Texas has been slow to ramp up coronavirus testing. Here’s what you need to know
A shortage of coronavirus testing kits has left many Americans in the dark about their health and frustrated doctors who are unable to procure tests for a disease that has become a global pandemic.
The situation is no better in Texas, including Tarrant County. In fact, testing in Texas has ramped up more slowly than in several other states.
Here’s everything you need to know about testing problems and the steps you must take to get a test.
Why is testing important?
At the most basic level, people with symptoms need to be diagnosed so health care personnel can know how to best treat them.
In addition, testing allows public health experts to see which parts of the population are most affected and where resources should be allocated, said Dr. Diana Cervantes, epidemiology and biostatistics professor at UNT Health Science Center. In an ideal world, Cervantes said, everybody who wants to get a test could get one.
“It is definitely important to be able to get a general idea of the burden of the disease,” she said.
Larry Brilliant, an epidemiologist involved in the World Health Organization’s efforts to eradicate smallpox in the 1970s, told Wired that we should be doing random testing to find out where the virus really is.
Mass testing could also help Texas and the United States return to normal sooner, as it could help identify people who are immune or no longer infectious, he said.
“And we have a system that identifies them, either a concert wristband or a card with their photograph and some kind of a stamp on it,” Brilliant said. “Then, we can be comfortable sending our children back to school, because we know the teacher is not infectious.”
But widespread testing has not been available. The United States had tested about 110,000 people as of Friday morning; South Korea, which saw its first case around the same time and has a fraction of the U.S. population, had tested about 275,000.
Texas, the second most populous state in the nation, is behind many other states, according to estimates based on tests conducted in private and public health labs.
As of Friday morning, the Texas Department of Health Services estimated that 2,300 people had been tested by private or public health labs. In Minnesota, as of Thursday, that. number was about 3,000. In both states, it’s likely that more people have been tested by private labs, which do not always share data with state public health officials.
Michigan, New York, California, Massachusetts, Illinois, Washington and Florida had all also conducted more tests than Texas as of Friday morning, based on estimates of public and private testing.
Why are so few tests available?
The roll out of testing was slow for a few reasons.
In the early days of the outbreak, only the Centers for Disease Control and Prevention were allowed to produce testing kits. Academic labs with the same expertise and capability to produce tests could not get quick approval from the FDA.
Then, in February, there was a manufacturing problem with testing kits that the CDC was sending to state labs, leading to confusion and shortages (Much more has been written about the political and supply chain problems that contributed to the lack of testing in every state).
Dr. Anthony S. Fauci, one of the nation’s most prominent experts on infectious diseases, told Congress last week that the shortage of testing availability was a sign of the United States’ healthcare system failing.
“The idea of anybody getting it easily the way people in other countries are doing it, we are not set up for that. Do I think we should be? Yes. But we are not,” he said.
Who is eligible for a test in Texas and who decides?
Anyone with symptoms (dry cough, fever, shortness of breath) and a doctor’s approval is eligible to be tested. Doctors are responsible for diagnosing patients and recommending a test based on the severity of their symptoms, their medical histories and their potential for being part of a high-risk group.
A patient approved for testing by a doctor could get tested by a private lab, such as Quest Diagnostics, or by one of the state’s 10 public health labs, which provide free tests. The public health lab would have to approve the doctor’s request for the test.
“At the (public) health department they take that seriously. They want to listen to what the provider says,” Cervantes said. “That provider knows better than the department.”
Has Tarrant County had problems with supply or capabilities?
Tarrant County’s public health lab had tested 64 people as of Tuesday; private labs had likely tested many more. Officials have released these details at occasional news conferences but have not responded to the Star-Telegram’s requests to talk more about the latest testing data.
Local officials said last week that they had enough supply for testing 4,000 specimens and were seeking more from the federal government. (A doctor is likely to collect more than one specimen per person for a test; for instance, 164 specimens were used for the first 64 people tested in Tarrant County.)
But many Tarrant County resident have told the Star-Telegram they have been unable to get approved for testing, even when they had symptoms and had recently traveled abroad.
And a 33-year-old Fort Worth woman told WFAA that her doctor wanted to test her but that Tarrant County’s Public Health lab did not approve the request.
“They said I did have all of the symptoms of this virus, but at the time, and still — as far as I understand — there was such a shortage of tests that they weren’t allowed to test me. They called [the Tarrant County Health Department] and tried to get permission, but I just wasn’t critical enough, with my age and everything,” she said.
As of Tuesday, the Dallas County public health lab, which serves 4.2 million people across nine counties, had tested 109 people. The Tarrant County public health lab, which serves 3.8 million people across 32 counties, had tested 64.
Is the testing shortage going to get better?
That’s what officials are saying. Testing capabilities are expected to ramp up this week in Texas, with Gov. Greg Abbott saying the state would be able to perform 15,000 to 20,000 tests in a week. Texas’s testing capabilities were about 10 percent of that two weeks ago.
What should I do if I can’t get tested?
People with minor symptoms should not attempt to get tested at this point, Cervantes said.
“If you have a runny nose, the last thing you want to do is go to a clinic and maybe expose yourself to people who have a virus.”
The recommendations for people with minor symptoms who get tested and find out they have the coronavirus would likely be the same as for anyone who has minor symptoms: get plenty of rest and fluids, don’t share linens or food with others, keep track of the severity of your symptoms and keep your doctor in the loop.
What should I do if I think I need a test?
For now, the best action is to contact your primary care doctor, if you have one. The doctor will be able to tell you where and whether you need a test. Typically, you are eligible only if you have symptoms such as fever, cough or trouble breathing.
If you do have symptoms, you should stay home and away from others, according to the CDC.
Your doctor will determine whether you need a test and could help you get one from a public health department lab or through a private lab group such as Quest Diagnostics.
If you don’t have a doctor, you could go to an urgent care center (call ahead), or call 2-1-1 for assistance with finding a doctor or medical clinic, especially if you are uninsured.
If you are concerned about symptoms but not concerned enough to call a doctor, you can use this free online screening tool from Baylor Scott & White to help determine what to do.
This story was originally published March 20, 2020 at 2:27 PM.
