We are flying blind into the coronavirus pandemic

I have COVID-19. SLO County does not know it. There are not enough test kits. This is my story.

I came down with “flu-like” symptoms on Sunday, March 22 and have since isolated at home per the guidance of the CDC and SLO County Public Health Department. My symptoms began with severe aches in my legs and hips. Next came a mild fever (99.0-100.5F) and chills that lingered for days. A dry cough began on Tuesday. At some point, I lost my sense of smell. I was seen on Wednesday night when my cough and shortness of breath became worrisome. The provider tested me for influenza. That test came back negative. I was not tested for COVID-19 because I am not a high-risk patient. I was prescribed an inhaler and directed to continue my home isolation.

SLO County does not have enough COVID-19 test kits to test all symptomatic and at-risk individuals. My provider wanted to test me. She could not. More troubling still, the county does not appear to be utilizing information from my case, or cases like mine, to inform the public and the Public Health Department’s response to the pandemic. If we are to curb the spread of COVID-19 in our community, this must change. These are my suggestions:

1. The county should modify its testing and reporting criteria to conserve tests and provide the public with as much information as possible. The county should identify and report “presumptive” cases of COVID-19 for individuals who meet certain criteria.
2. Testing family members of known positive cases is a waste of test materials. The county and the public should assume symptomatic family members of known positive cases are also COVID-19 carriers. This will conserve tests. Both symptomatic and asymptomatic family members of known positive cases should be directed to self-isolate at home. Symptomatic family members of known positive cases should be counted as presumptive cases of COVID-19.
3. Prolonged contact with a known positive case of COVID-19 should be removed as a criterion for testing. Without enough tests the premise is flawed. Testing should be completed based on symptoms and risk factors alone. Individuals who have had prolonged contact with a known positive individual should be directed to self-isolate at home whether they experience symptoms or not. Symptomatic individuals who have had prolonged contact with a known positive individual should be counted as presumptive cases of COVID-19.
4. The county should establish a self-reporting hotline and website whereby individuals can report their symptoms and presumptive cases can be tallied. In the absence of testing, this data is critical to inform the public and minimize the spread of the disease while it is still at a manageable stage.
5. The county should track individuals who present to medical providers with flu-like symptoms and test negative for influenza. These should be considered presumptive cases of COVID-19.
6. All persons with acute flu-like symptoms who require hospitalization must be tested in order to ensure our medical professionals are informed and able to take necessary precautions. The measures described above reserve our precious tests for these cases.

We can reduce the spread of COVID-19. It is not too late. We cannot if we rely on optimistic data. It is dangerous to assume the number of positive tests describes the scope of our local outbreak. We must use self-reporting and identification of presumptive cases to inform our leaders and the community. Without more tests, there is no alternative.

Paso Robles resident Paul Oyler is a graduate of the U.S. Naval Academy and the Navy’s TOPGUN course. He trains Navy F/A-18 aircrews and maintainers as a consultant and Navy reservist.