What’s the point of testing people who are not sick enough to be hospitalized?

[Florence NightinFAIL, BSN, RN]

After all, they are just sent back home to quarantine and rest anyway. That’s such a waste of a test. Everyone is already being told what kind of distancing and precautions to take. I feel like those tests are wasted of either asymptomatic individuals or individuals who are sick but are not sick enough to be hospitalized.

If they stopped doing those wasteful tests, then maybe those who really need it, like healthcare workers would be able to get them.

Am I missing something here?

[eerrmm]

Essential staff at pharmacies, grocery stores, Home Depot, mail carriers bla bla bla.. are all out there working every day potentially infecting other people because they have no idea that they're infected. It'd be very useful to know who to send home so they aren't unknowingly increasing the caseload for healthcare workers.

[Allison Applegate]

My boyfriend has mild symptoms (cough, fever, body aches). I am glad he was able to be tested. I work in geriatrics (home health). I need to know he is negative before I see my patients, because if he's positive and I've been in direct contact with him, I could transmit to my patients.

My work is saying for me to come to work anyways, but I think I'm going to refuse to work until he gets his results, for the safety of my patients.

[Wuzzie]

Data. It helps track burgeoning hot spots, allows for notification of people who were potentially exposed so they can quarantine and hopefully keep the curve flat. Wish we were testing everybody.

[Texasmama72]

So we don't spread it?

[mjjg]

I completely disagree. The countries that have done the best dealing with this such as South Korea and Germany are the ones that have rolled out mass testing. Read about Germany – while they have a lot of cases, their death rate is extremely low compared to most other countries. There are a lot of factors but probably the single biggest is that they have tested so many people. You can’t contain a problem if you don’t understand the magnitude of it.

[Alnitak7]

One reason I can think of is that they're looking for people that might have antibodies that don't know it and could give plasma. Another reason is that they might be contagious and not know it and need to isolate.

[moriahcat]

My (not-nurse) guess for a reason to get sick-but-not-hospitalized-yet people tested is mainly based on looking at the course of the disease in the WA pt who was hospitalized primarily for isolation purposes -- was written up in the NEJW.

Mainly, that there is a lingering period of illness that isn't quite so bad, and then people may either get well (yay!), or get far worse. In that guy's case, he wasn't "sick enough" to be hospitalized under normal guidelines at first, but he deteriorated fast when he did get "hospital-sick" vs fever/flu-like symptoms.

Then we have had multiple case reports now of COVID-19 positive pts dying at home -- the mammogram tech in GA whose sister said she'd "felt flu symptoms" for about a week, the WM worker who'd been feeling ill but not ill enough to be hospitalized who was found dead. Clearly this can progress to respiratory arrest in an unpredictable manner.

If we had enough tests/labs/reagents, I'd think testing the "sick but not that sick" would be important so they knew (even if they were being sent home) what to self-monitor for to prevent unattended unnecessary preventable death and that yes it could happen to them, and also so if they did have a return appearance in far worse shape, those responding in such an emergent setting would know the patient's COVID-19 status.

I would definitely be putting the hospitalized pts at the first in the queue testing-wise, though, because knowing their status is more important. If it takes 3-4 days to get around to the "not that sick" person's test, well, that may be the turnaround for both the lab test and the patient's return should things take a turn for the worse.

[toomuchbaloney]

On 4/6/2020 at 2:57 PM, Florence NightinFAIL said:

After all, they are just sent back home to quarantine and rest anyway. That’s such a waste of a test. Everyone is already being told what kind of distancing and precautions to take. I feel like those tests are wasted of either asymptomatic individuals or individuals who are sick but are not sick enough to be hospitalized.

If they stopped doing those wasteful tests, then maybe those who really need it, like healthcare workers would be able to get them.

Am I missing something here?

You are missing something important.

What is the intent and purpose of widespread and early testing within communities with pertain to pertain transmission? Is there value in identifying known cases and tracing their contacts.

[toomuchbaloney]

Clearly my phone decided that I was not speaking about person to person transmission...