I Wouldn’t Have Voted For Elizabeth Warren, But She’s Right About Coronavirus Testing
Sen. Elizabeth Warren (D-MA) was never going to get my vote, even if she hadn’t dropped out of the race before the Florida presidential primary. That doesn’t mean she’s always wrong about every topic — and a thread of tweets she posted today calling for America to “dramatically increase coronavirus testing” had me nodding in approval.
As a Floridian whose other job is in a grocery store bakery* and is concerned about immunocompromised people who are dear to me, this crisis is personal. My home state is an epicenter for this pandemic and the virus is coming after me, my family, my friends, and my coworkers. Warren is absolutely right that an immediate and massive expansion of testing is needed, and that Congress should take action.
“Restarting our economy will require one thing above all else – testing,” wrote Warren. “Testing to show who’s currently infected. Testing to show who’s had the virus and is immune. Social distancing won’t end because it’s Easter. It’ll end when we have sufficient testing.”
Restarting our economy will require one thing above all else – testing. Testing to show who's currently infected. Testing to show who's had the virus and is immune. Social distancing won't end because it's Easter. It'll end when we have sufficient testing. Here’s how we do it.
— Elizabeth Warren (@SenWarren) March 26, 2020
Noting that Congress was wrapping up a coronavirus relief bill but planning to recess, Warren objected — “It’s not time for us to go home” — and laid out a series of measures she felt Congress should enact to expand testing capabilities across America. Warren also expanded on her tweets in a Medium post.
If you aren’t already familiar with the details of how COVID-19 tests are conducted, FiveThirtyEight has a short post here that explains, in layman’s terms, the testing procedures and some of the issues affecting shortages, including a lack of machines that can run the tests and limited supplies of the necessary chemical reagents.
Among Warren’s recommendations were using the Defense Protection Act to provide funds for the manufacture of test kits (including cotton swabs, reagents, plus protective equipment like masks and gloves needed for medical personnel to conduct the tests) and to ensure these vital supplies are directed to the states. She also called for funding to guarantee contracts for public and private diagnostic manufacturers, to ensure that can purchase needed raw materials as quickly as possible and stay solvent as they increase capacity. Boosting funding for the Public Health Service Commissioned Corps to hire and train temporary workers to administer tests was another action Congress could take, Warren wrote.
Congress can also boost funding for the Public Health Service Commissioned Corps to hire and train temporary workers to administer tests. There are tasks that don’t require medical degrees & plenty of people temporarily out of work who can receive on-the-job training.
— Elizabeth Warren (@SenWarren) March 26, 2020
The delay and limitations on testing is one of the biggest roadblocks America faces in this pandemic. The number of confirmed cases — as well as, sadly, the death toll — continues to rise, but the reported numbers are likely far, far short of the reality.
Media reports are coming in with heartbreaking testimonials from health care workers struggling to care for critically ill patients, some who are dying before a positive test result can be confirmed, as described in this BuzzFeed article:
In California, one ER doctor who works at multiple hospitals in a hard-hit county told BuzzFeed News, “those medical records aren’t being audited by anyone at the state and local level currently and some people aren’t even testing those people who are dead.”
“We just don’t know. The numbers are grossly underreported. I know for a fact that we’ve had three deaths in one county where only one is listed on the website,” the doctor said.
…And two of the hardest-hit areas in the nation — New York City and Los Angeles County — released guidance earlier this week encouraging doctors not to test patients unless they think the test will significantly change their course of treatment. That means that potentially more people in both places could be admitted to hospitals with severe respiratory symptoms and recover — or die — and not be registered as a coronavirus case.
There are additional issues related to FDA and CDC regulations, as reported by the New York Times, that have prevented samples from being tested, held back by federal requirements for clinical labs and disclosure of information.
If we don’t know how many people have been infected, we don’t know where to direct resources, and we don’t know when it will be safe to relax the social distancing measures that have throttled the economy.
Unfortunately, the reality right now for far too many Americans is that if you aren’t a celebrity or member of Congress, you may not be able to get a test right away — even if you’ve been exposed to someone with a known positive test, even if you’re showing symptoms. And if you do manage to get a test sample taken, you may have to wait for a week or even two for the results.
— Bloomberg Opinion (@bopinion) March 26, 2020
I recently spoke to a woman here in Florida who had been in contact with someone who had coronavirus, had subsequently developed symptoms (coughing, lung pain, trouble breathing), and wanted to get a test. She called her primary care physician in the morning and spoke with his nurse, who advised her to set up an appointment at a local walk-in clinic that was conducting tests, and that the doctor would call her back later to review her symptoms and put in the order for the test.
Her doctor called later that day and advised that she should definitely get tested. She made an appointment for 5 p.m. at the location nearest her home and arrived early at 4:45 pm.
What followed was several hours of waiting and confusion, as the clinic double-checked her insurance and said they had to call her doctor’s office to confirm he had ordered the test. She told me about other stressed-out patients waiting to be seen and clinic employees who had clearly been working long hours. She ended up waiting around until closing time and was asked to return again the next morning.
The next day, she arrived at the clinic as they were opening and walked up to a table that had been set up for testing, standing 6 feet back from the nurse waiting there, who told her to get in her car and drive around to the back of the building for drive-through testing. She did as requested and another nurse approached her car, asking her to roll her window down just a crack to talk to him that way. He took her information and verified her doctor had ordered the test, and then another nurse came over, asked her to roll the window down all the way and lean her head back for the nasal swab test.
The nurse then told her that it could be up to “10 to 12 days” before she got the results, and instructed her to quarantine at home for the next 14 days.
She described her symptoms as slightly improving over the past few days, for which she is obviously grateful, but one that may hinder her diagnosis: the swab test only will give a positive result if the patient has active COVID-19 virus in their nasal cavities when they are tested. If she was too far along in her recovery, she may very well have had the virus but would still test negative.
The delays in being able to be tested potentially put other people at risk, if an infected person is circulating in the community. The Florida woman had wisely self-quarantined at home immediately after being informed she had been in contact with an infected person, but not everyone has been so disciplined — not to mention the unknown numbers of people who are unaware they have been exposed, and remain asymptomatic but still contagious.
“All in all, I’m just happy that I even had access to healthcare,” she told me. “I know so many are at home stressed about this and not sure what to do. They don’t have access to tests or doctors.”
She praised the clinic employees for their patience, and said that once she was able to get her test order verified on the second day, it had been a “fast and efficient” process, but there are obvious challenges for people without insurance or a current primary care physician. At least at this specific clinic, if you did not already have a doctor to order the test as necessary for you, you would need to be examined by the clinic doctors first.
“The most vulnerable are definitely going to have an issue getting a test,” she noted, observing that if you didn’t have a car you could sit in, potentially for several hours, to wait to be tested — not to mention the time off work and possibly child care — and a cell phone to allow clinic employees to communicate with you, it would be far more difficult to get tested.
Because of the highly contagious nature of this virus, and the current lack of a vaccine, Warren is right that we need to radically ramp up testing, but we also must go a step further and prioritize directing those tests to the people on the front lines of community interaction and exposure.
Obviously, every single medical professional — as well as the many clerical, administrative, janitorial, and other support staff working in our medical facilities — should be tested immediately, and regularly as this pandemic continues. Other tests should be directed to those working in the businesses we’ve deemed “essential” during this crisis, such as grocery stores, restaurants, and food delivery services. Tests should be provided free of charge, regardless of insurance coverage, and employers offered tax incentives to cover the necessary sick pay for any employee who tests positive, and government funding to cover those independent contractors, part-timers, and other workers who might not be eligible for sick pay.
Local and state governments across the country are stepping up to expand testing the best that they can, such as this program posted today by the county government in Orange County, FL (where my hometown of Orlando is located), offering tests to all health care workers and those over 65 years old who have symptoms.
There are currently no lines @OCCC #COVID19 Temporary Testing Site. If you are 65+, & experiencing symptoms, we urge you to go & be tested. All healthcare workers & medical responders are eligible for testing, regardless of age or symptoms. More info: https://t.co/ZhpL1Nqzl6 pic.twitter.com/n23JOajSgp
— Orange County FL (@OrangeCoFL) March 26, 2020
Congress can and should appropriate the funds to support and expand these local efforts. We cannot risk relaxing the social distancing practices until widespread testing allows us to more accurately access the scope of this pandemic.
*Disclaimer: I am currently employed as a decorator apprentice in a Publix Bakery in Tallahassee, FL. I am not an official spokesperson for Publix Super Markets, Inc. and this article is solely my opinion and should not be attributed to any other person or entity.
This is an opinion piece. The views expressed in this article are those of just the author.