Do I have coronavirus? Missouri and Kansas won’t test you unless you show symptoms
Worried Missourians are asking their doctors to test them for the novel coronavirus, but they won’t get the test unless they have symptoms, health officials told lawmakers this week.
“Every physician I’ve talked to (is) getting an increase in demands to be tested,” Stevan Whitt, chief clinical officer for the University of Missouri Health Care system, told legislators in Jefferson City.
The hearing, before a new House committee set up for the coronavirus outbreak, gave experts the chance to answer questions on the minds of Missourians — and people all across the United States — as cases ramp up in this country. They discussed symptoms, testing, treatment and the persistent question of whether the virus can be transmitted by pets (it can’t).
If you are healthy, don’t have a fever and don’t have a known possibility of exposure to the virus, “we would not run the test on you,” just as doctors don’t run scans on people who show no symptoms of cancer, Whitt said.
Johnson County health officials said as much in a statement Tuesday: The only people who will be tested are those who show symptoms and either traveled to countries most affected (such as China and Italy) or have been within about 6 feet of someone who is infected.
Health officials in Missouri and Kansas continue to say we are at low risk for the new virus — called COVID-19 — that has infected residents in 15 other states and caused nine deaths in the U.S., as of Tuesday afternoon.
Based on what they know about how the outbreak unfolded in China, federal health officials say 80 percent of people who get the virus will become mildly or moderately sick. Most can recover at home as they would from the flu.
The current mortality rate is 3.3 percent, Whitt told lawmakers, “which means you have about a 97 percent chance of survival if you get sick.”
“We will rely on self-quarantine … to get through it,” Clay Dunagan told legislators. He is an infectious disease physician and chief clinical officer for BJC HealthCare, one of the largest health care providers in Missouri.
Whitt asked lawmakers to encourage employers to be lenient “if people want to stay home sick.”
On Monday, Black & Veatch in Johnson County announced that two of its employees are being monitored for possible exposure and are “self-isolating” out of an abundance of caution.
The company said it was taking steps to “to ensure the safety and cleanliness of our work and public areas so that our professionals can return to work” the next day.
Two people in Kansas have been tested for the virus and the results were negative. The state has three more people under investigation, according to a coronavirus “tool kit” on the website of the Kansas Department of Health and Environment. (The department on Tuesday launched a website to answer questions: kdheks.gov/coronavirus.)
No one in Missouri has tested positive for the virus, state health officials say.
Led by Republican Rep. Jonathan Patterson, a physician from Lee’s Summit, Missouri lawmakers peppered Whitt, Dunagan and the state’s top health officer, Randall Williams, with questions, trying to steer clear of inciting “panic or overreaction,” Patterson said.
Two points they drove home: Wash your hands. And people who don’t have the virus don’t need masks, so stop hoarding them so there are enough for health care workers.
Here are some of the questions the experts answered.
Q: If having the coronavirus is like having a cold, how do you know when to go to the doctor?
A: Diagnosing coronavirus is difficult “because it shares several symptoms with influenza,” says the Mayo Clinic.
Coronavirus symptoms are a cough, shortness of breath and a fever.
As long as you’re not short of breath or light-headed, and you can eat and drink, in general you don’t need to see a doctor, Whitt said. “We recommend you stay home and let it run its course like every other virus.”
There are no medications for the virus. “Most people with mild coronavirus illness will recover on their own by drinking plenty of fluids, resting, and taking pain and fever medications,” says the Kansas health department’s website.
“However, some people have developed pneumonia and require medical care or hospitalization.”
A fever is a sign that you might have more than a cold, said Williams, director of the Missouri Department of Health and Senior Services. “If you have a fever we probably need to worry a bit.”
How high a fever?
100.4, according to guidelines set by the Centers for Disease Control and Prevention, Williams said.
What is the coronavirus test?
It’s a swab of the nose or oropharynx — the part of the throat at the back of the mouth, said Whitt.
When the virus first broke out, only the CDC could run tests, and results took days. In late January, Kansas state health officials spent a nerve-racking five days waiting for test results on a University of Kansas student who had been in Wuhan, China, the epicenter of the outbreak. The student tested negative.
Now that both Missouri and Kansas can do tests in their state labs, results can come back within hours, according to both health departments.
Patients get tested locally, and those samples are sent to the state.
What happens if you test positive?
Ideally, people who suspect they have coronavirus will call ahead before they arrive. For hospitals, “that allows us to intercept them at the door before they get into a busy waiting room,” Dunagan said.
The same holds true for doctor’s offices and urgent care centers.
Patients would be given a mask to wear and placed in a special isolation room where they would be evaluated, Dunagan said.
If doctors decide they are at risk — because of their travels or possible other exposure — they would be tested, said Dunagan. If they test positive and have mild symptoms, they could be sent home, he said.
“Patients at risk for instability” — such as some older people — would be moved to full isolation in the hospital, said Dunagan.
“That process should work, barring a large-scale outbreak with a lot of intensely ill people,” he said. “I don’t think we’re going to get to that point. I think we need to prepare for it, but I don’t think we’re going to face that kind of challenge.”
How long should people wait at home, in “self-quarantine” before resuming their normal life?
“That’s a feature of the disease we don’t have a clear handle on yet,” Dunagan said.
Given that, he recommended waiting 10 to 14 days after symptoms go away. That’s longer than the recommended seven-day waiting period after a flu fever disappears, he said. “I think we’re being a little more cautious with this.”
Can you get coronavirus twice?
“We believe unless you have some immune deficiency, once you get it and recover you’re immune from this strain,” Whitt said. “If you get it this year you’re probably good for this year,” unless you have other health issues.
Will the virus go away when the weather warms up?
While most viral diseases like the flu peak in the winter, Whitt said he’d be careful about speculating if coronavirus will dissipate when warm weather arrives.
And he had another concern: He expects that when travel advisories warning people away from countries that have had outbreaks are lifted, people will start traveling there again and still risk exposure.
Can pets give humans the virus?
Yes, a legislator asked that question.
“We do not believe your dog or cat carries coronavirus,” said Williams, who has a dog.
American Humane, the country’s oldest animal welfare group, reports that people around the world are worried that they’re going to catch the virus from their pets.
Much of the fear seems to stem from a false report last week claiming a dog in Hong Kong had tested positive for COVID-19, the group said in a release on Tuesday. It has heard reports that families in China are abandoning their pets or putting them down in a misguided attempt to stop the spread of the virus.
“Despite allegations to the contrary, your cats and dogs are no more likely to spread the coronavirus than your cellphone or keys,” the group said.
Should schools close if a student tests positive?
“I’m not going to speculate,” said Williams, who said local school boards and health officials should make those decisions.
The virus, he said, is not usually spread by children. Older people are more susceptible. It is “the exact opposite” of the H1N1 flu, which threatened children and pregnant women during the 2009 outbreak, Williams said.
Should we be stocking up on supplies?
“So this is one of those questions that’s darned if you do, darned if you don’t,” said Whitt. “I do not believe that Missourians are at an elevated risk of death … at the current time. This is not the same as we will never be at risk for it.”
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