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Coronavirus Testing Offered With Just a Doctor’s Approval, C.D.C. Says Coronavirus Testing Offered With Just a Doctor’s Approval, C.D.C. Says
(about 13 hours later)
Federal health officials announced on Wednesday that anyone who wants a coronavirus test may get one if a doctor agrees. But the nation’s testing capacity is still so limited that experts feared clinics and hospitals could be overwhelmed by an avalanche of requests.Federal health officials announced on Wednesday that anyone who wants a coronavirus test may get one if a doctor agrees. But the nation’s testing capacity is still so limited that experts feared clinics and hospitals could be overwhelmed by an avalanche of requests.
Under the new criteria, patients who have fevers, coughs or difficulty breathing qualify for diagnostic testing, depending on their doctor’s judgment. But with flu season in full swing, tens of millions of Americans already have respiratory symptoms, and doctors have no quick way to discern who should be tested.Under the new criteria, patients who have fevers, coughs or difficulty breathing qualify for diagnostic testing, depending on their doctor’s judgment. But with flu season in full swing, tens of millions of Americans already have respiratory symptoms, and doctors have no quick way to discern who should be tested.
The Trump administration has repeatedly promised to expand the nation’s testing capabilities by Friday, even as state laboratories estimated that it would be weeks before millions of American could be tested.The Trump administration has repeatedly promised to expand the nation’s testing capabilities by Friday, even as state laboratories estimated that it would be weeks before millions of American could be tested.
“We are already overwhelmed with calls day and night,” said Dr. Julie Vaishampayan, public health officer of Stanislaus County in Modesto, Calif. Public health laboratories in California are already working seven days a week, she said.“We are already overwhelmed with calls day and night,” said Dr. Julie Vaishampayan, public health officer of Stanislaus County in Modesto, Calif. Public health laboratories in California are already working seven days a week, she said.
Even as federal officials were announcing the new testing criteria, the House and the Senate agreed to provide $8.3 billion to combat the spread of the coronavirus. By the end of the day, the death toll in the United States had risen to 11 and the number of confirmed cases to 157.Even as federal officials were announcing the new testing criteria, the House and the Senate agreed to provide $8.3 billion to combat the spread of the coronavirus. By the end of the day, the death toll in the United States had risen to 11 and the number of confirmed cases to 157.
Ten deaths have occurred in the Seattle area, which is emerging as an epicenter, and on Wednesday night, Facebook announced that a contractor there had tested positive.Ten deaths have occurred in the Seattle area, which is emerging as an epicenter, and on Wednesday night, Facebook announced that a contractor there had tested positive.
California reported its first death from the infection on Wednesday. The victim was identified as a former passenger on the Grand Princess cruise ship, which was being held in the waters off San Francisco after 11 passengers and 10 crew members showed symptoms of the infection.California reported its first death from the infection on Wednesday. The victim was identified as a former passenger on the Grand Princess cruise ship, which was being held in the waters off San Francisco after 11 passengers and 10 crew members showed symptoms of the infection.
Six new cases were also reported in the Los Angeles area, and Gov. Gavin Newsom declared a state of emergency. In all, more than 50 cases have been identified in California, the most in the nation.Six new cases were also reported in the Los Angeles area, and Gov. Gavin Newsom declared a state of emergency. In all, more than 50 cases have been identified in California, the most in the nation.
In the new guidance from the Centers for Disease Control and Prevention, doctors were encouraged to rule out other causes of respiratory illness and to take into consideration whether there are other local coronavirus cases before ordering a test.In the new guidance from the Centers for Disease Control and Prevention, doctors were encouraged to rule out other causes of respiratory illness and to take into consideration whether there are other local coronavirus cases before ordering a test.
Health care workers who had close contact with a known coronavirus patient within 14 days of developing symptoms — as well as anyone who traveled recently to China, Iran, Italy, Japan or South Korea — might also be candidates for testing.Health care workers who had close contact with a known coronavirus patient within 14 days of developing symptoms — as well as anyone who traveled recently to China, Iran, Italy, Japan or South Korea — might also be candidates for testing.
The C.D.C.’s new criteria essentially relegate the decision to test to individual physicians who have little experience with, and scant scientific evidence about, coronavirus. Doctors cannot perform the tests themselves and must refer patients to state or local laboratories.The C.D.C.’s new criteria essentially relegate the decision to test to individual physicians who have little experience with, and scant scientific evidence about, coronavirus. Doctors cannot perform the tests themselves and must refer patients to state or local laboratories.
“You need some sort of framework within which to work,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University. “Not every patient who walks into the doctor’s office with a cough needs to be tested.”“You need some sort of framework within which to work,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University. “Not every patient who walks into the doctor’s office with a cough needs to be tested.”
Vice President Mike Pence said on Wednesday that “all laboratories at the state level can conduct coronavirus tests without any additional assets or resources from the federal government.”Vice President Mike Pence said on Wednesday that “all laboratories at the state level can conduct coronavirus tests without any additional assets or resources from the federal government.”
Some 2,500 testing kits “are going out this week,” capable of testing 1.5 million patients, he said.Some 2,500 testing kits “are going out this week,” capable of testing 1.5 million patients, he said.
But a surge in coronavirus testing by people who have no real need may divert resources from seriously ill patients whose diagnosis is unknown, experts said. When the diagnosis is uncertain, it is difficult to know how to use limited protective gear appropriately or whether to isolate the patient.But a surge in coronavirus testing by people who have no real need may divert resources from seriously ill patients whose diagnosis is unknown, experts said. When the diagnosis is uncertain, it is difficult to know how to use limited protective gear appropriately or whether to isolate the patient.
The nation’s testing capacity is being expanded, now that private labs and companies are being allowed to make their own tests. But the process has only begun, and it will take time to ramp up the production of new testing kits.The nation’s testing capacity is being expanded, now that private labs and companies are being allowed to make their own tests. But the process has only begun, and it will take time to ramp up the production of new testing kits.
The C.D.C. distributed its own diagnostic test kits to state and local health departments last month, but they turned out to be flawed, producing sometimes inconclusive results. The C.D.C. offered partial replacements, but on Saturday the Trump administration announced that commercial and academic institutions would be permitted to make their own.The C.D.C. distributed its own diagnostic test kits to state and local health departments last month, but they turned out to be flawed, producing sometimes inconclusive results. The C.D.C. offered partial replacements, but on Saturday the Trump administration announced that commercial and academic institutions would be permitted to make their own.
Many public health laboratories say they still have not received diagnostic kits, or are in the process of running checks to ensure they are working properly. Laboratories around the country are still not ready to test large numbers of samples.Many public health laboratories say they still have not received diagnostic kits, or are in the process of running checks to ensure they are working properly. Laboratories around the country are still not ready to test large numbers of samples.
Once they are operating, the labs can process only about 100 tests per day.Once they are operating, the labs can process only about 100 tests per day.
Officials with the Association of Public Health Laboratories said this week that member laboratories eventually would be able to conduct about 10,000 tests a day. On Tuesday, 54 labs were running at full capacity; another 46 are expected to be up running by Saturday.Officials with the Association of Public Health Laboratories said this week that member laboratories eventually would be able to conduct about 10,000 tests a day. On Tuesday, 54 labs were running at full capacity; another 46 are expected to be up running by Saturday.
Updated June 16, 2020Updated June 16, 2020
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Commercial tests — such as those developed by companies like Cepheid, Hologic and Qiagen — are expected to greatly increase capacity, but representatives for those companies said they were weeks away from approval by the Food and Drug Administration.Commercial tests — such as those developed by companies like Cepheid, Hologic and Qiagen — are expected to greatly increase capacity, but representatives for those companies said they were weeks away from approval by the Food and Drug Administration.
Hologic has said that once its tests are available, labs could run about 1,000 tests per day, but only if the labs did not also run other tests for other viruses, like the flu or H.I.V.Hologic has said that once its tests are available, labs could run about 1,000 tests per day, but only if the labs did not also run other tests for other viruses, like the flu or H.I.V.
“They’re not going to be able to test everyone, and if we let everyone through for testing, the people who really need it won’t be able to get it,” said Dr. Vaishampayan, the health official in California. “We can’t do that for the whole state,” where there are 40 million people.“They’re not going to be able to test everyone, and if we let everyone through for testing, the people who really need it won’t be able to get it,” said Dr. Vaishampayan, the health official in California. “We can’t do that for the whole state,” where there are 40 million people.
“There has to be some sort of prioritization,” she added.“There has to be some sort of prioritization,” she added.
As a general rule, screening for infectious diseases requires some sort of winnowing of potential candidates, experts said.As a general rule, screening for infectious diseases requires some sort of winnowing of potential candidates, experts said.
Priority should be given to people who are involved in an investigation of an outbreak — as well as their contacts, and exposed health care workers — and to symptomatic people who have returned from trips to affected regions, Dr. Schaffner said.Priority should be given to people who are involved in an investigation of an outbreak — as well as their contacts, and exposed health care workers — and to symptomatic people who have returned from trips to affected regions, Dr. Schaffner said.
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People with symptoms who are at high risk for complications and severe illness because of underlying health conditions — such as Type 2 diabetes, heart disease and lung disease — should receive priority, as well as individuals who are older and frail.People with symptoms who are at high risk for complications and severe illness because of underlying health conditions — such as Type 2 diabetes, heart disease and lung disease — should receive priority, as well as individuals who are older and frail.
Flu also should be ruled out before coronavirus testing is considered, Dr. Schaffner suggested.Flu also should be ruled out before coronavirus testing is considered, Dr. Schaffner suggested.
Until last week, the C.D.C. refused to test patients for the novel coronavirus if they had not been to China recently or had contact with a known, identified patient.Until last week, the C.D.C. refused to test patients for the novel coronavirus if they had not been to China recently or had contact with a known, identified patient.
But a severely ill hospital patient in Sacramento waited days to get a coronavirus test approved, and then days more to get the test processed at C.D.C. laboratories in Atlanta.But a severely ill hospital patient in Sacramento waited days to get a coronavirus test approved, and then days more to get the test processed at C.D.C. laboratories in Atlanta.
Following mounting criticism, the agency’s diagnostic criteria were slightly loosened to allow testing of certain hospitalized patients who did not have a clear exposure to the coronavirus and to include four additional countries where the virus has taken root.Following mounting criticism, the agency’s diagnostic criteria were slightly loosened to allow testing of certain hospitalized patients who did not have a clear exposure to the coronavirus and to include four additional countries where the virus has taken root.