Coronavirus: Delayed diagnosis in California highlights testing flaws
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A coronavirus patient at the University of California, Davis Medical Centre, in Sacramento, California, was not tested immediately because the case did not qualify under strict federal criteria.
PHOTO: NYTIMES
LOS ANGELES (NYTIMES) - Already in deep distress, the patient was rushed last week to a hospital in Northern California, severely ill and unable to breathe on her own.
Doctors at the University of California, Davis Medical Centre, near Sacramento, provided the woman with critical care but also considered an unlikely diagnosis: infection with the coronavirus.
Hospital administrators said they immediately requested diagnostic testing from the Centres for Disease Control and Prevention, but the procedure was not carried out because the case did not qualify under strict federal criteria: She had not travelled to China and had not been in contact with anyone known to be infected.
The announcement on Wednesday that the patient was indeed infected left health officials in California searching for other cases and raised difficult questions about who should be tested for the infection and whether the nation was prepared to shoulder a burden necessary to keep the virus under control.
The California woman's case may also offer the first indication that the virus has spread beyond Americans who had travelled outside the country, or had contact with someone who had.
Frustration has been mounting among health providers and medical experts that the agency is testing too few Americans, which may slow preparations for an outbreak and may obscure the scope of silent infections in this country.
"I think the diagnostic issue is the single most important thing that keeps me up at night right now," said Dr Lauren Sauer, director of operations at the Johns Hopkins Office of Critical Event Preparedness and Response.
CDC officials said that they had been unaware that doctors in California had made an urgent appeal for diagnostic testing of the woman.
Then on Thursday, the agency revised and broadened its testing criteria, adding to the number of Americans who qualify.
In California, health officials are tracing close contacts of the woman, who lives in Solana county, but has not otherwise been identified. Healthcare workers who have treated her are being monitored for the infection.
Under the new federal criteria, people with respiratory symptoms who travelled to Iran, Italy, Japan and South Korea should be tested - not just those who travelled in China.
It also applies to severely ill patients with acute lower respiratory symptoms who are hospitalised and in whom other diagnoses have been ruled out.
