New York Coronavirus Test Delays Meant Days Without Diagnosis

In late February, two New York City women returned from a Nile cruise in Egypt feeling ill. Their symptoms worsened, and one soon had a pneumonia-like illness.

They learned this week from New York City’s health department that someone else on the cruise ship had been diagnosed with coronavirus. But in spite of their symptoms, the two women — who are in their 60s and 70s — were initially told they weren’t going to be tested, according to Amanda, the daughter of one of the women, who also lives in New York City and has been closely involved in her mother’s care.

Amanda, 31, said officials from the New York City health department told the women they could pose a risk to others if they traveled to a health-care facility, and that if they did test positive, there was nothing that could be done. She said that was the point where she got involved, and was able to get her mother tested later that day.

In total, it took three days since the women learned about the other sick passenger, and two weeks since they first felt ill, to get diagnosed. During that time, it’s possible the women could have infected other people.

“For us, I think we knew regardless of the test,” Amanda said. “But it makes you think about how many people are out there not knowing and just living their daily life.”

For most people, the symptoms of the coronavirus are mild, like a cold or flu. But it’s far more dangerous for older people, or those with underlying medical conditions.

Without an effective drug or vaccine for the new coronavirus as the disease it causes, Covid-19, identifying and isolating new cases is the best tool health authorities have. The virus uses people to spread, and if they can be diagnosed and quarantined, it can be contained — and kept away from vulnerable groups. But without rapid diagnosis, that becomes impossible.

Test and Contain

“Contain, contain, contain,” New York Governor Andrew Cuomo said at a press conference Saturday. “Get a lead, chase it down, find a positive, quarantine. That’s exactly what we’re doing, and it’s going very well.” He said he’d like to be testing as many people as possible.

“The more you test, the better,” Cuomo said.

Amanda said the two women were tested on Wednesday after she repeatedly pushed the city health department. On Friday, her mother and her friend were told they were positive for the new coronavirus.

Bloomberg News reviewed an invoice from Amanda’s mother’s recent trip as well as documentation from a hospital visit. On Saturday, Cuomo said two of seven new cases in New York City were from a cruise ship. Bloomberg agreed to keep identities of the women private to protect their privacy, as well as not disclosing Amanda’s last name.

The New York City health department declined to comment directly on the case, and Cuomo’s office didn’t immediately respond to a request for comment. There are 11 confirmed cases in New York City, Cuomo said in a tweet Saturday.

Coronavirus cases in Maryland and Texas that emerged this week were also linked to an Egyptian cruise that returned around the same time as the one the two women were on. Egypt has at least dozens of confirmed coronavirus cases, many tied to tourism.

The availability of coronavirus testing in the U.S. has lagged far behind the needs of public health workers on the front lines, at least in part because of initial problems with a Centers for Disease Control and Prevention-developed test. Until recently, testing was also supposed to be restricted largely to those with known exposure to the disease, including travel to a narrow group of countries with large numbers of cases — even as the virus has spread elsewhere.

On Saturday, Food and Drug Administration Commissioner Stephen Hahn said that the U.S. has tested fewer than 6,000 samples from Americans suspected of coronavirus infection. The number of people tested is likely less than half that. There are more than 400 cases of the virus in the U.S., according to Johns Hopkins University, but experts say there are likely many more that have gone undiagnosed because of the lack of testing.

Amanda’s experience in New York City this week shows how delays in testing could be shutting out even those with likely cases, resulting in official counts that lag behind the reality of cases. Cuomo on Saturday declared a state of emergency due to the coronavirus outbreak.

It is unclear whether Amanda’s mother and her friend, who found out their results late Friday, were included in those counts or were the new cruise-related cases Cuomo mentioned.

Guidance posted online for New York City’s health department advises individuals with symptoms who have traveled to an area where the disease is spreading should speak with their doctor, who “will work with the Health Department to determine if you need Covid-19 testing.”

The hospital they were tested at told them to follow strict home isolation procedures for two weeks, Amanda said.

— With assistance by Jennifer Jacobs

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