Their doctors think they have coronavirus. But without tests, they’re in a ‘no man’s land’
On March 14, Brian Summerlin drove to several gas stations in Tarrant County and surrounding areas for his job restocking inventories of food and drink. He woke up the next morning with a sore throat and a fever of 101 degrees. By the next day, three of his four children showed similar symptoms.
Doctors have told him he and his family have likely come down with the novel coronavirus. But neither he nor his children have been able to get tested. And without a positive test, his employer is not offering paid time off.
Summerlin faced a Catch 22: risk infecting others throughout Dallas-Fort Worth or sacrifice his income and follow his doctor’s instructions to stay home. He chose the latter and is now one week into an unpaid leave of absence he expects will last for at least another week.
“I go to 10 to 15 different (gas stations) every night. And every night I’ll see up to 150 employees. And every store serves hundreds of people. I can do that math,” he said. “On the other hand my lack of pay is really bad math. All because I can’t get a test. All because I can’t get a simple test, man.”
Summerlin’s difficult choice is reflective of many DFW residents who doctors think likely have coronavirus but have not been able to get tested because of a shortage of tests in Texas and across the nation.
Gov. Greg Abbott said during a town hall last week that testing is to identify and isolate people with COVID-19 to limit the virus’ spread, and that, “there’s no health care benefit to having the test run because there is no medication or medical treatment for the person who has COVID-19.”
But there are personal benefits to getting a test and personal costs to not receiving one. More than a dozen people have written to the Star-Telegram with concerns about testing, unaware of how to get one or told by doctors they couldn’t get one. They’ve made financial sacrifices, skipped work, sacrificed relationships, felt concerned about their children and faced the fear of not knowing what’s wrong with them.
After weeks of limitations, testing is only now beginning to ramp up. According to the Texas Department of State Health Services, Texas has tested more than 13,000 people as of Tuesday — about 8,000 of them since Friday — although that estimate does not include all private tests. Abbott has said as many as 15,000 to 20,000 Texans would soon be able to get tested weekly. And Dallas County started two drive-through locations last weekend, providing tests for people who have cough, shortness of breath and a fever of 99.6 degrees or higher.
But in the earliest days of the pandemic — when public health experts said it was most important to identify the severity of the problem and stop spread — Texas and the rest of the country didn’t have enough tests.
From an epidemiological standpoint, more testing means gaining a clearer picture of how many people are infected and which communities are most vulnerable. It allows doctors to better trace everyone who may have come into contact with infected people and enact more specified isolation measures.
“I would rather burn 100 negative tests for one positive test and have a complete picture than save money by skimping on tests,” said Benjamin Neuman, a renowned virologist and biology professor at Texas A&M-Texarkana.
Coronavirus was first detected in the U.S. in late January. Private labs at universities and elsewhere attempted to set up tests, but the FDA delayed them. The CDC, around the same time, sent test kits to states and local authorities with a faulty ingredient. The resulting shortage of tests led to high and often varying standards for who was able to receive a test. In early March, it was necessary to have traveled abroad from an affected area or to have come in contact with somebody else who tested positive. On March 13, Texas Department of State Health Services commissioner John Hellerstedt said anyone who had serious symptoms requiring hospitalization was eligible for testing.
People who had symptoms often found that wasn’t the case — even those working closely with vulnerable populations. Casey Nickens is 46, has asthma and stage two kidney disease and works in the health care industry with his husband, Troy Whitehead, 55. He began dealing with a sore throat and cough that quickly led to a 100-degree fever and shortness of breath.
He went to the Texas Health Harris Methodist Hospital’s ER on March 14, where his chest X-ray for pneumonia and test for strep throat both came back negative.
It was then the doctor pulled up a chair and told him, “‘Look, the way you’re presenting to me and with the risk factors you have, I feel really strongly that this is what’s going on, that you are probably COVID-19 positive.’ He said, ‘But my hands are tied. I can’t test you,’” Newton recounted the doctor saying.
The shortage of testing has caused relationship difficulties for Judy, a 73-year-old Fort Worth woman with chronic health issues. Her partner recently attended a family reunion in Florida and also works in the health care industry. Given her partner’s travel and work around potentially infected people, Judy would like an assurance that she has not contracted coronavirus. Because testing is not readily available she has asked her partner to live separately from her for the time being.
“If she could be tested, then we could work something out,” said Judy, who asked to use her first name because of her occupation and community involvement. Instead, they’ve been interacting from afar. “We’ve seen each other but we haven’t been close to each other or touched or anything since she’s been back. It’s me taking things and putting them on the porch so she can come by and get them.”
Summerlin will be out $3,200 if he ends up missing two weeks of work. He also fears he’ll have to pay a hefty bill for treatment for his 16-year-old daughter. The staff at Baylor Scott & White Emergency Hospital in Burleson recommended she get a coronavirus test from Cook Children’s Medical Center in Fort Worth. She was suffering from a 103-degree fever, and flu and strep tests came back negative. But she was not tested for coronavirus, Summerlin said. Although Congress passed legislation making coronavirus testing and any doctor’s room or ER visits to get testing free, the limits of the coverage are unclear, especially if no test is administered.
Reflecting on the relatively low number of cases verified in Tarrant County — 71 as of Tuesday — Summerlin said, “I probably got six in my house right now.”
If hospitalization isn’t medically necessary, the appropriate treatment for most people who have coronavirus is isolation at home, the CDC recommends. And the state has been working on increasing the capacity of beds, whether that be establishing medical tents, reinstating recently vacated healthcare facilities or securing hotel rooms for people who cannot easily isolate around their families, Abbott has said.
The potential of hotel rooms for isolation and the predicted increase in Texas testing this week is no consolation for Summerlin because he needed a positive test to get paid time off a week ago. “I’m sure they’ll eventually figure out what the hell they’re doing,” Summerlin said. “But I’m not going to test positive (by then).”
Since Nickens first went to the ER, Whitehead said he has also developed a dry cough, although they didn’t have fevers as of Tuesday.
“It came to a point we just got exhausted with it all because we had looked at so many avenues, for our own mental health, we just had to shut it down,” Whitehouse said of trying to get tested.
Nickens and Whitehead said they feel grateful for their doctors who advised them to stay home, for their own health care backgrounds that help them know what symptoms to look for, for their jobs that continue to pay them during their quarantine and for the friends who have dropped off homemade tortilla soup or tracked down the Tillamook Oregon strawberry ice cream Nickens asked for.
They also want to get back to work, and a negative test would give them the peace of mind that they won’t be putting their coworkers or patients at risk. Without adequate testing, that’s something they can’t do.
“So I don’t have that test to say, ‘Yes you have it.’ So once you’re done with quarantine, once you get over this illness, you will have developed antibodies to it, you won’t get reinfected,” Nickens said. “It’s a really kind of no man’s land that they’re putting people in.”
This story was originally published March 25, 2020 at 6:00 AM.
