Being tested for the novel coronavirus at the center of a worldwide pandemic is no given in Iowa. However, local officials say there have been people tested locally and those tests have been negative.
As of Monday afternoon, there are no COVID-19 cases confirmed in Appanoose County. (Officials did announce positive results in Ottumwa and Kirksville, Missouri.)
News left some Daily Iowegian readers wondering if the lack of results in Appanoose County were simply because people aren't being tested.
Kris Laurson, the administrator of the Appanoose County Public Health Department, said that's not the case. While the testing is limited based on a framework from the Iowa Department of Public Health and guidance from the Centers for Disease Control, there have been tests locally and so far they've come back negative.
"The hospital has sent tests to the State Hygienic Laboratory for testing," Laurson said in response to a Daily Iowegian inquiry. "... We do not have a local laboratory that can perform the test to verify if someone has COVID-19. Here in Appanoose County we can, and have, collected the swab that gets sent to the State Hygienic Laboratory or a private lab that are equipped to perform tests."
Guidelines that were last updated on March 19 amidst the rapidly-changing environment within the COVID-19 worldwide pandemic outline who gets tested and when.
According to guidelines, the following individuals will be tested:
— All hospitalized patients with fever, respiratory failure and no alternate diagnosis will be tested,
— adults older than 60 years old with fever, respiratory symptoms and chronic medical conditions,
— people with fever or respiratory illness who live in a congregate setting (such as long-term care facilities, etc.),
— and people with fever or respiratory illness that work in essential services like emergency responders and healthcare providers.
The guidance specifically points out that healthcare professionals should only send "specimens from patients meeting the testing criteria above" to a lab for testing.
The swabs to perform the test are the same medical professionals already used to perform tests for other illnesses like Influenza A. Laurson said local clinics and hospitals are in a good supply of those currently.
More limited, however, are the kits used by laboratories that test the swabs to determine whether the patient is positive for COVID-19. While the number of tests that can be performed are rising, some think the state's testing abilities are too limited and that has skewed the low number of positive tests.
“The only way to get through it without testing is to keep the entire country quarantined for the next 18 months” said Dr. Ashish Jha, a Harvard University global health professor. “That obviously is untenable.”
Jha and his colleagues say the U.S. should be screening 100,000 to 150,000 people per day. The current rate is roughly 20,000 per day, he estimates, though it is accelerating as larger commercial companies ramp up testing.
Testing has three components: the kits themselves, re-agents and swabs, Sarah Reisetter, deputy director of the Iowa Department of Public Health, said Friday.
As capacity expands, more Iowans will eventually be allowed to be tested.
"Because we do have a limited number of tests available, it's really important that those tests be available for people who are hospitalized, for our essential workers like our healthcare workforce [and] our law enforcement officers," Reisetter said.
Those with minor illnesses should stay home until symptoms decrease, or no fewer than seven days from the onset of the illness, Reisetter said, and at least three fever-free days.
"These community mitigation strategies, they work if everybody adheres to them," Reisetter said. "That's what we're trying to do to limit the community spread of the virus."
Additional questions should be directed to an individual's primary care physician or the state's hotline at 211. Public health officials ask that those who feel they are ill to follow those two routes and not show up unannounced to a hospital or doctor's office.
The state's hygienic laboratory had resources to test about 600 Iowans as of Friday afternoon, Gov. Kim Reynolds said. Tests can also be sent to national laboratories.
Dr. Ryan Arnevik, chief of staff at MercyOne Centerville Medical Center, said doctors aren't seeing severely ill patients locally, but he's confident the tests will be available if that changes.
"It is well known that not as many test kits are as available as we would like," Arnevik said. "However, test kits are prioritized to the areas with the greatest need. Thankfully, at least locally at this time, we are not seeing severely ill individuals but if that changes in the future, I’m confident we will receive additional test kits."
The Associated Press contributed to this report.