NYC Health Department Says To Limit Testing

NEW YORK -
A worker wearing protective clothing carries a box to the entrance of a protective tent at at a state-managed coronavirus drive-through testing site that opened, Thursday, March 19, 2020, on the Staten Island borough of New York. (AP Photo/Kathy Willens)

A NYC Health Department memo advises not to encourage testing for asymptomatic people or those who has mild or moderate illness, even if they are hospital care workers or first responders. It advises that those patients be told to remain at home in order to prevent in-person healthcare visits. Only patients whose test results will impact the clinical management of the patient should be tested. The purpose of this directive is to preserve personal protective equipment (PPE) for the hospital care workers, which is in desperately short supply. In addition, there is also a dwindling supply of collection swabs and viral transport media supplies.

A nurse at Westchester Medical Center (WMC) in Valhalla, NY, told Hamodia that for the entire week, she was provided with just one protective mask, which she had to wear for all patients she serviced. Although she did not work in the emergency room and did not come in direct contact with COVID-19 patients (WMC has 6 such patients), nevertheless the unprecedented rationing of protective equipment is not the best practices for any hospital care.

This advisory asked that outpatient testing not be encouraged, promoted or advertised. Patients with COVID-like symptoms not requiring hospitalization should be advised to stay home, since it is safer both for the patients and the hospital care workers, and testing does not change the clinical management or recommendations about staying home. By following this protocol, the Health Department hopes to reduce the risk of transmission from ill patients to the emergency care and hospital care workers.

The Health Department also suggested that Emergency Department only receive severely ill patients or those who require immediate emergency care, and alternative venues may be set up by individual hospital systems to offload their emergency departments.

Due to this public health guidance that people with mild illness stay home and not get tested, the data may not reflect the true number of positive COVID-19 cases in NYC, and may overrepresent the volume of hospitalized cases vs those who are actually positive, since only those hospitalized will be documented as having tested positive.