Is lack of testing why Berks is virus free?
Nearly 100 cases across state, many close by, but county in clear — or is it?
Berks County seems like an island in a sea of the coronavirus COVID-19, with no confirmed cases as of Tuesday afternoon.
Meanwhile, nearby counties have announced confirmed cases since testing began a couple weeks ago, including neighboring Montgomery County, which has the most confirmed positive cases in the state with 32.
Overall the number of cases in the state is approaching 100, with none in Berks.
So why are our neighbors in Lehigh, Bucks, Montgomery and Chester counties reporting positive cases and Berks remains at zero?
Strict testing criteria limits who can be tested for the virus, which means cases in Berks and elsewhere might be unreported.
Loosening test guidelines
Until the past few days, all testing was approved by the Pennsylvania Department of Health based on guidelines provided by the federal Centers for Disease Control and Prevention.
If an individual did not fit the specific criteria, including not only showing symptoms but also having traveled to one of the listed countries or having contact with a known positive case, they were denied a test.
Testing was done at the state lab in Exton and positive results were then sent to the CDC for confirmation. Since then the CDC said the state lab and others no longer need to wait for confirmation of presumptive positive tests and positive tests are now confirmed positives.
Recently, commercial labs have been approved to process testing, which should mean more people will be able to get tested. Testing through a commercial lab does not require a physician to consult with the health department.
“I understand some people who do not fit the PA DOH criteria feel they should be tested and as a health care facility we are trying to meet the needs of our community,” said Mari E. Driscoll, infection control and prevention specialist at Penn State Health St. Joseph. “Once testing is available at commercial labs, I am sure we will see some positives in Berks.”
Regardless of the lab where testing is done, anyone who wants to get tested needs to speak with a physician first. Even then, getting tested for the coronavirus is not definite. A physician needs to determine if the person should be tested.
According to Sen. Pat Toomey and Dr. Ronald Walsh, clinical laboratory director at Health Network Laboratories/Lehigh Valley Health Network, there is a higher capacity in available testing than a month ago, but there is still progress to be made.
Walsh said LVHN is no longer limiting testing to only people who have traveled to one of the countries listed by the CDC or with known exposure to someone with a confirmed case, but those are still areas of focus.
‘This is so frustrating’
LVHN recently opened eight designated, standalone coronavirus assessment and testing centers for symptomatic people. Retired Berks physician Claudia Bahorik hoped she would be able to get tested at one of the centers after being denied testing last week at a hospital due to her lack of travel to one of the countries listed by the CDC.
Bahorik who is experiencing known symptoms of the coronavirus, a cough and shortness of breath, was tested for the flu and respiratory syncytial virus, which she said came back negative. The only symptom she does not currently have is a fever. While her recent travel does not include any of the countries listed by the CDC, it does include a visit to New York.
When she attempted to get tested at one of the centers over the weekend, she was told she did not meet the CDC criteria for travel or a known exposure to someone with a confirmed positive case. Instead she was told she should selfquarantine for two weeks.
“This is so frustrating,” she said.
Since becoming sick, Bahorik has been self-quarantining.
“How reasonable is it to expect that someone be quarantined for a month, disrupt their life, but not know if they were positive?” she asked.
How to get tested
Anyone who believes they have the virus or may have been exposed to someone who does is asked to stay home and contact their primary physician by phone. Medical professionals will determine if the patient has coronavirus symptoms and needs to be tested.
“I would ask the public call their primary physician’s office first so testing can be arranged,” Driscoll said. “We have partnered with a commercial lab and once the details are finalized, we will be able to test people we feel may be indicated, even if outside the DOH criteria.”
The DOH provided guidelines for how to get tested for the virus. At the state level, the following people are being prioritized for testing: people who are severely sick for unknown reasons; people in congregate care settings; people in contact with known cases of the virus; and health care providers.
If someone has mild symptoms, the DOH asks that they stay home and contact their health care provider if they feel worse. Those with severe symptoms including a fever over 100 degrees, shortness of breath and a cough should call their health care provider or 1-877-PA-HEALTH or their local emergency department.
If a health care provider feels a patient should be tested, they can order a test through a commercial lab without consulting the DOH or can call and consult with the DOH to see if testing is needed. If the DOH does not recommend testing, the physician can still order a test through a commercial lab if they feel a patient should be tested.
Currently physicians appear to be following the guidelines provided by the DOH and CDC in determining who should be tested. As testing capacity increases, it is expected that more people will be able to get tested.
As of Tuesday afternoon there were 96 confirmed cases of the coronavirus in the state. According to the DOH, there were 876 negative cases of the coronavirus in the state as of Tuesday afternoon.
That’s a ratio of about 9 to 1. The results of the negatives were all some other illness.