April 1st, 2020

We'll never have an accurate number of cases

I work 2 days/week at a free clinic here in Maine. We are a volunteer model clinic with 4 part-time paid staff people: two nurses (I am one of them) and two clerical staff. On Mar 10, the other nurse started feeling sick with flu-like symptoms. He'd been in NYC from Feb 28-Mar 2. He called out sick from work on Mar 11. His symptoms worsened and he was tested for COVID-19 on Mar 12; test was reported + on Mar 13--confirmed corona virus case #2 (CCC#2) in Maine. Our clinic is in a building run by the city of Portland. The building was immediately shut down for 2 weeks and everyone in the building (23 people in all--there are other clinics in the building in addition to the free clinic) was sent home on admin leave.

I have spent hours on the phone the past 2.5 weeks. A huge frustration has been the shifting and conflicting information and guidelines from various regulatory authorities: CDC, Maine CDC, city of Portland. Volunteers and patients are all very concerned and worried and the information that I am sharing with them seems to change from hour to hour.

Another frustration is the lack of availability of tests and when someone is tested, the delay in getting results. CCC#2 had 11 close work exposures (including me) from Mar 5 through Mar 10 (the day he developed symptoms). Of those 11 people: 1) 7 had symptoms--3 were positive; 3 were negative; and 1 person was not tested, despite the fact that she had sx and a known exposure. Her clinical course was very suggestive for COVID-19. She developed sx 4 days after exposure (Mar 14) and was sick for 14 days--only started feeling better on Mar 29. Of the 6 people who were tested, the results took anywhere from 24 hours to 8 days to come back. Frankly, 8 days seems sort of pointless! With this inconsistency in testing and delays in results, I have no confidence in the numbers of cases that are being reported. I think the actual incidence is much higher than what we are being told. Asymptomatic people are spreading the illness and don't even know they are infected.

The last frustration is the frequently reported stat of "80% have mild illness." "Mild illness" is a euphemism for "not hospitalized." Again, of the people I know directly who were positive, only one had "mild illness." The others were very sick and felt lousy for 10-14 days with spiking fevers, pain, cough, shortness of breath, sore throat, and no appetite. CCC#2 did end up hospitalized for 4 days; everyone else I know managed to stay at home, but they would not wish this illness on anyone.

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Comments (1)

Comments (1)

Hi Leslie:

Thanks for joining our conversation and sharing your experience. I hope you're staying well.

How would you like to see the response to the crisis changed? Would a federalized response make a difference? Better coordination with local authorities? Something else?

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