Thirteen days ago, Advisory Board's Ashley Fuoco Antonelli developed symptoms of Covid-19. Since then, she's had a first-hand look at America's response to the coronavirus epidemic—an experience that's been filled with delays and uncertainty.
The 3 biggest questions about Covid-19 testing, answered
'Is it possible this is Covid?'
Around 3:00 a.m. on Sunday, June 28, I woke up shivering yet drenched in sweat, and in pain from muscle aches like I've never felt before. After an hour of tossing and turning with bouts of chills and hot flashes, I got out of bed and took my temperature, which registered as a low-grade fever at 99.6 degrees.
A thought of Covid-19, the disease caused by the novel coronavirus, flashed into my mind. As a senior editor for Daily Briefing, I've been immersed in tracking and covering the new coronavirus since it first emerged in Wuhan, China, last December. For the past seven months, I've spent most of my days tracking the latest policies, research, and other developments related to the global pandemic.
I've also been a stickler for following guidelines and taking precautions to protect myself and my husband from contracting the virus. I'm able to work from home, so, since mid-March, I've ventured outside of my home only to walk my dogs and exercise outside while being careful to stay at least six feet away from others, and to procure essential items. In fact, I've been inside a public place—my local grocery story—only three times since then, and only while wearing a face mask, staying physically distant from others, and being careful to use sanitizers and wash my hands thoroughly afterward. And like many others, I haven't seen my friends or family in person since America's coronavirus epidemic began.
My husband has taken the same precautions, with one exception: He's an essential worker who must be physically present at his workplace to perform his job. And while he's been mindful of taking steps to reduce his risk of exposure while at work, we've understood there's no way he can eliminate that risk entirely. As states began reopening businesses and lifting stay-at-home orders, we started feeling as if being exposed to the coronavirus was a looming inevitability.
Still, I quickly brushed the prospect of Covid-19 out of my mind. "I've been doing everything I can," I thought. "There's no way this can be Covid-19."
But as the day progressed, my temperature rose. I was caught in a cycle of chills and hot flashes, became nauseous, had gastrointestinal issues, and couldn't eat. I developed pain in my back and chest, and had a hard time breathing if I moved around too much. I felt exhausted, but the pain and fever kept me awake.
Eventually, my husband asked, "Is it possible this is Covid?"
We couldn't dismiss the prospect anymore, so we decided to self-isolate until we could get some answers. As a first step, I arranged a virtual visit with a telehealth provider, who reviewed my symptoms and ultimately concluded: "We need to assume you have Covid-19." He couldn't confirm the diagnosis without a test, however, so he gave me a referral to get tested for the new coronavirus.
Just one testing site
Armed with my referral, my husband graciously stepped in and looked to schedule me for a coronavirus test. While I was acutely aware of the testing shortages America faced at the outset of its epidemic, I assumed that accessing a coronavirus test at this point would be easy. It wasn't.
I live in a fairly rural county about two hours from Washington, D.C. While we enjoy the small-town feel typically associated with rural areas, demand from a large, nearby military base ensures we don't lack access to medical care or other amenities. So my husband and I were surprised to learn there are just three coronavirus testing sites in our county—and two of those sites offered testing only during certain hours on weekdays.
Luckily, a nearby urgent care clinic conducts coronavirus testing on weekends, and I was able to secure an appointment for that evening. But my visit didn't provide immediate answers. I underwent rapid response tests for the flu and strep throat (both of which were negative), but after receiving the coronavirus test, I was told it would be about 48 hours until I received my result.
And while my urgent care doctor also said Covid-19 was a likely culprit, she was frank about the complexities of my situation: Not only would we be unable to confirm my diagnosis until I got the test result, but even then, we'd be faced with ambiguity. Like we've reported in Daily Briefing, my doctor explained that there are accuracy issues with the coronavirus tests currently available in the United States. Because of those issues, receiving a negative test result doesn't necessarily mean you're not infected with the coronavirus.
As such, the doctor said I should continue self-isolating for at least 14 days regardless of my test result. If I was still experiencing symptoms at the 14-day mark, I should continue self-isolating until I was symptom free for three consecutive days. The doctor instructed me to follow up with her if I developed any new symptoms and to rest, drink lots of fluid, and use a rescue inhaler if I felt short of breath. If breathing began to feel unmanageably difficult, I should seek emergency care.
Changing symptoms—and timelines
Over the next few days, my symptoms began to change. Days 1 and 2 with symptoms were largely the same: a low-grade fever, chills and hot flashes, nausea, muscle aches, and back and chest pain. On Day 3, all of those symptoms began to subside, except for the back and chest pain.
But on Day 4, new symptoms emerged: I developed a frequent, dry cough, and it suddenly felt difficult to breathe even when resting. My chest felt tight and breaths felt shallow. I started using my rescue inhaler every four hours and continued to rest, drink lots of fluids, and isolate.
Three days after I was tested for the new coronavirus, I was notified I would get my results within three to five business days from my testing date—up from the 48 hours I originally was told. And six days after I was tested—still experiencing coughing, chest and back pain, and difficulty breathing, but having not yet received my test result—I called the urgent care clinic to follow-up. A staff member told me that the laboratory conducting my test was experiencing delays due to increased demand, as new coronavirus cases began surging throughout the United States. It would now take seven to 10 business days to get my result.
Today is day 13 since I first developed symptoms of Covid-19. And while those symptoms seem to be slowly subsiding, I still have chest and back pain, I'm still coughing, and I still feel a tightness in my chest. I'm optimistic I'm on the mend—though I don't know from what.
While my symptoms certainly line up with Covid-19, I received my coronavirus test result on Thursday—nine business days after I was tested and 12 days after I first developed symptoms. My test was negative, but the nurse who called to tell me the result also directed me to continue self-isolating until I have three consecutive days without symptoms, "just in case."
Now, even though I've received my coronavirus test result, I can't be 100% certain I'm not infected with the virus. And as a result, I can't be certain of whether I'm at risk of transmitting the coronavirus to others.
But beyond my personal struggles, my experience navigating my "suspected case of Covid-19" illuminated three shortfalls in America's coronavirus response that broadly threaten our communities' health and the country's ability to gain control of the virus' spread. Be sure to check Monday's Daily Briefing, where I'll dive into those shortfalls and what they could mean for America's coronavirus epidemic.