Anyone can be tested for novel coronavirus, subject to a doctor's orders: Pence

Officials say up to a million tests should be available by the end of the week.

March 3, 2020, 6:52 PM

The Centers for Disease Control is issuing new guidance that anyone can be tested for COVID-19 with no restrictions, subject to a doctor's orders, Vice President Mike Pence announced in a briefing with reporters Tuesday evening.

The CDC's previous guidance was limited to people who traveled to countries affected by the novel coronavirus outbreaks and came in contact with a diagnosed patient or showed severe symptoms. But Pence said several governors raised concerns that people with only mild symptoms wouldn't be tested.

"Today, we will issue new guidance from the CDC that will make it clear that any American can be tested no restrictions, subject to doctors' orders," Pence said. "Several governors said to me that there was an impression that the test would not be administered to people who were only mildly symptomatic. We are issuing new guidance -- effective immediately -- from the CDC that will make it clear that any clinician on health authority can administer the test."

Senators also raised concerns to public health officials about confusion about who could get tested for exposure, especially Washington Sen. Patty Murray, whose state has announced 9 deaths related to a COVID19 outbreak.

PHOTO: Anne Schuchat of the CDC, National Institute for Allergy and Infectious Diseases Director Dr. Anthony Fauci, Dr. Robert Kadlec of HHS, and FDA Commissioner Dr. Stephen Hahn appear before a Senate committee, March 3, 2020, in Washington.
CDC Principal Deputy Director Anne Schuchat, National Institute for Allergy and Infectious Diseases Director Dr. Anthony Fauci, HHS Assistant Secretary for Preparedness and Response Dr. Robert Kadlec, and FDA Commissioner Dr. Stephen Hahn appear before a Senate Health, Education, Labor and Pensions Committee Hearing on the coronavirus on Capitol Hill, March 3, 2020, in Washington.
Andrew Harnik/AP

"It's unacceptable that people in my state and nationwide can't even get an answer to whether or not they are infected," she said in a hearing with officials from the Centers for Disease Control, Food and Drug Administration and Department of Health and Human Services on Tuesday.

Murray said residents she's heard from are "frantically" calling around to find out how to get tested and that she's concerned there may not be enough tests available.

Public health officials cleared up some of the confusion about COVID-19 testing in Tuesday's hearing with the Senate Committee on Health, Education, Labor and Pensions. Here's what you need to know:

How many people can be tested?

Right now, state and local public health labs have the capacity to test 15,000 people, according to the FDA, but they are working to rapidly expand the ability to process tests in public and private labs by the end of the week.

One company, Integrated DNA Technologies, is manufacturing the COVID-19 test both for CDC to distribute to public health labs and commercially for private and clinical labs. FDA says the company expects to distribute 2,500 test kits by the end of the week, each including 500 tests.

FDA Commissioner Steven Hahn confirmed Tuesday that the agency expects to have enough test kits distributed by the end of this week to conduct up to 1 million tests. The state and local public health labs will represent up to 75,000 of those tests.

Sen. Murray said the administration knows the 1 million number is misleading and that it doesn't mean that many people will end up being tested.

CDC’s laboratory test kit for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
CDC

"Dr. Hahn said that they hope to have a million, but each one of those -- the numbers are hard to follow because they're talking about 2,400 kits and you have to reuse them. … You have to get tested more than once, so a million people are not going to have a test, even if their most positive, hopeful projection is a million. We need the honest answer to that, so people can plan," she told ABC News ahead of Pence's briefing.

One problem has been that the initial test kits deployed by the CDC didn't work the way health officials wanted, so states are just now getting access to working tests. Compare that to South Korea: At one point last week, the U.S. had conducted some 3,600 tests total, whereas South Korea was over 70,000, including 10,000 tests in a single day.

Members of the coronavirus task force said they will be pushing manufacturers to increase production of testing kits in the coming weeks.

"We will see increasing demand and right now we are trying to increase capacity to meet that demand," Hahn told reporters Tuesday night.

How do you know if you have COVID-19 versus the seasonal flu?

You don't, and your doctor would have to conduct a special test. The symptoms of a cough and fever can be similar for both COVID-19 and the seasonal flu.

In coronavirus, the predominant symptoms are what's called a "lower respiratory" infection, or an infection in the lungs, said Anthony Fauci, director of National Institutes of Health's National Institute of Allergy and Infectious Diseases. That's what would cause the cough, along with the fever.

With the seasonal flu, symptoms can often start with an "upper respiratory" infection -- sneezing and a sore throat with the fever. A lower respiratory infection could develop though too, making it necessary for a doctor to review the symptoms and conduct tests if warranted.

So can I get the test?

Maybe. The ability to detect novel coronavirus requires a specific test, but the test as of early this week hadn't been widely available. That's expected to change later this week but health officials still say that everyone in the general public doesn't automatically need to be tested.

"Not everyone needs a test and we don't want to go through all our tests on low risk situations and not be able to really address that care and the contacts that are going to be critical," Schuchat testified on Tuesday.

PHOTO: Sen. Patty Murray, left, listens during testimony during the Senate Committee on Health, Education, Labor and Pensions hearing on how the U.S. is Responding to COVID-19, the Novel Coronavirus, in Washington, March 3, 2020.
Sen. Patty Murray, left, and Senator Lamar Alexander listen during testimony during the Senate Committee on Health, Education, Labor and Pensions hearing on how the U.S. is Responding to COVID-19, the Novel Coronavirus, in Washington, March 3, 2020.
Jack Gruber/USA Today Network via Imagn

CDC guidance to health care professionals specifies that a patient should be tested for COVID-19 if they traveled to an affected area like Wuhan, China, or some parts of Italy in the last 14 days, came in contact with a confirmed COVID-19 patient in the last 14 days, or have symptoms like fever and lower respiratory illness that can't be attributed to another diagnosis like the flu.

Should we be wearing masks? Is it a global 'pandemic'?

Health officials say people should not wear masks if they are not sick and are not in contact with someone who is infected.

Masks and other equipment should be prioritized for health care workers who wear masks because they know they are in close contact with people who are sick. But experts say it's not necessary for a person in a regular setting, and that the best thing they can do to prevent exposure to both the flu and COVID-19 is wash hands for 20 seconds, not touch their face and disinfect surfaces.

And if you do exhibit symptoms, the best advice is to stay home.

The World Health Organization hasn't labeled it a global "pandemic" yet, although U.S. officials on Tuesday predicted that was possible as it spreads from country to country.

Health and Human Services Secretary Alex Azar has said that label wouldn't change what the U.S. is doing to address the matter.

Are children at risk? When can I get a vaccine?

There's a lot U.S. officials don't know about coronavirus just yet. But health officials say they suspect, based on data from China, that children under 15 represented very few cases compared to adults.

Fauci said the mean age of a patient was about 50. He also said the primary concern is how older patients and people with underlying health conditions will fare if struck with the virus.

A vaccine is still 12 to 18 months away. However, researchers are also focused on treatment therapies that might improve symptoms. And unlike the vaccine, a therapy for coronavirus is possible much sooner with one drug already being closely looked at.

"We should know within a period of a few months -- several months -- whether or not this particular drug works," Fauci said. "If it does, the implementation of that would be almost immediate."

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