Coronavirus: To Test or Not To Test?

To test or not to test - that is the question. I explore each potential result here, and I conclude that blissful, asymptomatic ignorance is likely the best choice of them all.

As of this writing, I have no idea how one goes about trying to get tested for the coronavirus. I’ll assume they go to their doctor (or ER) with symptoms, a prescription is written, and some poor nurse gives them a test. The test itself looks pretty unpleasant, to boot.

This is how far back we have to put the swab to test you for #COVID19.

You might want to follow medical recommendations and #StayHome. pic.twitter.com/gCMqUdpsEk

— Jessica Peck, DNP APRN CPNP-PC (@DrPeckPNP) March 29, 2020

Lets assume at some point we’ll be able to get tested voluntarily. The optimist in me thinks this won’t be too far off; the pessimist thinks it will never happen - cases will drop off without the majority knowing if they ever had it.

I started mulling over whether I and my family would get tested. What would happen, and how would it change our behavior going forward? To be clear, nobody in the family is experiencing any symptoms - no fevers, no dry coughs. So, if positive, we might be in the most dangerous asymptomatic group.

I think there are rumblings of a test with results in under 15 minutes, but I think the more common case in the US is one that takes about two weeks. I predict that we’d be more irritable from test time until test result. Objectively, nothing has changed, but at the same time, the anxiety increases because it becomes more real. Ask anybody waiting for a biopsy result.

OK, so the time elapses, and we’ve got a result - what happens next?

• All family members negative
  • Feeling: Slightly relieved.
  • Behavior: Two possible outcomes:
    1. Clam up even more - we’ve dodged the bullet so far, so lets take extra, extra measures to ensure we don’t have to keep ducking bullets.
    2. Begin seeing friends and family who have also tested negative recently. At large, I can see society starting to loosen up a bit on our protective measures (going out more, no gloves/mask, etc), even though it’s likely those protective measures were the reason we’re not sick in the first place.
• All family members positive

  • Feeling: Oh shit. It’s real - we have it. Anxiety and fear up 10x. Every little cough or sneeze would bring back a flood of fear. Is it getting worse? Where did we get it? Why aren’t we showing symptoms? How will this effect the baby?!? An endless set of question resembling the stages of grief.

    (I’m getting stressed just predicting how we’d feel)

  • Behavior: Clorox everything. Only go outside in the backyard. Alert any neighbors we’ve had even passing contact with. Request family members do our supply shopping. Start logging all data points. I would probably dive head first into some of the things I’ve been trying to avoid, namely researching what is happening inside me from first- and second-hand accounts. Pack hospital go bags. Emergency prepare estate plans - we may be asymptomatic now, but that may not last forever.

• Mixed results - A strict subset test positive. All cases bring about questions of how that’s even possible - my son has sneezed in my face at least thrice in the past 24 hours, so this is probably the most unlikely scenario.

  • Son only: Likely would mean my wife would go to her parents. I’d bite the bullet to take care of him without risking exposure to the fetus.

  • Wife only: A whole bunch of unknown here. Our son would probably still go his grandparents’ house, and I’d stay here with here, but in separate parts of the house.

  • Me only: Likely a similar scenario to just my wife being positive, but I’d probably quarantined to the basement.

  • Son and wife: Tidal waves of survivors guilt-like feelings here. I likely would stay around and risk exposure here as well. In no circumstances do I think leaving a sick child and pregnant wife to be good for anybody.

  • Son and me: Wife would go stay with her parents to protect her and the baby. Little man and I get lots of time together.

  • Wife and me: Probably the worst case scenario - all of the fears from the All Family Members Positive option above. On top of that, we’d have to separate from our little man for an unknown length of time. As if that wasn’t hard enough, we’d constantly be in fear of “what if the test was wrong, and he was in fact positive, and now he’s with grandparents that are vulnerable?”.

Analyzing all of these scenarios demonstrates that there’s a huge asymmetry here: the best case scenario from taking this test is “slightly relieved.” Whereas the downside is an unending pit of fear, anxiety, and stress.

What would you do?