In other parts of the country, these priorities have also become the practice. “Health systems are reserving tests for the super sick” for fear of running out of tests, said Caesar Djavaherian, co-founder and medical director of Carbon Health Medical Group Inc., a California chain that provides primary care, urgent care and telehealth services.
At Carbon Health’s Oakland location, supplies are dwindling. A week ago, a patient with a fever and shortness of breath might have warranted a test. Today, he or she would be sent home and told to stay in touch, Djavaherian said. Carbon Health needs 200 or more tests per clinic each week to meet demand, but suppliers can’t handle orders that large, so the clinic is getting as few as 10 test kits at a time. A big shipment arrived Thursday, alleviating some concern, but Djavaherian says he’s still worried about keeping up with demand.
“We live and die by these shipments,” he said.
Widespread testing serves both the broader public as well as patient care, said William Schaffner, an infectious disease expert at Vanderbilt University. Early testing can improve monitoring, especially for those at risk such as older people or those with compromised immune systems, he said.
“When people present themselves for health care, it’s good to know what you’re dealing with, whether symptoms are severe or mild,” he said. “You can manage disease better and achieve far better infection control.”
There are signs of improvement. Ten days ago, physician Nick Stark was forced to self-quarantine after a colleague at San Francisco’s UCSF emergency department tested positive. He couldn’t return to work until he’d been tested, which took 5 days.
It turned out he was negative, but like many medical workers in his position, his absence put extra stress on an already over-taxed system.
The department still has too few tests to prioritize all but the sickest, but the supply of swabs and the reagent necessary to administer them is steadily increasing, Stark said. If he were exposed today, he’d likely be tested immediately. He’s optimistic that within a week, the hospital will be able to test patients with milder symptoms.
“This situation is constantly evolving,” he said. “It could change tomorrow.”