Parenting during a sudden school closure presents enough challenges for working mothers and fathers — even without a global pandemic.
But so it goes for Fanya O’Donoghue, a mom to four boys, who began coughing last week and contracted a fever, a sore throat and other symptoms that doctors and medical experts say are typical of COVID-19, the illness associated with the new coronavirus. The Baltimore County resident has tried to maintain a sense of normalcy in her household even as she awaits the test results, a process her doctors said could take five days or more.
The suspense, she said, has left her in a quiet state of agony as she tries to balance caring for herself and parenting her boys at a distance with the help of her husband.
“Our response time should be quicker,” O’Donoghue said. “We’re supposed to be the most powerful country in the world, but people are dying for information.”
O’Donoghue, however, also recognizes her luck. After all, she got a test, while many others have unsuccessfully implored their healthcare providers for the same — only to be denied.
The shortage of testing kits — and the lag time between taking the tests and getting the results — has alarmed and frustrated dozens of Marylanders, many who have tried to get themselves or their loved ones swabbed for the coronavirus to no avail or who have been cast into states of uncertainty.
A nationwide shortage of tests means only some will know if they are carriers of the highly contagious upper respiratory disease that has infected more than 250,000 people around the world and killed more than 10,000, numbers that will certainly rise as testing ramps up, experts say. In Maryland, three people have died from the coronavirus, and more than 200 have tested positive for it as of Sunday.
After initially reporting how may tests it was conducting, the state stopped last week. Gov. Larry Hogan has said he’s pushing the federal government to supply more testing resources. Without sufficient testing kits, more cases likely exist than those that have been confirmed.
“Testing for COVID-19 continues to be a challenge in Maryland, as it is across the nation,” said Charles Gischlar, a state health department spokesman. “Private/commercial labs and medical institutions are coming online and accelerating testing, which helps to improve statewide testing capacities.”
Not everyone needs to be tested, Gischlar said. Testing is needed for people with symptoms, those over 60 and those with underlying health conditions because they’re most at risk, he said.
Still, test anxiety has rattled state residents of all ages, backgrounds and health profiles, who say the state has not coordinated with medical systems and patients well enough.
Some said their primary care physicians have been overwhelmed with testing requests from patients and have been given insufficient guidance about where to refer them for testing. Others said they’ve been told they did not qualify for tests because their symptoms or health background did not match the Center for Disease Control and Prevention’s patient profile or because doctors have to save kits for their staffs.
“No one knew what to do or what the protocol was,” said Martha Connolly, 66, who got tested for the coronavirus after spending several days looking into where she could go. “They said, ‘we’re holding off for high risk people.’ But if you’re not looking into community spread, how do you know for sure who’s at risk?”
“People still not being able to be tested and in the meantime exposing lots of other people — I feel that’s crazy,” added Felicia Lovelett, 65, whose coronavirus test came back negative Wednesday. “A lot of people are really frightened.”
Some 80% of patients recover on their own, though no treatment regimen or vaccine yet exists. But some cases, especially among those more at risk, become severe, progressing into difficulty breathing and even pneumonia.
Experts and healthcare professionals said the ability to test allows researchers to more accurately track and understand the new virus and its traits, including those most susceptible to it and how it spreads. And yet, public officials have said the infirm should worry less about getting a test and focus instead on social distancing measures.
As more testing kits become available, some said they hope healthcare providers lower the testing standards.
Baltimore City resident Lucas Moten said he attempted to get tested in February at ExpressCare in Overlea but was told tests were reserved for people who had traveled from China or had been in contact with someone who had tested positive for it. ExpressCare is a LifeBridge Health partner.
And Jason Raysor, a single parent of four, said his cough is severe and continues to get worse, but healthcare professionals at Kaiser Permanente initially refused to test him because he had not recently traveled internationally, been on a cruise ship or could prove he had come into contact with someone who had tested positive. He was approved for testing Thursday.
“I’m just so scared. I thought I was going to die,” the 37-year-old Baltimore County resident said. “I don’t know how the elderly or people with compromised immune systems can handle this.”
Machelle Behzadi, Kaiser Permanente’s vice president of quality and safety and chief nursing executive, said the health provider remains focused on patient, staff and community well-being. Infectious disease doctors review the medical profiles of all patients who request testing, she said, to determine whether a person’s symptoms match the CDC’s algorithm.
“We’re ordering quite a significant number of tests,” she said. “There are not a lot of tests available, so we want to make sure we are testing people who are moderate to high risk.”
Raysor said he has quarantined himself and his children but worries that others who have not been tested, especially those without symptoms, will continue to spread the virus to vulnerable persons.
Other Marylanders, who have been tested, said the process is convoluted and needs to be reevaluated.
O’Donoghue, for example, said she spent all of last weekend figuring out where she could get tested since her primary care physician did not know. Eventually, she decided to show up at a drive-through testing site that opened Monday at Sinai Hospital of Baltimore.
Those who arrive at drive-through testing sites must first obtain a doctor’s referral and then register in the state’s COVID-19 testing system via a hotline. O’Donoghue spent hours trying to get through to the hotline only to encounter a busy signal on the other end.
“I sat in the parking lot with the car off, calling this number, coughing the whole time, trying to get through,” she said. "They can hear me coughing from outside the car window. I was like, ‘Are they going to turn me away when I’m sounding like this?’ ”
Eventually, with the help of Sinai staffers, O’Donoghue got through to the hotline and registered with the system. Nurses tested her through the car window, instructing her to tilt the seat back so they could swab up her nose.
“They went so far back I’m sure they touched my brain,” she said.
Meanwhile, Sinai staffers bent their fingers into heart shapes and made signs of the cross for O’Donoghue on the other side of the window.
“It gave me goosebumps,” she said. “They were so amazing.”
Dr. Jonathan Thierman, chief medical information officer at LifeBridge Health, said hospitals such as Sinai are adjusting to skyrocketing demand and are tightening their processes each day to make testing more efficient. He said LifeBridge has increased its staff and is working with LabCorp to reduce the lag time between when patients are tested and when they get their results.
“We’ve been ‘in business’ a week with this operation,” he said. “Call volumes have steadily risen but are flattening out now to around 600 calls a day. We’re in pretty good shape.”
While O’Donoghue said she has started to turn the corner, she frets about her mother, who had an aortic valve replaced a few weeks ago. She hasn’t seen her in since she developed her symptoms.
Aside from the physical discomfort, she said, that’s been the hardest part.