Health officials: COVID-19 test restrictions due to limited number of tests available

This photo shows the test kid for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2),...
This photo shows the test kid for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19. (Courtesy: Centers for Disease Control and Prevention)(KCRG)
Published: Mar. 16, 2020 at 9:54 PM CDT
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Right now, not everyone in Iowa who has the symptoms of the COVID-19 strain of the coronavirus is able to be tested for it.

Hospitals in Iowa no longer need to receive approval from the Iowa Department of Public Health to administer a test, as they previously had, but those hospitals report they are still following the guidelines set by the department and the State Hygienic Lab in Coralville to determine who gets a test.

In order to qualify for testing, patients must meet one of the following criteria:

  • Hospitalized patients with fever and respiratory failure and no alternate diagnosis.
  • Hospitalized older adults (> 60 years of age) with fever and respiratory symptoms (cough, difficulty breathing) and chronic medical conditions (e.g., diabetes, heart disease, immunosuppressive medications, chronic lung disease, or chronic kidney disease).
  • Any persons (including healthcare providers) with household contact with a laboratory-confirmed case of COVID-19 in the 14 days prior to becoming ill with fever or respiratory symptoms (e.g., cough, difficulty breathing).
  • Any persons with a history of international travel to a country with a Level 3 CDC travel health warning or have taken an international cruise in the 14 days prior to becoming ill with fever and respiratory symptoms (e.g., cough, difficulty breathing) and no alternate diagnosis.
  • As of Monday, March 16, nations included in the CDC’s Level 3 travel health warning are China, Iran, and most countries in Europe.

    The Iowa Department of Public Health and local hospitals said they’re following these restrictions for the same reason: There aren’t enough tests in Iowa for everyone who wants one, or even for those who only have symptoms.

    In an email to KCRG-TV9 on Sunday, Amy McCoy, policy advisor/legislative liaison for the Iowa Department of Public Health, said these restrictions have not prevented Iowa from screening for community spread.

    Gov. Kim Reynolds announced the first case of community spread of the coronavirus in Iowa on Saturday, in a positive test in Dallas County. The state announced two more cases of community spread on Sunday, with one each in Johnson County and Polk County.

    “Our testing is currently designed to test individuals who have risk factors for having COVID-19. With limited testing, the health care community is using the current capacity and prioritizing based on these risk factors,” McCoy wrote.

    University of Iowa Health Care is following those guidelines in its hospitals and clinics “to make best use of the limited number of tests available,” according to Jennifer Brown, a member of UIHC’s marketing and communications staff, in an email sent to TV9 on Monday.

    Doctors from two Cedar Rapids hospitals, Mercy Medical Center and UnityPoint-St. Luke’s Hospital, echoed those same sentiments at a press conference Monday.

    “The Iowa Department of Public Health limiting the criteria for testing really just has to do with, they’re saving the tests for the most at-risk or severely ill people,” Dr. Tony Myers, vice president of medical affairs at Mercy, said.

    “Despite that deficit, it is not impairing our ability to care for patients and to handle this situation,” Dr. Dustin Arnold, St. Luke’s chief medical officer, added.

    Arnold said a positive test wouldn’t change the way doctors at Mercy and St. Luke’s treat patients because for now, there’s no specific medication available to treat coronavirus.

    “It’s supportive care, so as physicians do every day, we’re going to evaluate the patient, determine a differential diagnosis, and then treat that patient supportively,” Arnold said.

    Those restrictions on testing are cause for concern for Cedar Rapids resident Cory Cozad.

    After returning home from a weekend trip to the Quad Cities last weekend, Cozad, who frequently travels domestically for work, started to feel sick with coronavirus-like symptoms, which worsened over the span of a few days.

    “My chest felt really tight,” Cozad said. “I had a really wicked dry cough that actually, it hurt to cough. And I had a fever. I just felt so warm.”

    Cozad went to two area hospitals and was denied testing at both because he did not meet the state’s criteria, despite his symptoms.

    “I feel very concerned for our community in that we’re not necessarily getting all the data collection that’s required to make a decision,” Cozad said.

    Cozad said he eventually tested positive — not for coronavirus, but for Influenza A.

    “I’ve never been happy to have the flu, but it seems like it’s better than the alternative, possibly,” Cozad said.

    But he’s worried there are more people in his situation, who have similar symptoms but do have the coronavirus and aren’t able to know, especially with community spread now present in Iowa.

    “I think it’s probably a much bigger issue than what’s being reported just due to the fact that not everyone can be tested,” Cozad said.

    Myers said that while Iowans don’t necessarily need testing to be treated for coronavirus, more testing will be beneficial in the state in the long term to help people better understand the illness.

    “Hopefully within the next couple of weeks, we’ll have the ability to test more frequently, and I mean, I’m sure we will,” Myers said.