As an Emergency physician...

[elias7]

I will say that unless we can develop immediate rapid in-house testing similar to rapid strep or influenza testing, there is no hope to contain the spread of COVID-19. Current guidelines for testing are unacceptable. With active community spread of this virus and most people having mild symptoms, it is unconscionable to reserve testing for those being very ill without alternative explanation, those being able to prove close contact with an infected person or those with travel to a level 3 affected country. So many people will fly under the radar that this policy has no hope of containing spread.

I cannot fathom the stinginess of policy that forces such a huge hurdle to testing, and even then, the test has to go to the state labs and take days to result. For the tested patient, such a delay will likely cause spread to multiple people wherever that person goes until they are informed they should self-quarantine. For the mildly ill patient who does not meet criteria, if infected, they will infect dozens of people in the community for weeks. This policy is insane and is virtually guaranteeing spread of the virus.

That this is politically driven is an American tragedy and we are witnessing in real time what will be a devastating pandemic. Our healthcare system will be overwhelmed in due course by this outbreak. Local hospitals in affected communities will find themselves short of resources, equipment and personnel. Healthcare workers will not only not be able to handle the influx of ill patients, especially in communities heavy with nursing homes and the elderly - running short of ventilators and ICU beds, etc., but also will face getting infected on a daily basis, literally risking their lives while having their hands tied diagnostically.

I am 58 years old and anticipate weeks to months of being exposed to a symptomatic and mildly symptomatic patients for whom I will unlikely be wearing PPE (personal protective equipment), as well as being exposed to moderately and critically ill patients while facing the reality that many docs an nurses are getting infected despite appropriate use of precautions. i feel certain I will get this virus, in large part due to our inability to appropriately test anyone with respiratory symptoms as we do with influenza. We appear to be dealing with something that is spread by droplet, contact and maybe even airborne spread. I’ve never seen anything like this. Mortality of influenza is 0.1%, mortality of COVID-19 is 20 to 35 times that.

I hope I live.