State tries to clarify confusion over ease of coronavirus testing

As Connecticut increases COVID-19 testing, officials have been reassuring residents that, unlike when the pandemic first struck in mid-March, anyone can get screened and a prior doctor’s referral is not required.

But a pair of May announcements from state health commissioners and other issues have muddled the situation for healthcare providers and the public.

“There’s so much confusion, misinformation,” said Patricia Baker, head of the Connecticut Health Foundation, which advocates for policies that address racial and ethnic health disparities. “What we really need is a very transparent, simple, clear and concise message if we want to maximize engagement and participation.”

On May 6, then-health chief Renee Coleman-Mitchell eliminated the need for a licensed health professional to authorize a coronavirus test. Coleman-Mitchell’s stated goal — echoed in a press release by Gov. Ned Lamont — was to allow for “mass testing of Connecticut residents to define and deter the spread of the disease.”

“There was a fair amount of information coming out ... that patients who wanted to be tested were running into this issue of having to schedule an appointment with their primary care physician to get authorization . ... It’s a barrier for people,” recalled Rob Rioux, chief operating officer for the Community Health Center Association, whose members in particular are relied upon to offer testing to poor and minority neighborhoods.

But six days later, Lamont abruptly removed Mitchell from her post.

Lamont made Deidre Gifford his acting health commissioner. And on May 14, she rescinded Coleman-Mitchell’s previous executive order on coronavirus testing, writing: “I ... thereby reinstate the requirement that a request for collection or analysis of a COVID-19 specimen be made by a licensed physician or other licensed person authorized by law to make diagnoses, including but not limited to, physician assistants, advanced practice registered nurses and pharmacists.”

Baker and Rioux said the abrupt reversal has remained a puzzle.

“I would love to have the insight on that,” Rioux said. “I’ve got to put faith in Dr. Gifford that from a clinical perspective, she has a point of view I think needs to be honored.”

Av Harris, a spokesman for the state health department,told Hearst Media that Coleman-Mitchell’s May 6 decision was reversed because one of the federally authorized emergency coronavirus screening methods “required a medical test order by a licensed healthcare provider in order to be processed.”

That is why, Harris said, that Gifford’s May 14 executive decision also expanded the ability to provide a doctor’s note to licensed “physician assistants, advanced practice registered nurses and pharmacists.”

“The requirement for an order from a healthcare provider will not restrict who can be quickly and easily be tested for COVID-19 in Connecticut because the increasing number of mobile or ‘pop-up’ testing sites have one of the identified healthcare providers on staff who can issue the order for the test,” Harris said. “This eliminates the need for someone wanting to be tested to have to obtain a testing order in advance.”

Cities like Bridgeport, New Haven and Hartford — some of Connecticut’s coronavirus hot spots where the Lamont administration is particularly focused on expanding testing — all independently confirmed that they have since found the ability to authorize tests at screening locations.

Similarly Rioux said community health center employees are “operating under doctor’s orders.”

“If someone would like to be tested, they simply need to call the center, find out where they are conducting tests, find a location suitable to them and show up,” Rioux said. “If a person is already a (health center) patient it’s an easy lift. If they’re not, while waiting to be tested we get your information, get you in to our system, answer a couple questions and you’re good to go.”

Summer Johnson McGee, dean of the University of New Haven’s School of Health Sciences, said she was aware of the confusion among health professionals and advocates caused by the state’s changing executive orders.

“The concern is this may also be confusing the public,” McGee said. “Anything that creates confusion for consumers or the public creates a barrier for testing — ‘If I’m not sure what to do, maybe I just won’t get it (done).’”

Complicating the situation further, McGee said, have been the recently launched drivethru testing sites at more than two-dozen CVS pharmacies around Connecticut. The first question posed on CVS’ scheduling website? “Do you have a referral from a medical professional?”

Follow-up questions focus on whether the individual seeking COVID screening has experienced symptoms and whether they may have been exposed at home or work.

McGee said — and Hearst confirmed — that if there is no medical referral and an applicant does not answer other questions related to risk in the affirmative, that person will be told, “You do not qualify for testing at this time.”