The patient seemed like a prime candidate to get tested for coronavirus.
She had traveled to Italy, the epicenter of the European outbreak, for 10 days in early March. She was employed at a New York City-area airport. And she had developed symptoms, including shortness of breath and a low-grade fever, which public health experts have identified as key markers of COVID-19.
But despite her doctor's best efforts, Dr. Anjali Viswanathan said she couldn't get a diagnostic test for the patient.
Viswanathan, an internal medicine practitioner who works at a New Jersey hospital and who also sees patients in her outpatient practice, described what she called mounting frustration among physicians around the country, who are having their requests to test patients they say meet the criteria for COVID-19 rejected by hospitals and health departments.
Testing has been a contentious issue in the U.S., with extremely limited availability compared to other countries battling the virus. That recently began to change as public health labs came online (as opposed to just the Centers for Disease Control and Prevention (CDC) in Atlanta) -- running thousands of specimens a day beginning in early March. And the Trump administration said Sunday that it plans to expand drive-thru testing, although the exact details of that plan are still not clear.
The testing process is not a simple and is time-intensive. Medical professionals have to don and doff personal protective equipment each time they administer a test. And some say focusing on testing is less important than practicing social distancing and other mitigation measures. Health care workers, first responders and Americans 65 or older with a cough, fever or other symptoms will receive priority for testing, Vice President Mike Pence said.
In the case of Viswanathan's patient, she said a New Jersey hospital told her that because the hospital only had a limited number of tests, the patient's age -- 28 -- was a disqualifying factor.
Viswanathan said she met similar dead ends when she called the state health department and two other hospitals.
"As far as the physician community, we're all experiencing this. We keep getting the answer that patients are not meeting criteria," she said.
"But in my opinion, it's even more important to know which patients carry the virus who don't fit the typical profile," she added. "That's the only way to protect the community at large."
Viswanathan said her patient is in stable condition and isn't concerned that she'll need to be hospitalized or go to the ICU, but she is worried about the patient being home from work for the foreseeable future.
"This is a single mom who would not be paid for those days off," she said.
'It's so difficult'
Even some patients who are at risk of being hospitalized say it's nearly impossible to get tested.
Robin Limmer, age 46, lives about half a mile from the containment zone in New Rochelle, New York, where one of the biggest outbreaks in the country is currently underway, with 220 reported cases in Westchester county, where New Rochelle is located.
Limmer herself is in good health, but her mother, who is in her 70s and who has lung cancer, recently visited a doctor's office in New Rochelle.
"That's where the anxiety comes into play," Limmer said. "Unfortunately now my mom has a cough," she added.
Limmer and her sister have been on the phone constantly, she said, with her mother's oncologist and with local hospitals, trying to get her mother tested for COVID-19.
The only advice those health professionals could offer was to tell Limmer to monitor her mother's temperature, or go to the emergency room, exposure that that Limmer doesn't want to risk, given her mother's compromised immune system.
"It's so difficult to know what to do and who should get tested and who shouldn't," Limmer said.
On Thursday, Limmer's mother was finally approved for a COVID-19 test and Limmer took her into Manhattan Friday afternoon to get tested for the virus. They're waiting for results, which doctors say will take four to five days.
'They refuse to test me'
Brittany Schacht, who lives in Washington, DC, expressed similar frustrations over not being able to get tested when she developed chest pain and congestion after returning from a work trip to Japan.
Schacht, 27, was told by her doctors that in order to get tested she'd need approval from the health department and wouldn't likely meet that criteria. Schacht, who has asthma and who traveled to a country with an ongoing outbreak, said she suspects that she isn't meeting that criteria because of her age.
"I was waking up at 1 a.m. and taking my inhaler, because I couldn't make it through the night," Schacht said of her symptoms. Doctors didn't want to see her in person, in case she had COVID-19, and she was unable to monitor her temperature during the week she felt sickest.
"Everyone is sold out of thermometers," she said.
A week later, most of Schacht's symptoms cleared up, but she says she can't go back to work without a clean bill of health and still doesn't know whether or not she had the virus.
"If this was a really bad allergy or asthma attack, I wouldn't know," she said. "They refuse to test me and see what I had."
Trying to rectify a 'failing' testing system
In contrast to President Donald Trump's claim last week that "anyone who wants a test can get a test," the reality is that as of March 15, only 22,700 specimens have been tested by the Centers for Disease Control Prevention and public health labs. Testing remains limited and difficult to come by for many.
"The system is not really geared to what we need right now, what you are asking for. That is a failing," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease said at a House Oversight and Government Reform hearing on March 12.
What to know about Coronavirus:
- How it started and how to protect yourself: Coronavirus explained
- What to do if you have symptoms: Coronavirus symptoms
- Tracking the spread in the US and Worldwide: Coronavirus map
Lack of widespread testing in the United States has meant waiting until people are ill to trigger a public health response.
“It is a failing. I mean, let’s admit it,” Fauci said.
While 10 states, including New York, Washington and Texas have begun to do drive-thru testing as a way to widen their testing scope, and others have similar plans in the works, a number of states, including New Jersey, have no such plans in place, state health departments confirmed to ABC News.
During a White House briefing Sunday, Vice President Mike Pence said that more than 2,000 commercial labs would begin high-speed coronavirus testing March 16, with 1.9 tests available by the end of the week.