By Julie Havlak
Carolina Journal News Service
RALEIGH — Gov. Roy Cooper encourages everyone to get a test for COVID-19, especially people who attended mass gatherings or protests. But medical providers are still catching up to new state recommendations, and online guidance from many hospital systems denies tests to exposed patients without symptoms.
Experts say patients’ access to tests is critical to slowing the virus. An N.C. Department of Health and Human Services website lists more than 500 testing sites. The state updated its guidance June 9, allowing tests for patients without symptoms and asking people to visit testing sites.
“We want all kinds of people to go get tested, particularly if they are in a crowd,” Cooper said in a news conference Thursday, June 18. “We encourage people when they are off work to go get tested.”
Online information from providers can be confusing or contradictory.
UNC Health said it tests all patients who have COVID-19 symptoms or were exposed to someone with a confirmed case, said spokesman Phil Bridges.
But the Coronavirus Help chat on UNC Health’s website still told exposed patients that “people without respiratory symptoms aren’t currently being tested for coronavirus.” It advised patients exposed to COVID-19 to self-isolate for 14 days, as recently as Monday, June 22.
UNC Health teams are meeting to update the website, Bridges told CJ June 16.
“We will definitely be updating the screening questions to reflect the system’s change in testing criteria that is now more permissive,” Bridges said in an email. “It will still depend on testing availability.”
UNC is working to test all hospital patients. It now tests all asymptomatic patients who are high-risk or who could directly spread the virus within health care settings, said Bridges.
“If there was an unlimited supply of tests, we would test everyone,” Bridges said. “DHHS recommendations are right, but we have to prioritize within a framework based on testing capacity.”
Atrium Health’s website advises patients to “get screened only if you have coronavirus symptoms — fever, cough, shortness of breath, or loss of smell and/or taste.” Atrium did not respond to requests for comment.
“Get tested, if you need it,” Atrium’s website advises patients. “Based on your symptoms, you might get tested in our mobile unit.”
Novant Health’s website doesn’t advertise updated guidance from the health department. It says Novant will test patients who are high-risk or showing symptoms. But patients with mild symptoms “should stay at home to recover and do not need testing.”
“If you do not currently meet the above guidelines, then you should not come to a medical facility looking for testing,” the website reads. “Coming anyway will only further your risk of exposure and put a strain on resources that we must reserve for those who need it.”
Novant didn’t respond to CJ’s request for comment.
Cone Health’s website says it’s testing patients with symptoms and risk factors, plasma donors, symptomatic first responders, and asymptomatic but high-risk patients. Duke Health’s website funnels patients through telehealth visits with a doctor.
Mission Health lists the testing criteria set by the Centers for Disease Control and Prevention, and tells patients they “may not be tested for COVID-19 because you do not meet the criteria established by the (CDC).”
“Patients without symptoms or with mild to moderate symptoms will likely not be tested for the virus,” Mission Health’s website says. “If you are worried but don’t have symptoms, please stay home. Going to a doctor’s office or hospital adds to a higher concentration of people and further overwhelms the medical staff.”
CVS Minute Clinic is offering COVID-19 tests at no out-of-pocket cost, but asymptomatic patients won’t qualify unless they know the state prioritizes their testing, they have underlying conditions, or they work in health care and caregiving.
To get a test, asymptomatic patients must answer “yes” when online registration asks whether they have “been prioritized by your state or local health department for testing,” Joe Goode, CVS Health spokesman, said in an email.
The state health department is encouraging providers to ramp up testing for patients without symptoms, said spokeswoman Kelly Connor.
“We are responding to COVID-19 on multiple fronts,” Connor said in an email.
Experts say the state still lacks critical testing capacity.
North Carolina ranks 32nd in the nation in tests per 1,000 residents, according to the Kaiser Family Foundation. The state has passed the first testing benchmark of the national COVID Exit Strategy and is averaging 14,000 tests per day in June.
But that only achieves a “minimal level of adequate testing,” Cyrus Shahpar, director of global health policy experts Resolve to Save Lives.
The 7.6% rate of COVID-19 tests coming back positive is too high, Shahpar said.
“That number needs to be driven down by more testing,” Shahpar said. “It’s a mixed picture. They’ve done a good job increasing tests, but it’s not sufficient to keep up with the caseload.”
The state is starting to target testing but expects more problems getting supplies and reagents, as well as finding people to give and read tests, Connor said.
“The supply chain has been a challenge since the beginning,” Connor said. “North Carolina now has the capacity to perform more testing. … However, as testing increases across the country, we anticipate these challenges to continue.”