You have questions about COVID-19 tests in Idaho. Here’s what we know
Editor’s note: For information on Gov. Little’s press conference to announce the first confirmed case of novel coronavirus, go to: https://www.idahostatesman.com/living/health-fitness/article240956606.html.
Months after the first case of novel coronavirus in the nation was detected, Idaho announced its first confirmed case of COVID-19 late Friday afternoon and a second case Saturday. State and private laboratories had completed 176 tests as of Saturday afternoon.
People around the state are wondering how to get tested.
Who is being tested? Why not everyone? How many people can be tested in Idaho? Where can you get a test? What if you have all the symptoms, and you want to make sure you’re not spreading it to vulnerable people?
The answers to those questions are changing almost daily. But here are some answers, as of Friday, March 13:
Who can be tested?
The rules have been relaxed somewhat since testing began.
Health care providers now make the call on whether to order a test for COVID-19. But they are following guidelines that give testing priority to certain groups. That includes, generally, people who are sick enough to be hospitalized and people who are at high risk for contact with the virus.
“At this time, the (U.S. Centers for Disease Control and Prevention) doesn’t recommend testing of people who do not have symptoms,” Central District Health spokeswoman Christine Myron said. “Because of the limited number of tests, there is still a need to preserve them for the sickest and those with the highest risk of infection.”
The state is not currently testing everyone who has coronavirus symptoms and has no immediate plans for widespread testing. Gov. Brad Little said Friday at a news conference that discussions are underway to create a drive-through testing program “ASAP.”
That won’t change after Idaho’s first confirmed case, Little said. That case involves a Treasure Valley patient who returned from a conference in New York City earlier this month. The conference had three attendees with COVID-19. Little characterized that kind of infection as less concerning, because it could be traced to somewhere outside Idaho.
He didn’t say whether the state will take a different approach to testing and other policies as soon as the virus is found to be spreading locally, or what the tipping point would be.
David Pate, a retired physician and retired CEO of St. Luke’s Health System, said widespread testing isn’t as simple as it sounds.
“That currently would be a logistical issue, to just be randomly testing everybody who happened to have any exposure to people,” he said. “If you have a large gathering of people, certainly that increases the odds that you could come into contact (with novel coronavirus, and) you’re increasing your odds. However, you don’t really have to go to a large gathering to be exposed to this, either.
“If we test (a patient) today and (she) is negative, great, but my guess is for the foreseeable future (she is) going to continue to run into people,” he added. “Do I test her every week? Every month? What if she becomes infected between then?”
Pate is a member of the governor’s coronavirus work group, but he stressed that he isn’t speaking on behalf of the group, on behalf of St. Luke’s or any other entity. His comments are based on his own experience and education, and based on his reading of federal and state guidance.
He said “the people that we have the most serious concerns” about are being tested for COVID-19.
South Korea has ramped up its testing and found many cases that wouldn’t have been caught otherwise. That effort is believed to be contributing to the nation’s much-lower fatality rate of 0.7% — because of early interventions and/or because it identifies the mild cases that limited testing does not.
Pate said that going into communities and testing people who aren’t sick is “helpful eventually” when it comes to figuring out fatality rates and disease surveillance. But it’s not helpful “in the moment,” he said.
“When you see disease at the scale we’re seeing now … let’s just presume everyone is at risk” and take safeguards, he said.
How many people can be tested in Idaho?
The state has enough supplies to test hundreds of people — 700 to 900 as of Friday. It has ordered more supplies to meet increased demand. It’s unclear how many people can be tested through private labs.
It takes anywhere from hours to days to get test results. A doctor with a patient in Boise could have results in a matter of hours, because of proximity to the state laboratory. But samples that go to private labs in Utah and Washington take longer, due to shipping time and the hours it takes to run the tests.
Where can you get a test? How does it work?
Unlike with the flu or strep throat, a person cannot yet walk into a clinic or public health office in Idaho and find out whether they have COVID-19.
The process is fairly involved. First, a health care provider evaluates the patient and makes the call on whether to order a COVID-19 test. They generally rule out influenza with a flu test before ordering the new coronavirus test.
If the patient is a candidate for a test, the health care provider works with the local public health agency to order a test.
The test starts with swabbing the patient’s nose and throat to get a sample. That sample is sent to a laboratory, which decides if it is positive or negative. If it’s positive, it will be sent to the U.S. Centers for Disease Control and Prevention to confirm that the positive result is accurate.
“There is no authorization or approval process,” Idaho Department of Health and Welfare spokeswoman Niki Forbing-Orr said. “If a doctor decides to take a swab for a test and sends it to the state lab, we’ll process it.”
The state laboratory in Boise is running tests for Idaho, but it has limited capacity. The lab can do more than 15 tests a day and, so far, has been able to keep up with tests as they come in, Forbing-Orr said.
Three private companies, including well-known LabCorp and Quest Diagnostics, also are doing tests for Idaho. The results of those tests are included in the daily testing update at coronavirus.idaho.gov.
The Idaho Department of Health and Welfare says COVID-19 cases will be announced as soon as a lab reports a positive test result. The announcements won’t be delayed to wait for CDC confirmation.
As for costs, any test processed by the state laboratory is done free of charge. Health insurers in Idaho earlier this month announced they would cover testing for COVID-19 at no cost to the patient, making it easier for patients to be tested through private labs. Regulators caution that private labs might still charge patients if they’re not “in network” with the patient’s insurance plan.
What if you think you have it? Can you find out, so you can avoid spreading it to other people?
Probably not. People without severe symptoms and high risk of exposure aren’t being tested right now. That could change.
If you’re sick, take precautions to protect others. Wash your hands. Stay home if you’re sick — even if it’s just a cough or mild fever. Cover your face when you cough or sneeze. Don’t touch your eyes, nose or mouth. Clean and disinfect household surfaces and high-use objects like your phone.
People who are at risk for pneumonia and other complications of respiratory illness should take extra precautions and avoid people who are sick.
Even as the coronavirus spreads, people who get a fever and cough are more likely to have the flu, the common cold or another illness like the Respiratory Syncytial Virus, commonly known as RSV. There were 73 cases of RSV confirmed in Idaho during the last week of February alone. The flu, meanwhile, is still widespread in Idaho, killing four people in the last week of February. The number of people hospitalized in the U.S. with a laboratory-confirmed case of the flu was still on the rise as of late February.
“If you’ve got someone in your home who is at risk because they are elderly or they have a particular health issue, act like you have an infection,” Pate said. “At some point, we can’t let testing be the guidance, we just kind of have to act like it and protect ourselves and others from us.”
This story was originally published March 12, 2020 at 6:07 PM.
