The coronavirus, the congressman and me

I got the COVID-19 text at 8:30 Tuesday night, three days after returning from a journalism conference in New Orleans.

"At least one NICAR attendee has tested positive for coronavirus," wrote my colleague Liz Lucas. Several of us had attended the data journalism conference, which draws reporters and editors from across the country.

What do you do when you think you might have been exposed to a virus that is shutting down countries? As health care journalists, we are - in theory — uniquely equipped to know. But in real life, figuring out if we are at risk and getting tested is nearly impossible. It turns out that both medical advice and access to tests vary dramatically depending on where you live and who you are. And it isn't immediately clear what the standard is.

I looked at my own experience, that of my colleagues and that of some other, higher-profile figures in Washington, D.C. There was Rep. Matt Gaetz, a Florida Republican who was exposed to an infected person at the Conservative Political Action Conference and who later flew on Air Force One.

All of us - Gaetz and four KHN staffers — had the same problem. We showed no symptoms but were exposed to some level of the novel coronavirus that causes COVID-19.

Gaetz, a big supporter of President Donald Trump’s, was the only one of this group tested. It didn't seem he faced much of a runaround. (Nor for that matter did Senator Lindsey Graham or Rep. Mark Meadows, neither of whom showed symptoms.) Gaetz got back a negative result. Gaetz's office didn't respond to my questions about why he could get a test when many average Americans can't.

Indeed, for the rest of us, it hasn't been so easy. We haven't been able to find out if we're infected, or, for that matter, what we should do.

The KHN team was told by editors to work from home. I texted the friends I had seen Sunday for dinner, warning them of my possible exposure. All of us are younger than 30, which further mitigates our risk of complications from the virus. But, if infected, we would be at risk of passing on the virus to our families and co-workers. When those friends told their employers, two were instructed to self-quarantine. Others are going about their lives as usual.

Initially, none of us had experienced any symptoms associated with the virus: fever, dry cough, fatigue, body aches. (In fact, I had gone both running and rock climbing in the days between NICAR and the fateful text message.) Research suggests that if you are going to experience symptoms, they would probably appear within four or five days. It's been six days.

My circumstances felt muddled. So I decided I should try to get tested, as Gaetz did. After all, Trump promised tests would be available for anyone who wants one. (It’s not true.)

Cases like mine - in which there's some risk of exposure, but not a ton, and there are no symptoms — pose a particular conundrum. Generally, the medical guideline is that, given the shortage of test kits, you shouldn't test someone who is asymptomatic.

I have generous insurance. But, like almost half of my peers (adults under 30), I don't have a primary care doctor - so navigating the system poses its own obstacles.

I do have a gynecologist whom I regularly see, so I called that office. Since it was before office hours, the on-call doctor told me he didn't have the expertise to recommend a test either way. I could try getting a primary care doctor to see me, but that would take days. He suggested I visit an urgent care facility.

The others affected at Kaiser Health News got similar non-answers. Co-worker Victoria Knight called the coronavirus advisory line through her insurance provider, Kaiser Permanente. She was directed to an automated reply.

"Due to increased general concerns around coronavirus, we are experiencing higher-than-normal call volume. If you currently do not have any symptoms, we encourage you to use our automated appointment system," it said. The message added that Kaiser Permanente is not testing people who are asymptomatic. (KHN is not affiliated with Kaiser Permanente.)

My colleague Lucas, who is based in Missouri, called her primary care doctor. She was told that if she develops symptoms, she should go to the emergency room and then get a test. (Going to the emergency room for a test is not recommended by most public health officials.) She also called city, county and state health departments, and no one she spoke with could immediately offer guidance on whether she should self-quarantine. One person at the state level didn't immediately know what she meant by "self-quarantine" and said they would look into it.

Another potentially exposed colleague, out in California, is now showing some symptoms. She got fairly responsive help from county health officials — but had to wait until Thursday for a coronavirus test.

Since D.C.'s coronavirus advisory says you should "call your health care provider before visiting," I phoned a local urgent care clinic. A staff member suggested I come in for screening so medical professionals could tell me if I qualified for a test. I couldn't be screened over the phone but was advised to check the back of my insurance card for a nurse hotline number. I found no such number. The card did suggest an urgent care visit would require a $40 copay.

My last bet: I called D.C.'s health department. When I explained my situation — mentioning I had no symptoms - they also told me I should go to the urgent care center and see if I qualified for a screening. The phone call lasted less than a minute.

In the midst of all this, my parents and friends had urged me not to go to urgent care — where, they worried, the risk of contracting an infection might be heightened and the odds of qualifying for a test appeared slim.

So, defeated, I put down the phone, mail-ordered more cleaning solution and walked over to the sink. I started humming the first 30 seconds of "Call Me Maybe" as I - per all the best public health advice — once again washed my hands.

Kaiser Health NewsThis article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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