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.
- Testing for novel coronavirus is only available to people over 65 or those with certain symptoms. Ultimately, providers decide who gets tested, but many local doctors, clinics and hospitals follow the Oregon Health Authority's guidelines.
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.
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.”
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.
- U.S. Air Force
- Drive-thru testing is not yet available in Central Oregon, though local health professionals have been advocating for it.
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.