavirus. CNN's Drew Griffin reports.

Posted: Mar 22, 2020 4:11 PM
Updated: Mar 22, 2020 4:11 PM

If you want to get a test for the novel coronavirus, you're in good company.

"One of my sisters called me yesterday [and said], 'I have to have my daughter tested for coronavirus,'" New York Gov. Andrew Cuomo said at a press briefing Wednesday.

The governor's niece had a fever and flu-like symptoms. Yet he told his sister "there's no reason for a test" since her daughter hadn't traveled to a coronavirus hot spot or been in contact with anyone who had tested positive for the virus.

Across the United States, physicians are sending the same message: Not everyone who wants a test will get a test.

"If we had all the resources in the world and could wave a magic wand, we would be happy to test these people, but they're not there, so I'm afraid we're having to prioritize," said  Dr. William Schaffner, a professor in the division of infectious diseases at Vanderbilt University Medical Center.

This week, New York City and Los Angeles County laid out guidelines for testing, recommending that doctors avoid testing patients except in cases where a test result would significantly change the course of treatment.

Schaffner, a longtime adviser to the US Centers for Disease Control and Prevention, and Dr. Rochelle Walensky, chief of infectious diseases at Massachusetts General Hospital, explained to CNN who should and shouldn't get tested, given that there are not enough tests to go around.

Their thoughts essentially echo what was done in New York City and Los Angeles: At a time when there aren't enough tests to meet demand, they should be given to patients when the result would make a difference in their care.

First, a few notes. There will, of course, be exceptions to these categories, and different doctors and hospitals will have different rules. In addition, this rubric is a snapshot in time; as more tests become available, doctors can be more liberal about who they test.

The CDC has some testing guidelines but notes that "decisions about testing are at the discretion of state and local health departments and/or individual clinicians."

Some states, such as New York and Washington, have more specific recommendations about who should be tested.

Also note that there's no clear definition of what it means to be "elderly." The rubric below says 70 and older, but different doctors and hospitals will have different definitions. At Mass General, for example, for the purpose of coronavirus testing, they consider someone to be elderly if they're over 70, but depending on someone's health status, a patient could also be considered elderly if they're in their 60s.

Finally, testing protocols for health care workers are different, since they can spread the virus to their patients and colleagues.

Who doesn't need testing

If you don't have symptoms of coronavirus: According to the CDC, symptoms of the virus include fever, coughing and shortness of breath. If you aren't experiencing them, you should not receive a test right now.

That's true even if you've recently traveled to a coronavirus hotspot, such as China or Italy. It's true even if you've been in close contact with someone who has been diagnosed with coronavirus.

The doctors noted that it's certainly possible you could have coronavirus even if you don't have symptoms, but that there just aren't enough tests right now to go around.

If you have symptoms, you're healthy and under age 70: The doctors said even if you have symptoms, you should not receive a test right now because of the shortage.

"The test isn't going to change what we do for you," said Walensky, a professor at Harvard Medical School.

"A lot of the reason we test for the flu is we have something to give you if you test positive," she added, referring to antivirals that can lessen the duration and severity of flu symptoms. "But this isn't like the flu. We don't have anything specific to give you for coronavirus."

The doctors said their advice to young healthy people with a fever and cough would be the same no matter what's causing it: Go home; rest; get plenty of fluids; stay away from other people; and get medical attention if you develop shortness of breath.

That last bit of advice about seeking medical attention would be true whether you have coronavirus, the flu, or any other respiratory ailment, they said.

"If you're in this group, you're not in trouble. Whether you have flu or Covid-19 or some other respiratory virus, we anticipate you will do well," said Schaffner, using the medical term for the disease caused by the novel coronavirus. "But should you develop any symptoms that show you're getting worse, particularly if you have any difficulty breathing, you will call us."

After you recover, you should continue keeping away from other people as much as possible, whether your illness was due to coronavirus or something else.

"Everyone should be social distancing," Walensky said. "Where in God's name are you going?"

 Who might need testing

If you're over age 70 or have an underlying severe medical condition and you have mild to moderate symptoms of coronavirus: If you're in this group, doctors would do an evaluation to determine what tests you might need, including whether you need a coronavirus test.

"We would want to see you. You're a little more fragile to begin with, so not just because of Covid, we would want to make sure you're OK," Walensky said.

Who does needs testing

Anyone who has symptoms and has been in close contact with someone who has had a positive coronavirus test: The CDC defines close contact as having direct contact with the infectious secretions of someone who has coronavirus, such as being coughed on, or being within about 6 feet of an infected person "for a prolonged period of time."

Anyone who has symptoms of coronavirus and needs to be hospitalized: If you have symptoms of coronavirus and you need to be hospitalized for any reason, doctors will want to test you. If you do have the virus, for infection control reasons, it will influence where you get placed in the hospital, and doctors will take special precautions to protect themselves when caring for you.

As more tests become available, Schaffner and Walensky say they hope to be able to loosen up these categories and test more patients.

But it's not just a matter of test availability.

Swabs and other supplies needed to perform the test are also in short supply. Also, doctors and nurses have to put on personal protection equipment to perform a coronavirus test, such as gloves and special masks. Since that equipment is in short supply, doctors want to conserve it for those who most need testing.

Finally, if everyone got a test, it would overload the system.

"We have to do the test, and then somebody has to process it and get it to the lab. And then somebody has to call the patients back and tell them the results. I can't see having health care facilities having that kind of manpower," Walensky said. "Maybe we'll get there, and that would be great."

Indiana Coronavirus Cases

Data is updated nightly.

Confirmed Cases: 48626

Reported Deaths: 2717
CountyConfirmedDeaths
Marion11723689
Lake5212244
Elkhart332051
Allen2815132
St. Joseph198168
Cass16399
Hamilton1596101
Hendricks1414100
Johnson1288117
Porter73637
Tippecanoe7279
Madison66364
Clark66044
Bartholomew58944
Howard58057
LaPorte57926
Vanderburgh5706
Kosciusko5564
Marshall4926
Noble48428
Jackson4723
LaGrange4719
Delaware45050
Boone44943
Hancock44935
Shelby43025
Floyd38244
Morgan32931
Monroe30128
Montgomery29720
Grant29526
Clinton2892
Dubois2836
Henry28016
White26510
Decatur25532
Lawrence24625
Vigo2368
Dearborn23323
Warrick22129
Harrison21622
Greene19032
Miami1842
Jennings17612
Putnam1708
DeKalb1634
Scott1628
Daviess14717
Wayne1426
Orange13523
Perry1359
Steuben1302
Franklin1268
Ripley1227
Jasper1212
Wabash1132
Carroll1102
Fayette1017
Newton9910
Whitley965
Starke933
Gibson872
Randolph804
Huntington782
Wells751
Jefferson722
Fulton711
Jay680
Washington671
Pulaski661
Knox640
Clay604
Rush583
Adams501
Owen491
Benton480
Sullivan451
Posey440
Spencer411
Blackford392
Brown391
Crawford320
Fountain322
Tipton311
Switzerland270
Martin230
Parke230
Ohio170
Vermillion140
Warren141
Union130
Pike110
Unassigned0193

Ohio Coronavirus Cases

Data is updated nightly.

Confirmed Cases: 58904

Reported Deaths: 2970
CountyConfirmedDeaths
Franklin10587431
Cuyahoga8048379
Hamilton6158204
Lucas2788303
Marion273439
Pickaway220141
Summit2175207
Montgomery213431
Mahoning1849238
Butler163747
Columbiana130660
Stark1133113
Lorain105167
Trumbull97473
Warren88124
Clark7729
Delaware58815
Fairfield58516
Tuscarawas56810
Belmont55422
Medina53632
Lake50819
Licking49612
Miami47231
Portage44959
Ashtabula43644
Wood43651
Clermont4226
Geauga40843
Wayne36352
Richland3475
Allen32341
Mercer2879
Greene2769
Darke25326
Erie24622
Holmes2393
Huron2232
Madison1999
Ottawa15024
Sandusky13714
Crawford1365
Washington13520
Ross1303
Putnam12915
Coshocton1272
Hardin12312
Morrow1171
Auglaize1074
Jefferson912
Monroe8917
Union891
Muskingum861
Hancock791
Hocking788
Preble781
Guernsey743
Lawrence720
Williams722
Shelby694
Clinton680
Logan641
Athens631
Fulton620
Ashland601
Carroll593
Wyandot595
Brown581
Knox521
Defiance513
Fayette460
Highland451
Scioto450
Champaign411
Van Wert380
Perry351
Seneca342
Henry300
Paulding260
Adams241
Jackson240
Pike240
Vinton222
Gallia181
Harrison121
Meigs120
Morgan110
Noble110
Unassigned00
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