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COVID-19: We Can't Test

It's not easy to get COVID-19 testing right now. An individual I know tried to go to the hospital for suspect symptoms. He already had significant comorbidities impacting his survival. His family called EMS and was told that it would be better for him to stay home, the hospitals weren't testing everyone. They said that if he had the coronavirus, he would risk exposing others if he went in; and if he didn't have the coronavirus, he was at risk of getting it by going in. The patient accepted staying home. He decompensated a few days later and was admitted to hospice with respiratory failure.

As a hospice physician, I'd like to be able to test these "end-stage" patients. But we can't yet procure a test for them or us. Even in this modern age of rapid mass production and global distribution transcending international lines, actual, available tests seem as unreal as unicorns. The current testing in our region only appears to be available through certain remote channels and for relatively mobile patients. Hospice patients - clearly home bound and terminal - don't even appear to be on the radar for consideration. Never mind their families, loved ones, and caregivers; never mind our hard-working hospice nurses, certified nursing assistants, and psychosocial staff who come into routine contact with these patients: with limited resources, why test if you're terminal?

But testing has always mattered. Testing matters for every patient, every time, in terms of diagnosing his or her particular disease and its extent, planning for tailored cure or tailored palliation, and ultimately providing closure. Testing matters for families and communities to help recognize disease, spread awareness of it, and protect themselves from it. Testing is crucial for the medical profession to keep themselves protected and to help streamline treatments for combating morbidity and mortality. Testing - specifically in this difficult COVID-19 pandemic - is a fundamental for recognizing what shape-shifting beast we're dealing with. As a mainstay of diagnosis, widespread testing will be the cornerstone of advancement and victory. Let's hope more testing becomes available soon.


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