Thread by @AbdulElSayed

THREAD on what’s wrong w/ #testkits right now:

A friend had a patient w/ chills/cough, plausibly w #Covid_19, but w/o known exposure.

He requested a #coronavirus test. He was denied.

Then he tried an X-ray to rule out pneumonia, but he was denied for possible #COVID

1/

So this poor guy can’t get a #Covid test because he had no travel history or known exposure to #coronavirus.

And he couldn’t have pneumonia ruled out because a doc thinks he might have #Covid_19.

He’s caught in a testing catch-22

2/

The OBVIOUS first issue is that we STILL don’t have enough #testingkits otherwise this guy would get one.

But there’s a second issue: we’re not using them correctly either.

In medicine/public health you never run a test that won’t change your management.

3/

Running a #COVID test in a patient w/ BOTH a known exposure AND symptoms is useless.

You’re going to treat/isolate that person ANYWAY.

It’s a waste of a test.

Instead...

4/

The two scenarios YOU SHOULD run tests are in

1) ppl who are exposed but w/o symptoms. For them a + test leads to stringent isolation and monitoring.

Or

2) ppl like this patient who have symptoms in whom there is no known exposure, so you isolate/monitor.

5/

So not “everyone who wants a test can get a test,” and WE HAVE TO FIX IT.

AND hospitals need to rethink the way we use these tests so that they actually change our management, rather than confirm what we ALREADY know.

6/6