When Should You Get Tested for COVID?

When Should You Get Tested for COVID?

The decision of when you should get tested for COVID is not an easy one.
The main reason is that, as of right now, there aren’t many tests available. The last time I checked the CDC, that number is around 80,000 or so. Probably more by the time you watch this video because they are ramping up production.

When reporters asked President Trump about testing, their response was…
“Anyone in this country who needs a COVID test can get a test.”
Well, that’s not true.
Because I can tell you from first-hand experience, If I want to do a COVID test someone, it must first be approved by the state DOH.

And this is the case with thousands of other doctors in this country.
Why is this the case?
Because there are so many tests available.
Yes, there are more and more tests being made.
But there still are not enough.
You see, South Korea was prepared before the covid hit them.

When they saw the COVID outbreak start in December 2019 in Wuhan, they immediately got the RNA genetic code of the virus from China. A private company in South Korea started developing the PCR test before it even hit South Korea. That’s why they were able to test so many people so quickly. That also was why their case fatality rate was so low because they tested many people, not just the sickest people.

But the USA has had more than 2 months to prepare, but we were not prepared. And we do not have enough tests. There are 4 reasons for that.

1. Our current administration drastically reduced our public health infrastructure, and two years ago, the CDC stopped funding epidemic prevention activities in 39 countries, including China…. At that time, former CDC director Dr. Tom Frieden said the move "would significantly increase the chance an epidemic will spread without our knowledge and endanger lives in our country and around the world”…well, it looks like he nailed that prediction

2. There are so few tests is that there were malfunctions in the test kits, which lead to delays in manufacturing

3. About 5 weeks ago, we could have used the WHO’s test, but that was rejected for whatever reason

4. In the beginning, unlike South Korea, we did not have private companies making testing kits

But we can’t rewrite the past. So in the here and the now, we have to be selective in who we test moving forward.

The CDC says it’s the physician’s clinical judgment on who we test. But that’s only partially true, because like I said, I still need approval from the state Dept of Health to test someone. And this has already happened to me several times.

 And that is a common frustration among all of us doctors on the front lines.

The way most physicians are deciding on who to test falls into one of the following 4 scenarios:

If that person had a fever and/or lower respiratory tract symptoms such as cough and SOB, who have had any of the following in the prior 14 days:

1. Close contact with a confirmed or suspected Covid case, including in a health care setting. Close contact includes being within approximately six feet of a patient for a prolonged period of time.

2. Residence in or travel to hotspot areas, meaning widespread community transmission, has been reported (China, South Korea, Japan, Iran, and most of Europe [especially Italy]. This would especially mean NYC, the state of Washington, Colorado, California, and others within the US.

3. Potential exposure through attending events or spending time in specific settings reported covid cases.

4. Those with severe lower respiratory tract illness cannot be identified with an alternative diagnosis, even if there has been no clear exposure. This would include low oxygen levels, abnormal findings on CXR or CT scans of the lungs, or clinically unstable patients.

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Doctor Mike Hansen, MD
Internal Medicine | Pulmonary Disease | Critical Care Medicine

#covid #covid19 #pandemic

[DoctorMikeHansen]

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[jkim]

I'm an American living in S Korea. I see lots of comments everywhere that everyone needs to be tested (even regularly). Just want to tell you some sobering facts. Here in Korea where we lead the world in testing, we have tested a total of 287k so far as of Mar 17 (officially released figures from Korea CDC) around 12k to 15k per day. Impressive as it sounds this is still only 0.5% of Korea's 55m population. You have to realize just because you mass produce test kits does NOT equal overnight increase in results. Look at the logistics: testing sites have to be set up => testing kits have to be delivered => testing facitilies have to be staffed => staff have to learn correct protocols and safety procedures => staff has to wear personal protective equipement (PPE) => samples have to be shipped to labs => labs have to run the tests using complex and not readily available machines => and then you finally get the results. You see the logistical nightmare? If any part of this simple chain has a bottleneck as it is only natural as you set this complex infrastructre up = testing stops. It's not just about the test kits but you have to have the trained personnel, facility, logistical network, equipment, etc, etc.


It is truly remarkable in my view but little noticed is that S Korea has been able to roll this out over the last month and a half to run over 10k tests per day with less than 24hr turnaround to deliver the results to those tested. Btw, this has only been possible due to unseen countless sacrifices of our medical professionals, local and federal government including military to handle logistics/transport/disinfection, community volunteer work and general public support and donations and private sector doing their part to speed up the process. I'm not trying to brag about how good things are here as it is not perfect here either (S Korea has had its own set of obstacles despite recent hopeful news of cases slowing) but just trying to point out to those politicans that like to throw big numbers around (like million tests this week and 4 million next week) and so many ignorant and irresponsible comments on SNS that we need this and I need that and why can't we test everyone. Things don't magically appear just becuase you want it. This is not shopping on Amazon.


Although already a way too long a comment but two more things I want to say. Medical professionals in S Korea and all around the world like Dr Mike are the true heroes in this crisis and I am truly humbled by their dedication and sacrifice (also embrassed to have not realizing it during my frivolous daily life before). Two examples that touched my heart are stories of nurses and doctors who can't go to the bathroom for hours (6+ hour shifts) once they don on the PPE as it hinders safety protocols and wastes time re-equipping (also saves equipment as they are not reusable) and the numerous bandages worn on the forehead and nose of young nurses to cover marks and sores rising from hours of wearing protective masks and goggles. They call it "Badges of Honor". There is a famous photo by photojournalist Ed Jones of AFP which you can find online.


There is a lot of focus on testing recently as finding who has COVID-19 is extremely important especially in countries that are facing ramp up of the spread. Easily the key first step in tackling this crisis. But I think the US will soon find out that without the next steps of ISOLATING the infected (as every case cannot be hospitalized as we painfully found out in the early days when 2 paitents suddendly developed severe symptoms while waiting for a hospital bed and died on the way to the hospital. So Korea/China has emptied and set up hotels and resorts where the positive cases can be separated if they cannot be self-isolated in their homes to prevent infecting their families) and TESTING/QUARANTEEING every possible contact that the infected case may have come in contact with. It is worrying to see videos of recent confirmed cases in the West staying in their own home to recover with their families around.


Lastly, life here in Korea is now quite different then it was in Jan. Everyone is focusing on improving personal hygeine and wearing masks and consciously practicing social distancing wherever you go and also trying their best in their own way to help our their neighbors and this nation. As we are not in lockdown and Korea is not an authoritarian society, still there are plenty of selfish idiots here who goto church, clubs, protests, etc. that is endangering other, prolonging the crisis and extending the suffering especially of small businesses who have seen their livelihood plummet. Unfortunately for now, all we can do is just increase awareness and putting added social pressures on these fools to change and act more responsibily for the good of the many. Despite being infuriating there are surprising little legal means and penalties even than the US to stop them. We live in a very inter-connected global world now and I know myself as well as most Koreans understand that just by us winning the battle here will have little use unless we win the war globally. Although it was distrubing to see places like the US and UK badly fumble policies in the beginning of their respective outbreaks led by un-impressive politicans with things like "it will just disappear" and "herd immunity", hopefully we are seeing more positive actions going forward. And finally, really hope to see more empathy and unity in the world instead of our ugly greed and divisiveness. Hope everyone can do their part and stay safe and healthy.


Dr Mike, should you read this long rant I wrote, really appreciate your efforts in taking the time to provide quality and factual information in these difficult times. Thank you. I have learned a lot from your videos. Truly wish you good health while you face challenges on the frontlines on our behalf.

[DoctorMikeHansen]

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[BlackHatTy]

My sister is having symptoms. Today shes calling the Health Dept to see if she's eligible for the test, for approval. Dr. Mike is 100% right.

[mariaaastarr]

Hi doctor. I'm in Pittsburgh Pennsylvania and they're doing drive by testing today. 670 patients tested negative and 76 patients tested positive in Pennsylvania...thanks again for the information...✌💙🙏

[laurenhaber]

I don't see why we are still worrying about the tests... Assume most will contract the virus... The question we should be asking is how many ventilators/ breathing machines do we have for those who will need intensive care...

[whatadollslife]

we need to seriously ramp up production of ventilators /breathing machines PLEASE

[kamadogrove]

There are going to be plenty of tests. Yesterday the task force suggested that only the elderly with the symptoms or those with underlying condition and symptoms of fever and shortness of breath should get tested. Today the WHO strongly urged everyone with symptoms in every country to be tested. The problem as I see it, is that we don’t have enough masks and everything else we need to care for an influx, or should I say tsunami, of positives. We really need to be educating people how to care for themselves at home unless they’re critically ill. That’s what we we in the medical community need to be educating on. I just made a video on this today and should have it posted to my channel by tomorrow. Thanks for all you do Doc!

[maliequizhu]

Thanks Dr. Hansen for doing these helpful videos! 👍👍👍 Great jobs! 👏👏👏

[emilymilas]

Please keep in mind that a neg test only means your negative at that point in time, you still can aquire the illness later even the next day and having the neg test might let your guard down. I am a physician and also feel frustrated with the constraint of limited testing. Let's hope the dire predictions are wrong. Your videos are very helpful. SC MD

[matthewalbers]

Cleveland Clinic does their own on campus testing... They have a drive up window for testing...

[robertpercevil]

Yeah we should be asking questions of these doctors!!
why were you buying everything from China??? super cheap supplies and drugs. but you’re charging an arm and a leg for medical care??? Doctors are not prepared, neither are hospitals and all I hear is excuses!

[jeffreybrunken]

Please keep these coming. I’m a retired food safety professional of no use use to anyone, but I pass these along to Kid#3 who is an ER physician.

[susiethomas]

Thank goodness, we have two drive through testing facilities in Austin, TX now. The second one just opened today and is less than a mile from my house.

[ExecDefense]

Thanks Dr. Mike Hansen for such a professional and informative presentation without emotional embellishment! Our country needs m, ore of this approach! Thanks again.

[horsepanther]

Dr. Hansen, can you explain why the U.S. is not getting tests from the WHO now, since we have realized that it was a mistake to decline them previously? I don't understand why we're not doing that to ramp up our testing capacity.

[bostondan]

Same here, wasn't able to send out COVID-19 tests until a few days ago. We've yet to get results back. We have to be very selective on who we can test.

[DurrHunt]

"anyone who wants a test can get a test"
state: must follow strict criteria

[pold]

Hot damn it dude!!! You have been always spot on and honest!!! I suggest Donald Trump appoint you as the head of the cdc or something! Spot on and no bull shish! Thank you and god bless for all your hard work!!!

[marydoherty]

a friend of mine is a nurse at tameside hospital here in lacashire and she has told me they have been warned to keep their mouths shut about the true number of deaths at our hospital which she has told me is 10, not the 1 that has been reported!! she has also told me that they have been warned that even if they do have coronavirus they still have to go into work!!!! it beggers belief!!!! maybe that is why public health england have told frontline staff that under no circumstances will they be tested unless they present at A & E (accidant & emergancey department, our equivilant of the american ER) with critticle symptoms! she has also told me that a police officer has told her (unofficially ofcourse!) that our gov will announce a 6 week closeure of schools for the easter break instead of the 2 week normal holiday but i dont know how true that last bit is as it was second hand info from a police office, i have found this out as of today 16/03/2020