NJ COVID-19 Testing rant: a sick joke, unfit for purpose

One might suppose the COVID-19 test is being offered to answer two questions:

1) From a public health perspective, who is currently infected with the SARS-CoV-2 virus?

2) From an individual perspective, is a person who has been shown to be ill with COVID-19 currently infectious?

3) From an individual perspective, are the symptoms being experienced by a person caused by COVID-19?

The facts on the ground make it clear that these are NOT the purpose of the public testing now available. 

Far too few tests are being run to serve the public health purpose. Beyond the issue of limited supplies, the screening criteria being used to reject people at the test site mean that many, many people with active SARS-CoV-2 infections will be refused testing. 

The test cannot be used to meet the CDC requirements to show that a person with confirmed or suspected COVID-19 can return to work, because people meeting CDC criteria for recovery will be refused a test.

The test may be useful to those individuals wondering if their symptoms are caused by COVID-19 if they are sick enough to meet screening criteria at the test site but not so sick that they can't bear a three hour wait in a line of cars in the middle of the night, or so sick that they don't need immediate medical care. From what we already know about the disease. This makes no sense.

So what is the point? It seems a theatrical, palliative gesture aimed at defusing the anger of New Jersey residents who are realizing how deeply they have been let down by government at the federal, state and county level. If there is another function of this, I would love to hear what it is and how it's supposed to work with this lousy implementation.

It's not good enough. 

The successful efforts by other countries with competent leadership make it clear what is needed: test every suspected case, trace every contact, isolate every case, quarantine and test every contact. 

Since we are NOT doing that, we can expect the infection rates to be high and the resulting deaths to be high the infection and fatality estimates we have seen are likely to be highly optimistic, given the extreme inadequacy of the response so far. 

It's infuriating. Governor Cuomo seems far more effective in trying to correct early errors than Governor Murphy. We need more tests, more protective equipment and decisive action to limit the impact of hoarding and panic buying. 

The "test" centers:

https://covid19.nj.gov/search.html?query=Testing+Centers+in+NJ

CDC guidance:

https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html


I think that they are ramping up.  Also, under current CDC guidelines, one may be released from isolation without further testing if at least three days have passed since the end of fever (without the use of medication) and if there was an improvement of respiratory symptoms and if at least seven days passage since the first appearance of symptoms. 

I think that it is crazy as this does not indicate whether or not the person is still contagious, but that is one of the current CDC standards.


so you are really sick, you need to line up at a testing site before it opens and sit and wait for hours to be tested....makes a lot of sense.  a couple sites are saying appointment only.

with my pre existing health issues i CAN'T get there at 7am and sit for hours.  I can't be away from home for more than a couple hours under normal circumstances...


and I have to wonder with most people testing negative...did they need to be tested in the 1st place?  could there be that many people with fevers or other illnesses?  are are most people being tested just exaggerating 'symptoms' to get tested?  an oxford study said its possible half the UK has already been infected and recovered...and just had such mild symptoms, didn't notice they were sick...it may be that people hospitalized/died a couple months ago where thought to just have 'usual' pneumonia. 


Do not get me started.  Testing in this country is a ******* joke, and the joke is on us 


jmitw said:

so you are really sick, you need to line up at a testing site before it opens and sit and wait for hours to be tested....makes a lot of sense.  a couple sites are saying appointment only.

with my pre existing health issues i CAN'T get there at 7am and sit for hours.  I can't be away from home for more than a couple hours under normal circumstances...

 7 am is too late. They are already closed for the day, a big digital display tells you as you approach. I tried 6:30 on Monday, too late. I tried 5:45 on Tuesday, too late, though that time I was able to line up thinking I was in, only to have the police PA tell me that by my space in the line, they were done for the day and everyone back there had to leave. 

Down at the PNC Arts Center they close off the whole exit with cones and park a salt spreader across the ramp to confirm the message. Digital displays over the parkway tell you they are closed but will open again at 8 am, somehow galling when you read it at 7 am and realize they mean 8 am the next damn day, which probably really means 5 am or 4 am.


they need to block all access until 15 minutes before opening..and publicize you can't even get in line...ridiculous to have sick people sitting there for hours.


New Essex County test facility opening soon. Sign up for appointment at

https://essexcovid.org/

You answer a basic questionaire and they will review and get back to you.

Hoping this is better.


I’m pretty sure the Essex County testing site is only for those with fever and shortness of breath.  So many people who have it, and are contagious, won’t be allowed to get tested there 


It’s a crap show for sure. Spon-did you see that CVS is working on a drive through testing option focused on health care workers,,,not immediate, but it’s the right idea.


spontaneous said:

I’m pretty sure the Essex County testing site is only for those with fever and shortness of breath.  So many people who have it, and are contagious, won’t be allowed to get tested there 

 People can lie...


I don't think these other countries have it together as much as we may think.  I noticed that Greta Thunberg mentioned she thought she had Covid-19, as she has all the symptoms. However, she also mentioned that she hasn't been tested because Sweden only tests those who require hospitalization.   


A good plan now is preferable to a perfect plan later.

TomR


just blast the heat in your car while waiting....blowing at your head...and you have a 'fever'...claim shortness of breath, fake a few coughs...and you get tested.  it is actually even possible to get a fever from stress and anxiety......


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spontaneous said:

Do not get me started.  Testing in this country is a ******* joke, and the joke is on us 

 


My spouse got tested TEN days ago from Quest. Still no results!!!!!!!!!!!!!!1


Lots of changes, new sites coming online, new procedures at existing sites. Net result, nothing has changed. 

Test are prioritized for those who match a profile they already know is not representative of many infected people.

Tiny number of tests are available at each location. 

They want to encourage you not to even bother with testing unless you need medical care in a hospital. 

They advise you to call your doctor if you have stronger symptoms that don't require breathing support at a hospital, but your doctor is likely to tell you to call the hotline that tells you to look at the website that tells you about this testing sham. 

They are still reporting "confirmed cases" in New Jersey, Essex County, Maplewood and South Orange as if those numbers meant something, although they know full well their confirmation process is garbage. 

I can't find words to adequately express my frustration with the situation.


This new test developed by Abbott will be available next week and hopefully will be available in N.J. at doctors' offices so that people don't have to go through the horrendous experience of Adam_West and many other N.J. residents.  This was tweeted last night at 8:00 PM.  

"This is GAME CHANGER. Abbott to market, starting next week, a fast point-of-care #coronavirus test, delivering positive results in 5min and negative results in 13min. Will deliver 50K tests/day to start. Kudos to Abbott and FDA’s Jeff Shuren and team at CDRH who are in the fight."

https://twitter.com/ScottGottliebMD/status/1243696001958981632


From Abbott's press release: 

ABBOTT PARK, Ill., March 27, 2020 /PRNewswire/ -- Abbott (NYSE: ABT) announced today that the U.S. Food and Drug Administration (FDA) has issued Emergency Use Authorization (EUA) for the fastest available molecular point-of-care test for the detection of novel coronavirus (COVID-19), delivering positive results in as little as five minutes and negative results in 13 minutes. The test will run on the company's ID NOW platform, providing rapid results in a wide range of healthcare settings such as physicians' offices, urgent care clinics and hospital emergency departments.

https://abbott.mediaroom.com/2020-03-27-Abbott-Launches-Molecular-Point-of-Care-Test-to-Detect-Novel-Coronavirus-in-as-Little-as-Five-Minutes


terp said:

I don't think these other countries have it together as much as we may think.  I noticed that Greta Thunberg mentioned she thought she had Covid-19, as she has all the symptoms. However, she also mentioned that she hasn't been tested because Sweden only tests those who require hospitalization.   

Ahem


cramer said:

This new test developed by Abbott will be available next week and hopefully will be available in N.J. at doctors' offices so that people don't have to go through the horrendous experience of Adam_West and many other N.J. residents.  This was tweeted last night at 8:00 PM. 

I don't think doctors will be happy to have possibly infected patients clogging their waiting rooms, mixed with non-infected or immune compromised patients, such as diabetes.

It would be better to have separate segregated testing areas as we see some hospitals have or car lane places like at PNC. 


doctors can come out to the cars to do the test...just like the drive thru places.


jmitw said:

doctors can come out to the cars to do the test...just like the drive thru places.

You ever see how busy a doctor is caring for patients?

You expect them to scrub up in protective gear and leave their office to go to your car? Do you then expect them to remove their possibly infected gear so they can reenter the office? Not practical.


Update: Just got an email with a test date for the Essex county site for the end of next week.

Symptoms seem to be improving a bit every day, so it may not be needed, but I am pleasantly surprised to have gotten a test date at all. 


BG9 said:

You ever see how busy a doctor is caring for patients?

You expect them to scrub up in protective gear and leave their office to go to your car? Do you then expect them to remove their possibly infected gear so they can reenter the office? Not practical.

 Do physicians not scrub up and don protective gear between in office visits? If so, what would be the difference between doing so for inside vs outside?


To the first question:  No


My cousin is a doctor in RI. He said the big problem is the lack of testing. They have to assume everybody coming in is positive and so it causes them to go through more PPE than would be needed if they were able to do tests. He said he is at least 60% likely to get it, because he won't have the appropriate equipment when he has to intubate somebody. 



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