(CNN) – If you want to be tested for the new coronavirus, you are not alone.
“One of my sisters called me yesterday [y dijo], ‘I have to get my daughter tested for coronavirus, ‘” New York Governor Andrew Cuomo said at a press conference on Wednesday.
The governor’s niece had a fever and flu-like symptoms. However, he told his sister “there is no reason for a test,” since his daughter had not traveled to a risk point for covid-19 or had not been in contact with someone who had tested positive for the virus.
Across the United States, doctors are sending the same message: Not everyone who wants a test will receive a test.
“If we had all the resources in the world and could wave a magic wand, we’d be happy to test these people, but we don’t have them, so I’m afraid we have to prioritize,” said Dr. William Schaffner, professor in the division of Infectious Diseases at Vanderbilt University Medical Center.
This week, New York City and Los Angeles County established guidelines for testing, advising doctors to avoid testing patients, except in cases where a test result would significantly change the course of treatment.
Schaffner, a longtime advisor to the United States Centers for Disease Control and Prevention (CDC), and Dr. Rochelle Walensky, chief of Infectious Diseases at Massachusetts General Hospital, told CNN who should and who shouldn’t. get tested, since there are not enough tests available.
His thoughts essentially echo what was done in New York and Los Angeles: At a time when there is not enough evidence to meet demand, patients must be administered when the result would make a difference in their care.
First, some notes: There will, of course, be exceptions to these categories, and different doctors and hospitals will have different rules. Also, this category is a snapshot in time; As more tests become available, doctors may be more liberal about who is tested.
The CDC has some guidelines for testing, but notes that “testing decisions are at the discretion of individual and local state and / or clinical health departments.”
Some states, such as New York and Washington, have more specific recommendations on who should be tested.
Also note that there is no clear definition of what it means to be “old man”. The category below says they are 70 or older, but different doctors and hospitals will have different definitions. At Massachusetts General Hospital, for example, for the purpose of coronavirus testing, someone is considered an elderly person when they are over the age of 70, but depending on someone’s health, a patient could also be considered an elderly person if he is 60 years old.
Finally, the testing protocols for healthcare workers are different in that they can transmit the virus to their patients and colleagues.
Who does NOT need proof
If you don’t have coronavirus symptoms: According to the CDC, virus symptoms include fever, cough, and shortness of breath. If you’re not experiencing them, you shouldn’t have a test right now.
This is true even if you have recently traveled to an access point for the new coronavirus, such as China or Italy. You will also not receive tests if you have been in close contact with someone who has been diagnosed with coronavirus.
Doctors have pointed out that it is certainly possible that you may have coronavirus even if you do not have symptoms, but that at this time there is not enough testing for everyone.
If you have symptoms, you are healthy and you are under 70: Doctors said that even if you have symptoms, you should not be tested at this time due to a shortage of symptoms.
“The test is not going to change what we do for you,” said Walensky, a professor at Harvard Medical School.
“Much of the reason we test for the flu is that we have something to give you if your test is positive,” he added, referring to antivirals that can decrease the duration and severity of flu symptoms. “But this is not like the flu. We have nothing specific to give you for the coronavirus. ”
Doctors said their advice for healthy young people with fever and cough would be the same regardless of the cause: go home; break; you should drink more liquids; stay away from other people; and seek medical attention if they have difficulty breathing.
That last tip about seeking medical attention applies if you have coronavirus, the flu, or any other respiratory illness, they said.
“If you are in this group, you are not in trouble. Whether you have the flu or covid-19 or some other respiratory virus, we anticipate that it will do you good, ”Schaffner said, using the medical term for the disease caused by the new coronavirus. “But if you develop any symptoms that show you’re getting worse, especially if you have any trouble breathing, give us a call.”
After you recover, you should continue to stay away from other people as much as possible, whether your illness is due to coronavirus or something else.
“Everyone should be distanced socially,” said Walensky. “Where are you going, for God’s sake?”
Who might need proof
If you are over the age of 70 or have an underlying serious medical condition and have mild to moderate symptoms of coronavirus: If you are in this group, doctors will do an assessment to determine what tests you may need, even if you need a coronavirus test.
“We want to see you. For starters, you’re a little bit more fragile, so not just for Covid-19, we want to make sure you’re okay, “Walensky said.
Who DOES need proof
Anyone who has symptoms and has been in close contact with someone who has had a positive coronavirus test: The CDC defines close contact as having direct contact with the infectious secretions of someone who has coronavirus, such as coughing, or being within two meters of an infected person “for an extended period of time.”
Anyone who has coronavirus symptoms and needs hospitalization– If you have coronavirus symptoms and need hospitalization for any reason, doctors will want to examine you. If you have the virus, for reasons of infection control, it will influence where you are admitted to the hospital, and doctors will take special precautions to protect themselves when they treat you.
Schaffner and Walensky say that as more evidence becomes available, they hope to be able to loosen these categories and evaluate more patients.
But it is not just a matter of evidence availability.
Swabs and other supplies needed to perform the test are also scarce. In addition, doctors and nurses must wear personal protective equipment to perform a coronavirus test, such as special gloves and masks. Since that equipment is scarce, doctors want to keep it for those who need tests most.
Finally, if everyone got a test, the system would be overloaded.
“We have to do the test, and then someone has to process it and take it to the laboratory. And then someone has to call patients back and tell them the results. I can’t see that healthcare facilities have that kind of workforce, “Walensky said. “Maybe we will get there, and that would be great.”
– CNN’s Michael Besozzi contributed to this report.
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