A COVID Christmas Tale

On Dec. 23rd I started feeling dizzy. What happened next is more concerning. Here are some tips on getting tested, and a warning.  If you can contribute advice via comment, please do so.

My balance, which I use in sailing and other sports, is pretty good, so when I found myself stumbling and holding onto dressers and other furniture to make it across the bedroom to the bathroom it was: a) kind of a fun challenge, and b) most unusual. I found I only had a slight fever of 99, and aside from a little nausea and ringing in my ears, no other symptoms. Nonetheless, I quarantined myself away from the family for 24 hours until I found I could still taste a chocolate biscotti and my temperature bounced around from 97 to 99, but never higher. Unlikely I had COVID, but there were reports of dizziness – and no other symptoms – being present in people later diagnosed with COVID. So on Dec. 24th I started looking for testing….

…And the HMB test site had none available until Jan. 4th or later. And my primary MD was out, and a call to Mills Peninsula resulted in them telling me only all the ways they DON’T do COVID testing (they left off ER testing, which they presumably still do). Mills said there was a testing site in SF, somewhere. The San Mateo County (SMC) website listed a bunch of sites including the County Event Center (the old Fairgrounds) but none had appointments available for as far into the future as they displayed dates, and a national site called Project Baseline also listed a bunch of sites. I got recommendations from friends, including our beloved Editor here, and used my phone to fill out forms for Project Baseline. It took a good 10 minutes (ever try to find the Group Number on your Health Insurance Card? I still can’t), and I completed questionnaires about my symptoms and insurance status and read all the required disclaimers and got two emails acknowledging my completion thereof…. And then after all that time I got to the stage where they told me there weren’t any appointments anywhere in the County – couldn’t they have started with that fact? – for the forseeable future. My MD wrote back and recommended I try a site called virusgeeks.com — [they are at the Marriot hotel in San Mateo]. When I called I got a VM message saying “Leave a message for Frank”, with no mention of testing or any health care, so I didn’t leave a message.

Now it was Christmas Eve day, so I could understand a few days lapse, but no site was showing anything earlier than Jan 4th, and I’ve got a family to worry about. My colleague & co-author Bruce Laird found a Santa Clara site which was inconvenient, but would probably be open [SCC has a public testing site at El Camino Hospital (Grant Road, semi-near El Camino Real), in Mtn View. You need to make an appointment, by calling: 650-940-7022, option 4. Not very convenient for you, but the swab is literally sent across the street to a Labcorp laboratory, so the turnaround time is fast. I got tested on Thur, 3 Dec at 10am. My results (Neg!) were posted online by 6pm the next day. ] Since my balance was largely recovered, and I had no fever, and the hospital system is overwhelmed with more serious patients, I decided to wait.

Then, at 9am on Christmas Day my MD called me back. He had contacted one of the Sutter facilities, the Palo Alto Medical Foundation in San Carlos, and told me to call 650-596-4100 and that he had put in an Order for a test for me. So, I did, and they gave me several choices for the day after Christmas. I drove to 301 Industrial Rd., San Carlos, CA 94070 and followed the signs around to the back of the parking lot, waited a few minutes and was confirmed for screening, then waited a couple of more minutes and was swabbed in both nostrils while seated in the car.  They told me results would be online in about 24 hours. Within one (1) hour – barely after I got home – the results were posted online: Negative. My guess is my test was 2.5 days after symptoms, so I’m estimating a 5% potential false negative error.  If the results had been positive, it is almost 100% likely they would have been correct.

What was interesting about my conversation with my beloved MD was his second question (right after reviewing the symptoms and timeline). He asked “Do you take Vitamin D?” Which I have done for over a year. I found that very telling, and there are a suite of supplements which are recommended, including Vitamin C, Zinc, Melatonin, etc. A full article on the disease and supplements is here: https://www.evms.edu/media/evms_public/departments/internal_medicine/EVMS_Critical_Care_COVID-19_Protocol.pdf
Of note is the anti-parasite veterinary drug Ivermectin, which is highly recommended. However, I can find no well-run clinical trial substantiating the benefits. A well-designed trial on a few hundred people is not yet complete. International evidence is suggestive of benefit, but may be due to use of corticosteroids, not Ivermectin. There are plenty of other suggestions, ranging from crackpot (like Trump’s) to Unproven, and I’ll skip even mentioning them until I have a decent study to support them. I would suggest the basic diet supplements mentioned in that link, and here: https://www.mdlinx.com/article/supplements-proven-to-help-with-chronic-disease/55lHMHbqDFh2gu3ckgT5Fr?utm_source=alert&utm_medium=email&utm_campaign=ajm_49770 Bottom line: in addition to the public health measures frequently cited, there appear to be a number of specific PERSONAL health measures we can take to reduce the dangers of COVID-19.

What distresses me most about this story is how difficult it was to actually get a test. If my MD hadn’t played Holiday Hero, I would have tried Santa Clara and/or had to wait. As far as Santa Clara, local news reported that El Camino Hospital is now turning away ambulances because the ER is overburdened.

What I hope you, Dear Reader, will do is comment on this article and help us understand if I missed something important.  Is there a better source for testing site info?  What could someone without a responsive family MD do?  What if I hadn’t had health insurance?  What if I didn’t have a car to reach the San Carlos facility? One would expect that – in the nation with the most expensive health care system in the world, after 11 months to prepare for this Pandemic, with the obvious need from the Thanksgiving surge… that it would have been much easier to get a (free) test scheduled.

Our hospitals are at the brink, and they are just on the verge of being pushed over,” said [Santa Clara] County Director of Health Preparedness Dr. Ahmad Kamal on Wednesday.

Why? Well, Southern California.
There is a much longer analysis required to understand the connection between demographic and behavioral differences and COVID-19 case rates.  But those differences are stark.  For example:
7-day avg Cases/100k pop (as of Dec 28th)
– SoCal counties: 49-150
– Central Valley counties: 52-107
– 9 Bay area counties: 25-73
– California, all counties: 100

This can be seen in the latest case map of CA counties, from the NYT (at right):

No area is doing well in the post-Thanksgiving viral surge; the Bay Area counties are in trouble too. On the news recently, Bay Area counties were reported to be down to 11.3% of ICU capacity. But SoCal counties had zero ICU beds open, and have been sending patients north to Bay Area hospitals

I hope this article (and commenters) helps you find a test for yourself or your family.  As importantly, I hope it helps motivate you to Really Stay Safe until you’re vaccinated.