Lack of testing adds to fear, frustration for people who are sick
STEAMBOAT SPRINGS — As Crystal Kish got sicker and sicker, she was doing her best to follow the guidelines from public health agencies.
But on March 29, it got to the point where she had days of high fever, difficulty breathing and an uncontrollable cough.
Her lungs, her kidneys and every organ in her body hurt.
“It was the scariest thing in my life,” Kish said. “I couldn’t breathe. I was in so much pain. I 100% thought I was dying,”
Kish’s whole family had been in self-quarantine since March 18, when her husband’s employer, Steamboat Ski & Resort Corp., informed her husband he had direct contact with some of the Australians who later tested positive for COVID-19.
This made Kish nervous because she was in a higher risk category. About a year ago, Kish was diagnosed with Hasimoto’s disease, an autoimmune disorder that can cause a person’s immune system to attack their thyroid.
On March 23, Kish had a fever of 103 and was experiencing diarrhea, vomiting and a worsening cough.
Two days later, she started to feel a little better. But the next day “it all came back,” she said, including the fever and a debilitating headache. From there, things only got worse.
She called her doctor, took showers, Ibuprofen and Tylenol and tried herbal remedies.
But on the morning of March 29, when Kish said she literally felt like she might die, she called the nurse hotline and described her symptoms. She was told to wait for a call back.
About an hour and a half later, she received a call from someone telling her she could come into the emergency room.
By the time she arrived, the coughing fit had subsided and her breathing was a little better.
They checked her breathing and her vitals, Kish said, and told her they didn’t have any reason to admit her. They also said she couldn’t get tested for COVID-19. They told her it was presumed she had the virus, Kish said, and she would need to recover at home.
She said she was told they could only test health care workers, frontline responders and people who were hospitalized with severe COVID-19 related respiratory symptoms.
Kish left frustrated, confused and scared. She described it as the fastest hospital visit she had ever experienced.
About two hours after she got home, Kish went into another coughing frenzy and felt like she couldn’t breathe.
That’s when Kish posted a desperate plea on social media. She felt helpless and wanted to see if anyone else was going through what she was or had suggestions on what to do.
Kish said she understands the need to save the tests for health care workers, and she understands that having a positive test would not change the treatment.
But she doesn’t understand why they couldn’t rule out other illness or why her breathing problems, indirect contact with a positive COVID-19 case and having an immune disorder wouldn’t qualify her for a test.
Testing criteria is restrictive
Kish may have been able to get test had she gotten sick a week or two earlier.
The criteria for testing has only grown more restrictive in recent weeks, not less. And yet the experts continue to say the same thing: the best way to flatten the curve is early and aggressive testing.
For places like New York City, it may be too late to contain the virus — at least this initial outbreak. For other places, widespread testing may still play a part in identifying, isolating and containing cases.
There’s also peace of mind from either knowing you have it or knowing you don’t. In this new reality full of unknowns, knowing whether you have the virus gives at least some semblance of control.
Public health and hospital officials have been clear they would test more people if they could, and they are also frustrated by the lack of supplies.
Scott Bookman, the Colorado Department of Health and Environment’s COIVD-19 incident commander, said on Thursday, April 2, that because of the lack of testing resources from the federal government, officials estimate there are between four and 10 times more cases of COVID-19 in the state than can currently be confirmed.
The state and federal government continue to promise a ramping up of testing, but it has yet to materialize here.
Routt County officials have been at odds with the state over testing. On March 16, the Colorado Department of Public Health and Environment announced the state would bring a one-day testing clinic to Steamboat Springs.
The state cancelled, citing weather, and rerouted the mobile testing unit to Buena Vista.
Asked on March 24 if they would be rescheduling in Steamboat, Mike Willis, director of the Colorado Office of Emergency Management, said public health officials in Steamboat had informed them they had the capacity to conduct tests locally. Willis added that test kits and protective equipment had been provided to Routt County, and “testing has been completed in Steamboat.”
“The statement that health officials did not want the mobile lab to come to Routt County is incorrect,” said Director of Routt County Public Health Kari Ladrow. “We did want for them to come, and when we were notified they would not be coming because of scheduling elsewhere, we asked if they would at least send us the supplies for the lab, which they did.”
UCHealth Yampa Valley Medical Center President Soniya Fidler said the criteria for testing is being reevaluated every day, and hospital officials are always working on expanding capabilities. But at this time, the hospital is only testing people who are admitted to the hospital for COVID-19-related illness, health care workers and first responders.
“As with any emergency room, the team is here and ready to care for you,” said Dr. Laura Sehnert, YVMC emergency medicine physician and chief medical officer, when asked about general protocol for patients with COVID-19 symptoms.
If a patient comes in with COVID-19 symptoms, they are screened and given a mask, she said.
The protocol was developed at a systemic level by UCHealth “to help make sure we are all appropriately managing patients and that we are universal in our approach,” Sehnert said.
Vital signs are monitored and respiratory status determined, she said, in order to assess whether a patient can recover at home or if they need to be hospitalized.
“If they are able to be discharged home, we would give them specific criteria on what would warrant a repeat trip to the ER and information on how to monitor symptoms at home,” Sehnert said.
Navigating the unknown
From the beginning, Kish tried to do what she was supposed to.
“I sat at home for a long time,” she said. “I tried to listen to all the guidelines. I didn’t want to bog down the system.”
But then when the pain, the coughing and her difficulty breathing increased, Kish didn’t feel she had any other choice but to call.
Kish said she understands the hospital doesn’t have the supplies available to test her, but she’s still worried her illness will get worse or that she has something else wrong with her. Watching what is happening across the country, she’s scared she might die. At least if she had a test, she would have some answers.
On top of being very sick for weeks, both she and her husband have suddenly lost their sources of income, and Kish has been isolating herself from her three sons.
“I just want to protect myself and my family,” she said.
Kish said her husband and one of her sons experienced symptoms, but nothing like what Kish went through.
Kish said she was nervous about sharing on social media, but through telling her story, she found much needed comfort and encouragement. She also received advice on medications and home remedies, as well as community resources.
Routt County Commissioner Beth Melton replied on Kish’s social media post, “The reason that testing is not necessary or recommended for all patients is that because there is not a treatment for the virus, there is no difference in clinical treatments whether you test positive or not. If your doctor advises you or your family to self-isolate, then you should. If you tested positive, this would be a self-isolation order from public health. You should not hesitate to call your doctor or 911 if your symptoms warrant that. If you are in need of help to take care of your family, you can email firstname.lastname@example.org or ask for help within this group. Anyone who brings you supplies or anything else should leave them on your front porch and not make any contact (including touching the doorbell).”
Still recovering, Kish is talking about starting a support group for people like herself who are isolated at home and feeling very sick.
Even if widespread testing is not available now — and it will still take time to build that capability — state officials have said it is needed for potential future outbreaks and until there is a treatment and vaccine.
There were no new cases of COVID-19 reported Sunday, April 5, in Routt County. As of Sunday, there were 29 positive cases, with 19 of those listed as “recovered.” A total of 336 people in the county have been tested.
Before immediately heading to the hospital, people who are exhibiting symptoms of COVID-19 have several resources, including:
- The Colorado Department of Public Health and Environment is providing a phone line to answer questions from the public about COVID-19. Call CO-Help at 303-389-1687 or 877-462-2911 or email email@example.com for answers in English and Spanish, Mandarin and more.
- UCHealth Yampa Valley Medical Center offers Ask-A-Nurse, a 24/7 call line staffed by registered nurses who can assess symptoms and provide advice on seeking care. In Routt County, Ask-A-Nurse can be reached by calling 970-871-7878.
- Virtual Visits can be done from the comfort of your home and only require a computer or tablet with a working webcam, speakers and microphone, or a smartphone.
- If patients are experiencing severe symptoms or having difficulty breathing, they should visit the hospital’s emergency department.
Take precautions in everyday life:
- Frequently and thoroughly wash hands with soap and water for at least 20 seconds. If soap and water are not available, use hand sanitizer with at least 60% alcohol.
- Cover coughs and sneezes with a tissue, then throw the tissue in the trash, or use your inner elbow or sleeve.
- Avoid touching your eyes, nose and mouth with unwashed hands.
- Stay home if you’re sick and keep your children home if they are sick.
- Clean surfaces in your home and personal items such as cell phones, using regular household products.
- Be calm but be prepared.
- Employees at businesses and customers are required to wear a mask, according to a statewide public health order.
- Limit distance between non-household members to 6 feet when indoors and outdoors.
- The maximum group size for indoor activities is 10.
To reach Kari Dequine Harden, call 970-871-4205, email kharden@SteamboatPilot.com or follow her on Twitter @kariharden.
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STEAMBOAT SPRINGS — Routt County will write its own version of a COVID-19 dial governing local restrictions when the state dial is expected to end Friday.