If COVID-19 Testing is the Key to Reopening then We Are Screwed

Yesterday I went to Eli Lilly’s drive up COVID-19 testing facility to get checked for the virus. I’m going to tell you about that experience and then I will tell you why I think we are in deep trouble.

My Testing Experience

It all started on April 17, 2020 when I learned that one of my home health aides had been exposed to the Corona Virus. That same day I developed a fever of 101.2°. Although I was able to get it under control with Tylenol easily, I decided to call my doctor on April 20. He prescribed a Z-Pak antibiotic and told me that if I got worse or cannot control the fever to go to the ER.

The next day I was informed that the aide who had been exposed to the virus had tested positive. I called my doctor back again to tell him I was still doing well but the test on my aide had come back positive. After brief discussion we decided I should go to the Eli Lilly drive-up testing facility. The problem was… I was stuck in bed. One of my other aides having learned that I have a fever and had been exposed to someone who had tested positive, decided not to come back to work with me. I can’t really blame her. These home health aides only make about $11 per hour and she has children and a family to consider.

I didn’t want to try to schedule the test until I was certain I had someone to get me out of bed. I finally got a replacement aide on April 24. She did so wearing full PPE consisting of a mask, gloves, and a paper over garment. After I got up I called to schedule my testing appointment.

The registration process included emailing them the written orders I had from my doctor. their requirements are that you be a first responder such as police or fire, be a healthcare professional, or be symptomatic over 65, or be symptomatic and be at risk for other health conditions. With my disability, limited lung capacity, and a variety of other medical issues I fit into the last category. There was only one catch… By the time we got thing scheduled, my fever had subsided. Technically I was no longer symptomatic but I didn’t tell them that. I told them that I was at risk which was true. I told them I had recently been exposed to a healthcare worker who had tested positive which was true. And I had my written doctor’s orders.

After going through the registration process, they assigned me a time of 10:15 AM the next day Saturday, April 25. Unfortunately my home health aide usually arrives at 9 AM and it takes at minimum 90 minutes to get me up and dressed but considering she was new it was going to take at least two hours. There’s no way I could be there at 10:15 AM. The only option was to call back later in hopes of getting a later time. They could only assigned you the next available appointment. You could not pick a later time.

I called back a few hours later and managed to get an appointment for 11:30 AM. It turns out my aide was going to be coming a little bit early and we would be able to meet that time. This was a Saturday and they were only going to be open until 1 PM. They would be closed Sunday so if I waited much longer I would be getting a Monday appointment and it would likely be early morning. So I took what I could get.

Saturday morning I got up and we drove down to S. East St. at about the 900 block. The line of cars waiting to get into the facility was more than 2 city blocks long. We were going north on East Street and had to go down and go around the block to get headed southbound and get in the line. By the time we did that, the line was even longer. We ended up making a U-turn in the middle of East Street which was otherwise pretty much deserted. We arrived in the line at about 11:25 AM five minutes prior to my scheduled appointment.

The line was barely moving but it did move. The first check-in station on East Street about a block away from the entrance to Eli Lilly had people standing there in orange vests. They would hold up a sign with a phone number so that you could talk to them without rolling down your window. Signs everywhere warned you “Stay in your car. Keep your windows up”. We had been warned we had to have a fully charged cell phone available.

Apparently in addition to the testing, there was also sign up for something else and I think she said it was a clinical trial of some kind. Depending on what kind of testing you were getting or whether you were signing up for this “something else” you would get a different colored ribbon of crêpe paper tied onto your side view mirror.

My biggest concern about this entire process was that from what I had seen on TV, you would pull up to this drive-up testing, you would roll down your window, and they would swab your nose through the window. Of course I would be sitting in the back of my van with Barb driving and there was no way I could lean out a window. I was fully prepared to raise a big stink if they refused to test me. Barb kept trying to calm me down about that. At the first check-in station on East Street we told them that I was the patient in the back of the van and that we could open the doors and let them into test me but I couldn’t get my head out the window. The rear windows on the van don’t open. The girl we were talking to over the cell phone called over her supervisor and the supervisor called ahead. After a brief minute she seemed they would work something out.

Eventually we made our way to the entrance and turned off of East Street into the Eli Lilly campus. The lawns were perfectly manicured. There were lots of trees and the dogwood trees were in full bloom. It’s a gorgeous looking place. We went another hundred yards or so and then the people directing traffic started letting the pink ribbon people cut the line. We had a green ribbon. Apparently the pink ribbon line was moving faster.

The line eventually turned into a parking garage beneath the facility. We turned left and the pink ribbon people went straight. The cars would pull up in 2 lines with 4 stations on each line. Again they would hold up a sign giving you a cell phone number and you would call it to speak to a person sitting at a table with a laptop computer. They asked us a confirmation number that we had printed from the confirmation email. With that number they knew my name and confirmed address date of birth etc. to make sure it was really me. They then put together a plastic bag with my testing supplies in it and my name written on the bag. A guy placed it behind our windshield wiper and we drove on to the final station.

Up until now, people were wearing regular street clothes or perhaps an orange vest. I think some of them were probably wearing masks. But at the final testing stage the workers were in full hazmat suits. They looks a little bit like those Tyvek paper suits but I’m pretty sure it was head to toe. Their head was completely covered and it was a hose coming out of the top of the helmet. We explained to them again that I was in the back and I was the one who needed to be tested. We opened up the side doors and let down the wheelchair lift. The woman doing the testing climbed in the van and stuck a long swab up both of my nostrils. I couldn’t turn my head so she had a little trouble getting the left one but we got it done. They gave us some paperwork including a code number that we will use to get my results from their website. It was now about 12:30 PM so it took about an hour in line.

Overall it looks to me to be a very smoothly run, well designed, efficient process. I think if they hadn’t had more than one kind of thing going on at the same time, the wait time would have been shorter but I can’t say that for sure. Even though it was a bit frustrating at times, looking back I can’t see how it could’ve been run any better.

Why We Are in Trouble

Even though my experience went relatively smoothly, I have to think about all of the things that could’ve gone wrong.

First of all… What if I hadn’t found an aide who could get me out of bed? What if I was completely bedridden? I had discussed this possibility with my doctor when we first talked about doing the drive through testing. My only option would have been to call an ambulance and have them transport me to St. Vincent ER to be tested. That would’ve exposed me to an ambulance gurney, a pair of EMTs, and the environment of emergency room and the workers and their. While we would hope that all of those would be safe and sanitary, the truth is we’ve had hundreds of such people catch the virus and sadly many have died. There is a strong possibility I do not have the virus. If I did, my doctor and I both believe I would be sicker than I am. But if I couldn’t get out of bed to get tested, the process of getting me tested would’ve exposed me to not only COVID-19 but who knows what other diseases? Not to mention the expense of 2 ambulance rides and an ER visit. I’ve already discovered the only way to get Medicaid to pay for an ambulance trip is to call 911 and tell them it’s not an emergency. To schedule a routine doctor visit for example and be transported by ambulance you have to schedule 2 days in advance and you need confirmation from the doctor that you absolutely have to be seen in person and that you have no other means of transportation.

I was in a kind of Catch 22. It was going to be hard to get an aide to come take care of me when my virus status was unknown. However I couldn’t get tested unless an aide would come get me up. The bottom-line is we need a system of visiting nurses or doctors who can test at risk people in their homes.

While Barb thinks my fears that they would not have tested me in my van were overblown, and in fact we had no problems with that issue, it could’ve very easily turned out differently. People are living by very strict rules these days. At least the responsible people are. They might’ve had a rule that said under no circumstances could one of the test personnel enter a patient’s vehicle to perform the test. As unfortunate as that would be for me and as insulted as I would be, I sort of understand why they might have that kind of rule.

If you have watched the news lately, there was a feature with a woman who had a disabled daughter. They wanted to take advantage of the bicycle and hiking trails at Eagle Creek Park. But the parks department has closed the park to all but pedestrian traffic. She wanted to drive in to the grounds to unload her daughter in her wheelchair so that they could go hiking. The park refused to make an exception and suggested she could drop off her 10-year-old daughter at the gate, go park somewhere else, and then catch up with her. Yeah… Like you’re going to leave your 10-year-old child unattended at the entrance of a public park. Do that and you could get arrested for child endangerment. Even after the TV station contacted the parks department, they refused to budge. That kind of inflexibility and accommodation for people with disabilities is quite common. And to be honest while the park situation was ridiculous, I could understand why people might want to refused to enter a vehicle to test the patient. The bottom line here is we need assurances that tests are accessible to people with special needs even if they can get out into the world. Although this went well, it doesn’t take any imagination to think it could’ve gone badly. Trust me on this.

I have to ask, what if I had been honest and told them my fever was over? I would’ve been completely ineligible for this test. As it turned out, later that day after I got home from the test, my fever did return slightly up to 99.1°. While that doesn’t seem like much, my normal temperature is about 97.8°. The Tylenol took care of it easily but at the time I was taking the test, I had been completely symptom-free for more than three days. What do you do when you know you are at serious risk, at risk of infecting others, have been exposed to someone who is positive? What do you do? If my fever had gone up the day before instead of the day of would’ve been clearly eligible and not had to stretch the rules of the system. Depending on when that fever actually returned I might have really had the fever sitting there in line and getting tested.

I did a Google search asking where else I might be able to get tested. Here is the link to the search I did. In addition to the Eli Lilly facility several hospitals are doing testing. The VA hospital is for veterans only and only if they are symptomatic. Ascension St. Vincent has basically the same rules as Eli Lilly. You have to be first responder, healthcare worker, at risk and above all symptomatic. Community Hospital doesn’t say what their criteria are. They just say to call for a virtual doctor visit and then they will advise you what to do.St. Francis hospital system says that depending on their available supplies, the rules on who can be tested might change daily. Basically they are saying they are rationing supplies for testing. It’s obvious that the other testing centers are limiting testing to certain priority groups because of the lack of supplies. A couple weeks ago when Trump said “Anyone who wants a test can get it” we all knew it wasn’t true. What I’ve seen here in Indianapolis proves that. Of course public officials such as Trump and his cohorts have all been tested for the virus even though they are completely asymptomatic. Whose life could’ve been saved by that test they did on the tigers in the zoo?

So the bottom-line is… The only thing you can do if you are asymptomatic and have been clearly exposed to someone like I was, is to completely self isolate. That means if you’re one of the people who is lucky enough to still have a job you have to quit. God knows what kind of process you would have to go through to keep from getting fired for not going in. And then you would have to prove that your unemployment was COVID-19 related. What would a single parent without a support network of family or friends do under such circumstances? Abandon her children to CPS? What if you are responsible for caring for an elderly family member? Does that make you a “healthcare professional”? If not, your choice would be to put your elderly relative into a nursing facility which would probably be more risky than you taking care of them yourself. Of course when they catch the virus from you, you get to blame yourself rather than blaming the nursing facility. None of these options are fun.

Under the current circumstances, testing supplies are in such short supply that they have to be rationed and prioritized in this particular way. I don’t deny that. The people who are getting priority for testing deserve the priority. And it was only a difference of a day and a degree of fever that I sort of stretched the system to get my test.

We are told that in order to safely open up our economy we need MASSIVE amount of testing and contact tracing. The truth is my home care agency and I have done our own contact tracing. If I come back positive, I will be the one contacting everyone I’ve been in touch with over the past few weeks to let them know of my status. None of the people that I will tell about my positive test will qualify to be tested until they become symptomatic. At which point God knows how many other people they have infected. Are they supposed to self isolate on the off chance I might have passed it to them? Are they going to shut down what is left of their life for 2 weeks just because they can’t get peace of mind that they are negative?

I don’t know how it is around the country, but Indianapolis was mentioned by the US Surgeon General a few weeks ago as an emerging hotspot. With the limited capacity we have for testing right now, we are NOWHERE NEAR READY TO REOPEN.

I witnessed an amazingly efficient and well-run testing program. And it is totally inadequate to meet our needs.

We are screwed.

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