we all just lose our minds from the collective incompetence.
It Took Me 3 E.R. Visits to Get a Coronavirus Test in New York
Thinking I had symptoms, I got a disturbing glimpse of the city’s chaotic and self-contradictory approach to containing the virus.
By Robin Shulman
March 9, 2020
Two weeks ago, I flew from La Guardia Airport to Toronto for a 24-hour trip.
In the immigration intake area, at least 100 passengers streamed off a flight from Shanghai, where the coronavirus had been found a month earlier. We all pressed our fingers on touch screens to answer immigration questions and waited for about 15 minutes for masked, gloved agents to examine each passport.
The next day, I flew back.
That fleeting contact with people arriving from a country at the epicenter of the coronavirus outbreak — and the knowledge that people were probably arriving at the airport from every other outbreak spot as well — rattled me enough that when I developed respiratory symptoms several days after I got home, I was more insistent in seeking health care than I might have been otherwise.
Maybe I was overcautious, but the experience gave me a disturbing glimpse of New York City’s chaotic and self-contradictory approach to containing the virus.
I first developed a cough. Soon, I also noticed that I was losing my breath just walking a few blocks. I didn’t want to overreact — the most logical explanation was a simple chest cold.
Just in case, I went to my primary care practice — I have an immune disorder that could make me more susceptible to illness, and with two young children in school, I wanted to make sure my family didn’t spread something pernicious.
When I said I wondered if I had the coronavirus, the nurse told me I should have gone straight to the hospital. But she didn’t seem overly concerned, and didn’t put on a mask or gloves. I felt relieved when she listened through her stethoscope and said she heard no sign of lung infection.
A few days later, I developed a fever, gastrointestinal symptoms, and tremors in my hands. On Google I learned that two people who were later diagnosed with coronavirus had landed at the Toronto airport on the same days as I passed through, Feb. 20 and 21. One person arrived from China and the other from Iran.
Meanwhile, Covid-19 was being diagnosed in the United States in people who had not traveled abroad recently or been in contact with anyone who had.
There must have been many people in New York City like me with symptoms consistent with the coronavirus, wondering: Should I take precautions, to protect other people? Should I avoid panic and just proceed with life?
Last Tuesday, after a night fever of 100.8, I called the new New York State coronavirus hotline. I was told to go to the hospital for a test. I called ahead to the emergency room of Mount Sinai Hospital on Madison Avenue in Manhattan.
At the emergency room, I was dispatched to a private room. Two staff people entered wearing masks and gloves.
But the attending doctor came in without a mask and offered his bare hand for a shake. He assured me that I was low-risk because I hadn’t been to an epidemic country like Italy, South Korea, or China. The hospital would not test me, since I did not meet the hospital’s criterion for testing, travel to one of those countries, he said. He advised me to go home and continue life as normal. If I felt sick, stay home, and if I felt well, go out. I should only come to the hospital if I felt sick enough to need hospitalization. And my children and husband should continue to go to school and work as usual.
That did not seem like a good way to contain an epidemic.
Still, I felt some relief — a doctor had told me I did not have the virus and therefore could stop fretting about transmission and start nursing my illness.
That relief dissipated that evening when my 6-year-old son began sobbing at bedtime. He looked flushed. He had a fever of 99.6. And because I had been sick that day, my 76-year-old mother, who has respiratory problems, had taken my son to an appointment.
I felt scared, guilty, and enormously frustrated that I didn’t know what it was I was potentially transmitting.
Later that night, I heard that Vice President Mike Pence had announced that testing for Covid-19 would be possible for anyone. “Any American can be tested,” he said. “We’re removing that barrier.” Other officials promised that a million people could be tested by the end of the week.
I wanted to be one of them. On Wednesday, I called the hotline again. I explained that Mount Sinai had refused to test me and asked where I could get tested — in a doctor’s office? At a special clinic? The operator told me to go back to the hospital.
Then the Centers for Disease Control and Prevention took up Mr. Pence’s edict, announcing that anyone could be tested if a doctor agrees. I called the Mount Sinai emergency room, and asked if testing criteria had changed at the hospital. I was told to come back in, and I arrived that evening.
This time, the E.R. doctor put on a mask, gloves and a gown before entering my room. She explained that the criteria were still not actually that broad: People would be tested if they had either traveled to an epicenter or had knowingly come into direct contact with a diagnosed coronavirus patient. I, of course, had done neither.
I told her I was worried about my son and my mother and my children’s classmates. The only way to stop this from spreading is to know who is sick, I said.
“I’ll talk to the powers-that-be,” she said.
She came back and said she would take two swabs — one would be tested for flu and another virus. If tests for the flu came back negative, the other swab would be tested for Covid-19, she said. It was supposed to take about 45 minutes to get the results of the first test.
Three hours later, when I still hadn’t received the results, I stepped out of my room wearing my mask to ask for information. “Get back in your room, Ms. Shulman,” called one of the staff at the desk. I paused. “Ms. Shulman, get back in your room now!” she said. I surmised that the flu panel was negative and they were assuming I had the virus.
When the doctor gave me those results, she hovered by the door in her mask, gloves and gown without even entering the room.
“You are officially under quarantine,” she said. The other swab would go to the C.D.C. for testing.
She left and returned, after another phone call. This time, she walked into my room and sat on a chair opposite me without even putting on her protective gown. My quarantine had been lifted.
Other officials had decided, based on my history, that I was low risk for Covid-19. It seemed to me that the shortage of tests might be influencing their diagnosis.
Nonetheless, she said, I should self-isolate — I shouldn’t go to children’s birthday parties, but I could wear a mask and go to the grocery store. When I felt better, I could resume activities. My children and husband should stay home if they were sick, but otherwise continue at school and work.
Instead of sending my swab for Covid-19 testing, she told me, they would send it out for a second panel of less-common illnesses. If I was negative for all of that, the New York City Department of Health would consider sending my sample to the C.D.C. for Covid-19 testing, she said. I should call the next day for results.
On Thursday, I phoned for results. “All I know is your test came up negative and you have to do a full quarantine for 14 days,” said the physician’s assistant in the E.R. I said that was starkly different from my most recent instructions. “Based on your negative test results, that’s the information I have,” she said. “You need to call the Department of Health.”
The number she gave me for the Health Department was wrong, so I called her back. “Honestly, I would just call anyone I can find,” she said. “I’m just looking on Google, just like you.”
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The operator at the state coronavirus hotline gave me another wrong number. Finally, I called 311, the city information line. After one more erroneous connection, I reached a call center for the city Health Department, where someone told me she had no idea where my swab was or what my quarantine instructions should be — only Mount Sinai Hospital could answer that. She, too, said the city was only testing people who had been to an outbreak country or in contact with someone known to have the virus.
In the meantime, two more seriously ill people were diagnosed with Covid-19 in New York City — neither had any foreign travel or known contact with a diagnosed coronavirus patient. Local person-to-person transmission had already begun.
At that point, I called my primary doctor. He said he had just gotten off a call with the C.D.C. “We’re all going to get it,” he said. “At a certain point, they’re just going to stop testing and assume people with symptoms have it.” Meanwhile, he thought that testing should be happening broadly, in every doctor’s office — but of course there were nowhere near enough tests for that. He advised me to stay home except for grocery and pharmacy runs, and wear a mask.
Just because I wanted to see this through, I made one more call to Mount Sinai and asked where my coronavirus swab was. “It wasn’t sent,” said the same physician’s assistant I had talked with before. “Actually, I really don’t know,” she said.
On Friday morning, my 4-year-old daughter, as well as my son, had a fever. Following medical advice, I had sent her to school throughout the week and potentially exposed other children. I was furious. I should not have had to make that decision on my own, without clear medical directives. But the emergency room doctors giving me instructions were trained to save individual lives, not strategize to head off a pandemic.
When I called the press offices of Mount Sinai Hospital and the governor’s office on Friday to request clarifications for this article, officials at the hospital offered me a Covid-19 test that evening.
On Sunday night I found out it was negative.