Covid-19–It Gets Real

We humans are story-tellers and story-learners. It is one thing to read about numbers of Covid-19 cases and deaths; it is something different to hear the story of a fellow Spokanite. A friend of a friend of mine had been feeling crummy for a couple of weeks. She obtained one of original tests for Covid-19. A week and a half later It came back negative –certainly not a “rapid” test–or very useful one from the standpoint of case management. The crummies persisted, spurring a second test–and that second test came back positive. She is still convalescing. Another contact, a funeral director in his fifties described his test positive case of Covid-19 as feeling the worst he has ever felt for seventeen days straight, constantly wondering if he would die. A few weeks later he reports being back to “about 85%” of normal. This is not the flu, no matter what they say on Fox. 

We hear a lot about the need for testing. Early on, tests for Covid-19 took more than a week to come back. Such a tests may help for gathering statistics, but it is nearly useless for identifying people who need to be quarantined because they’re shedding virus. 

Abbott Laboratories announced FDA approval of its new ID NOW COVID-19 testing device March 27. The device tests one sample at a time. It requires about five minutes to detect the virus and offers a negative result in fifteen minutes. The devices shipped to laboratories, but only with very limited available test kits (in spite of the unrealistic Presidential hype). Last Wednesday, April 22, a hitch appeared. Testing by the Cleveland Clinic revealed that ID NOW COVID-19 accurately reports negative results if the nasal swab goes directly from the nose into the machine, but if the sample is placed in a “viral transport medium” (the typical method of getting a sample to a lab, even a lab just down the street), the test produces about 15% false negatives, offering false reassurance safety. 

Of course, at one critical place there is no lack of test kits–and swabs go directly from the nose into the machine. Visitors to the White House have been screened with that Abbott Laboratories’ rapid test since early April. With this level of testing Mr. Trump can safely declare that “wearing a mask is optional” and the he won’t wear one. When you function in a protected bubble it costs you nothing to recommend that others expose themselves.

Speaking from his bubble, Mr. Trump feels free to exhort his followers to go out and make a display of their patriotic bravery (irony alert), threatening Democratic governors and grabbing media attention with demands for the “liberty” to gather and ignore public health recommendations. 

Closer to home, Stacey Cowles, in an Editorial in the Spokesman on April 19, argued for the urgency of re-opening of Spokane’s economy. He, somewhat breezily, cited a Spokesman article to indicate “good progress” in testing availability. 

Let’s examine that. According to the article, rapid testing would be available in Spokane through Providence Express Care starting last Friday, April 16. That was great news, but the fine print told a more nuanced story: a “pilot program will target health care workers, first responders and high-risk patients who can access rapid testing by referral and appointment only.”

There is a disconnect between these scenarios.

In Trump’s virus-free bubble, everyone who sees him, asymptomatic or not, has been proven minutes earlier to be free of viral shedding. Presumably, if the same person visits again in a week, that person will again be tested before coming into his presence. 

In Spokane, where Mr. Cowles is arguing to start opening up for business, there is zero chance (as an asymptomatic person-on-the-street) of my obtaining a rapid test for SARS-CoV-2 before I go out to a re-opened factory, restaurant, or shop. It offers me no reassurance that the guy next to me at the gym isn’t spewing virus after protesting with Heather Scott last weekend or attending a church gathering. 

No matter how much Mr. Trump, the talking heads on Fox News, and Mr. Cowles want the economy to re-open, the reality is that we still lack anything close to the testing (and contact-tracing ability) to make it safe to do so. Letting up on social distancing now in anything but a very careful and measured way will guarantee a body count that will make the flu look tame.

Keep to the high ground,