Getting home late the other night I spotted the Dog Star peaking out from behind a few clouds. The light emanating from Sirius took about 8 and half years to reach my eye. Looking up at a star is like looking back in time at an image of what it was like when the light first left it.
It served as a poignant reminder that during this Coronavirus crisis we’ve been constantly relying on old information to make decisions. Despite what politicians claim and media outlets repeat, testing for Covid-19 continues to be poor, with testing times swelling daily, if you can get a test at all. Here in North Carolina, we’ve essentially given up on outpatient testing. With few exceptions, we’re only testing selected inpatients at this point. And our wait times for those tests has grown to 8 days.
The infection rates in North Carolina remain low, currently only about 5% of all tests have been coming back positive. This would seem encouraging, but those tests likely reflect what the virus was doing a week ago. In a crisis that moves at lightning speed, 8 days might as well be 8 years, just ask any New Yorker.
The delay in testing, leads not just to poor or late clinical decisions, as we’ve seen, it can also lead to some catastrophically bad policy decisions. North Carolina’s Governor recently scorned the advice of numerous medical societies to issue a “shelter in place” order. They cited lack of PPE as well as potential pitfalls of current data as reason to take urgent action. That urgent action could prevent or at least blunt the surge of sick patients that seems increasingly inevitable. The Governor instead sided with recommendations from the North Carolina Chamber of Commerce who’s essential message was (to loosely paraphrase) “we ain’t like those big city folk, we’re different”.
Meanwhile, as I look up at Sirius, I can’t help but think that if there’s someone looking back, what might they be thinking? Silly humans.
Deep Ramachandran, M.D. is a Pulmonary, Critical Care, Sleep Medicine physician, founding CHEST Journal Social Media Editor, and co-Chair of ACCP Social Media Work Group. He blogs at Caduceusblog. He is on twitter @Caduceusblogger.