Tests for coronavirus hard to find in Wisconsin
Patients don’t qualify despite symptoms
As coronavirus threatens to overwhelm the state’s health system, many Wisconsin residents told the Journal Sentinel they have not been able to get tested despite having concerning symptoms — fever, coughing and sometimes shortness of breath.
Even health care workers with symptoms are struggling to get tested. Their experiences underscore the uncertainty of how widespread COVID-19 already is in Wisconsin.
Patients say they’ve been told there aren’t enough tests. They say they’ve been told they don’t qualify because they haven’t traveled abroad, or they aren’t in a population at high risk for needing a ventilator or having other serious health consequences.
With a shortage in critical testing supplies, the state’s public lab in Madison drew a new line Sunday night, asking clinicians to restrict testing to “those where the results would make a significant impact on (patient) care.”
The continuing shortage comes more than a week after President Donald Trump told reporters “anybody that wants a test can get a test.” The first cases of coronavirus emerged late last year in China.
Experts say testing is the key to understanding the spread of the virus and mandating proper quarantining procedures to contain it.
Dr. Amesh Adalja, a senior scholar at Johns Hopkins University Center for Health Security who specializes in pandemic preparedness, said authorities should not limit tests based on travel history or known exposure, as the virus is so widespread.
“It is allowing cases to go undiagnosed, and if it goes undiagnosed, then it’s allowing people to make additional contacts,” Adalja said. “There are still many cases that are out there that are unconfirmed.”
The U.S. was slow to roll out tests. The Centers for Disease Control and Prevention developed its own, rather than deploy those already in use in other countries. When its test was found to be faulty, the CDC had to make a new one.
There are now six labs in Wisconsin that can test for the virus, including the state’s primary public lab, the Wisconsin State Laboratory of Hygiene. Alan Bateman, assistant director of the communicable disease division there, said two hospital systems recently started testing for the virus, and he expected two more to start in the next week.
Still, workers at the state lab are working weekends and training new staff as they face growing demand. Staff were testing fewer than 100 samples a day early last week but tested more than 100 on Thursday, and broke 300 a day on Friday and Saturday.
The lab is testing every sample that comes through the door, leaving the choice of whom to test up to clinicians, Bateman said. The lab is able to provide results the same day or the day after receiving samples, though there could be delays as demand grows, he said.
James Schauer, director of the lab, wrote a letter Monday to the state’s top health official asking for help getting more testing supplies and prioritizing cases.
“Specimen numbers are expected to continue to increase, and reagents and supplies for this test are limited,” he wrote. “(The lab) needs to ensure that high-priority patients receive prompt results.” Reagents are chemicals used to evaluate test samples.
On Tuesday, the State Patrol announced troopers were helping deliver coronavirus kits and samples.
Since confirming the first Wisconsin case in early February, state health officials have announced results from 1,110 patients who were tested, with 72 positives as of Tuesday afternoon.
In Ohio, the top health official said last week that at least 1% of the state’s population had COVID-19, given community spread, even though far fewer had tested positive. On Monday, officials in Wisconsin acknowledged likely community spread, which means people are getting infected in the area they live from unknown sources.
Ryan Westergaard, chief medical officer of the state’s bureau of communicable diseases, said there’s no need to test people with mild symptoms like the common cold except in certain cases — health care workers as one example.
“At the present moment, there is not enough capacity to test every person, or even every person with respiratory symptoms,” Westergaard said.
Testing is encouraged for anyone who has flu-like symptoms such as fever, cough, and shortness of breath, he said.
But many people with these symptoms told the Journal Sentinel they were turned away for testing because they did not have compromised immune systems or had not traveled to certain countries.
Health care workers with symptoms can’t get tested
A health care worker in central Wisconsin, who asked not to be named for fear of discipline at her job, said clinicians told her Thursday they couldn’t test her because she hadn’t traveled abroad. The Journal Sentinel agreed not to name some of the people in this story because of the stigma attached to COVID-19
The worker was especially concerned because she has asthma and works with patients recovering from lung diseases. She had a fever for four days, an uncontrollable cough and shortness of breath, she said.
Now that she’s feeling better, she wants to return to work but worries about her patients. Experts say people with coronavirus can potentially be contagious for weeks after symptoms end.
“I would feel a lot more comfortable before dealing with my vulnerable patients knowing if I should or should not be there,” she said.
In Fond du Lac, a hospital worker who called the COVID-19 hotline Thursday due to a bad cough said she was told she would get a callback within 24 hours. She was called back on Saturday afternoon and told she would receive another call Sunday morning. By Sunday night, she still hadn’t heard from anyone.
Shelly Haberman, a spokesperson for Agnesian HealthCare, which operates the hotline, said there were “very high call volumes” with more than 400 calls on Monday alone coming from around the state. She said staff aim to respond to callers within 24 hours.
The hospital worker said she has self-isolated since Thursday with no paid leave. She’s not allowed to return to work without a negative test.
The worker wrote in an email that she hopes hospitals start offering paid leave “so that we can willingly disclose our symptoms without the fear of financial hardship if asked to quarantine.”
A sick workforce in hospitals will make an already stark shortage worse.
“I know my coworkers need help, and I can’t wait to get back to them and our patients,” she wrote. “I work in a critical care setting where my skill set is vital to fighting this fight. I want to be there, and I can’t be.”
Other Wisconsinites rejected for testing despite symptoms
A 66-year-old truck driver in the Fox Valley said he became suddenly ill on Wednesday, running a fever of 102.4, and tested negative for the flu.
“It hit me hard and fast,” he said. “I came home and laid down and woke up a couple hours later, and I was having trouble breathing, and coughing and hacking, and then started running a fever.”
Given his COPD and asthma, his urgent care clinic told him to call the state health department. He left a voicemail and wasn’t called back.
After his roommate came down with similar symptoms, the truck driver arranged a tele-visit with a hospital in Milwaukee. He said a nurse practitioner told him he was a good candidate for coronavirus testing, but there was a limited number of tests.
“He said, ‘We really have to reserve those for the sickest, the ones who are going to be on the ventilator, and you don’t qualify for that,’ ” the truck driver recalled. He said he was told to go to the ER if things “went south.”
He’s most worried about returning to work. He’s staying home now even though he doesn’t have paid sick leave because it seems like the responsible thing to do. The experience made him wonder just how wide the virus has spread undetected.
“Obviously, they do not have a clue just how extensive this is, if they aren’t capable of testing,” he said.
A 67-year-old from Door County, who asked to be unnamed, was also unable to get tested after coming down with a fever and “constant cough.” She called her doctor’s office, which instructed her to call a hospital, which instructed her to call her doctor back for a referral. Her doctor’s office wouldn’t do it.
The woman had recently attended a conference in the Wisconsin Dells with hundreds of people from all over the country, including areas with community spread. But she was told the Dells were “not a high-risk area” and that tests were being reserved for people with compromised immune systems or lung conditions.
“I just wanted to be aware because I had been around other people,” said the woman, who had visited a friend with advanced COPD. “You gotta be able to tell people.”
Sabrina Stephens, who works at a Walgreens in Milwaukee, was worried about returning to work Monday night after being unable to get tested.
She and her partner, after experiencing fevers, coughs and chest pressure, started by calling their primary care doctors Friday night, as health officials have advised people to do. Staff said someone would call them back Monday.
Stephens said she called an urgent care clinic and was connected to a nurse. The nurse told them to go to an ER, without advising them to wear masks. Stephens was skeptical as health officials have urged people to use primary care providers before visiting ERs to help avoid overcrowding.
Stephens then called an ER and was told only people who have traveled out of the country or were in direct contact with someone who tested positive would be tested.
“They were like, ‘You can come in but that’s still the criteria,’” she said. “So we haven’t. I don’t want to waste anybody’s time to not be tested and incur an ER bill.”
Stephens said she worried most about infecting others.
“It seems really irresponsible to go to work and not be able to get tested,” she said. “I come into contact with people every day, people who might be immunocompromised and elderly people, so it’s more about that than my own health concerns.”
Mother says daughters may have been exposed but can’t be tested
Wanda Lavender, a manager at a Popeyes, said her family wasn’t tested though two of her three younger daughters were coughing and all attend Hopkins-Lloyd Community School, where an employee tested positive for COVID-19.
Lavender, 38, received a message Saturday night saying that she or a child of hers may have been exposed to someone diagnosed with COVID-19. On Sunday, she said, her 12-year-old son, who attends a different school, was getting warm and light-headed. Two of her daughters, 7 and 9, were coughing but feeling fine.
When she went to Aurora Sinai Medical Center with her children, she said she was told to wait in a tent outside the hospital after she explained the situation.
By then, her son didn’t have a temperature. She said medical staff saw them in the tent and a doctor told her they should self-quarantine for 14 days. She said the doctor told her they wouldn’t be tested because there weren’t enough resources to test everyone.
An Aurora Sinai spokeswoman said in a statement that hospital staff understands many people are struggling with how to seek appropriate medical care during this uncertain time and that in Wisconsin testing is administered with a doctor’s order.
“With a nationwide shortage of tests, it’s not possible to test everyone who wants to be tested, and as public health officials have stated, it’s not recommended all people with mild symptoms are tested,” the statement said.
The statement said that in line with public health guidelines, physicians may advise patients with mild symptoms to go home, self-quarantine and rest and that if symptoms worsen they should call their doctor for further guidance. The hospital’s patient hotline is 1866-443-2584.
A spokeswoman for Aurora Health care had previously said that the hospital is testing patients who have had close contact with someone who is confirmed to have COVID-19, as well as those who have recently returned from an area where there is an outbreak or patients who have had symptoms for more than five days if a flu test is negative and no other cause is apparent.
Lavender thinks authorities should test people like her so that they can better control the pandemic. She doesn’t have symptoms, but she is afraid that, if she has the virus, she may have inadvertently passed it on to others.
“My fear is that it could be corona, and I have no way to protect anyone who I came in contact with,” said Lavender, speaking over the phone while selfquarantining with her children.
Lavender, who is an activist with Fight for $15, a movement to push for higher wages, said she has some insurance through her employer that will kick in if she stays home for more than five days, but she doesn’t have paid sick leave to replace her salary until then. She is staying home because she wants to protect others.
“I have to do what I have to do as a person and make sure that I’m not spreading this disease and make sure that I’m doing my part as a citizen,” she said.
“It’s a very scary situation.”