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deleted676737
That’s the rub. We have no idea how many active cases there actually are; in most (all?) states, the number of people getting tested is minimal, and it’s largely due to issues of supply and staffing. I’m at a local health department in Missouri and the state only sent us 5 (seriously) test kits for the whole county. Hospitals all also got only 5 each, and there are only two of them. So that’s currently 15 available test kits for a county of around 150,000 individuals in the metro area of the largest city in the state. The hospital I previously worked out is already nearly out.
In an ideal world where we have all of the financial support and manpower necessary, we’d test everyone concerned. We’d love to test everyone to have more accurate data. Unfortunately, we can’t right now and we have to prioritize based on relative risk and certain other criteria and it sucks because that means our number of active cases is likely quite a bit higher than what has been reported. At least, that’s what it’s like here in Missouri, which is a state that is... not exactly the best known for funding and staffing their public health offices adequately, to say the least (much to the chagrin of my coworkers and supervisor).
Our epidemiologist did say something about more test kits going out to primary care physicians and urgent cares, not just hospital ERs, over the next few days. I’m really hoping that that's happening; for the cases out there in most otherwise healthy, young people with relatively mild illness, I think it’s far more likely we catch them for evaluation and testing there versus an ER. And that isn’t even mentioning the costs to the patients... there’s also a ton of confusion going on among the public. We’re trying to educate and encourage basic protective measures to mitigate, slow the spread, and start “flattening the curve”, so to speak (social distancing, proper hand washing, stay home if you feel sick, go to an ER if you’re having difficulty breathing or other severe symptoms, etc.) especially among vulnerable populations, as much as possible. But most of them are utterly freaking out and won’t listen. They don’t understand that we don’t have the capability to test every single person who thinks they’re sick because we don’t get the support that we need and we have to carefully pick and choose who gets tested at this point.
Also, our hospitals are nowhere near equipped currently to handle a rash of complex cases. The hospital I worked at previously has a grand total of 5 ICU beds; I think the other hospital in the county has a similar amount of space. Basically, if things go bad here, we’re in trouble.
Anyway, this is just to say that I can’t thumbs-up your posts enough, @Stroganoff. We aren’t prepared for the worst case scenario. We aren’t testing enough and we are frustrated, too. I’m two weeks into this job and am learning a lot about how the U.S. health system, especially public health, actually functions in the real world, on the front lines. It isn’t pretty. IMO, the federal response really, really needed to have been faster and more substantial upfront than it actually was.
ETA that, on my commute to work, I saw an announcement that both Missouri and Kansas will be receiving more federal funding ($10M and $6M, respectively). That will help, but I still think that it’s too little too late at this stage. The virus is more widespread than what the official numbers are saying.
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