IN HARD-HIT AREAS, TESTING RESTRICTED

Health care workers, hospital patients being given priority

Health officials in New York, California and other hard-hit parts of the country are restricting coronavirus testing to health care workers and people who are hospitalized, saying the battle to contain the virus is lost and the country is moving into a new phase of the pandemic response.

As cases spike sharply in those places, they are hunkering down for an onslaught, and directing scarce resources where they are needed most to save people’s lives. Instead of encouraging broad testing of the public, they’re focused on conserving masks, ventilators, intensive care beds — and on getting still-limited tests to health care workers and the most vulnerable. The shift is further evidence that rising levels of infection and illness have begun to overwhelm the health care system.

Health officials are struggling with a complicated message — more people can get tested, but those with mild symptoms should stay home and practice social distancing. Some go so far as to warn that widespread testing at this point could threaten the U.S. response by burning through precious supplies just as a tidal wave of sick people descend on the system

“In a universe where masks and gowns are starting to become scarce, every time we test someone who doesn’t need one, we’re taking that mask and gown away from someone in the intensive care unit,” said Demetre Daskalakis, deputy commissioner for the Division of Disease Control of the New York City Department of Health and Mental Hygiene.

Jeff Engel, executive director of the Council of State and Territorial Epidemiologists and former health director for North Carolina, said it was time for a “pivot” in the testing strategy.

“If you have mild illness and can stay at home . . . don’t get tested,” Engel said. “You’re not only putting others at risk if you go out and about with symptoms, you’re wasting all these valuable resources we really need to conserve for society.”

Other county and state health officials are sounding similar alarms — just as drive-thru testing sites are finally opening and weeks after federal officials announced 1.1 million tests had been shipped out and another 4 million more were coming.

Los Angeles County health officials advised doctors in a letter Thursday to give up on testing patients as a strategy to contain the outbreak, instructing them to test patients only if a positive result could change how they would be treated, the Los Angeles Times reported. The department “is shifting from a strategy of case containment to slowing disease transmission and averting excess morbidity and mortality,” according to the letter.

In Washington state, where hospital workers have been fashioning makeshift protective medical gear using parts purchased from Home Depot and craft stores, officials are restricting testing to high-risk populations, including health care workers and people with more severe symptoms.

The shift represents a change in both messaging and strategy after weeks of efforts to expand access to testing after the federal government’s botched rollout of testing kits, which hampered states’ ability to know whether the virus was already circulating and to take steps to try to get ahead of it. Now, the repeated reassurances from various federal officials that testing is plentiful and free have sown confusion. Every day, White House coronavirus task force officials have promised Americans they’re ramping up widespread drive-thru testing.

On Saturday, however, those officials laid out explicit guidelines for who should get tested, emphasizing that top priority should be given to those who are hospitalized, health care workers and residents of long-term care facilities who have symptoms, as well as people over 65 with symptoms, especially those with health problems like heart and lung disease that place them at higher risk.

“Not every single person in the U.S. needs to get tested,” said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. “When you go in and get tested, you are consuming personal protective equipment, masks and gowns — those are high priority for the health care workers who are taking care of people who have coronavirus disease . . . . We want to make sure that the people who are taking care of people with coronavirus disease do not endanger themselves because they do not have the protective personal equipment.”