A medical worker tests a person for the coronavirus at a drive-through facility primarily for first responders and medical personnel, Tuesday, March 17, 2020, in San Antonio. Credit: Eric Gay | AP

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As the number of confirmed COVID-19 cases in the state continues to grow, Mainers are running into a problem: There aren’t enough tests available for all who seek them.

With a limited supply of tests, health care providers are deciding which patients who ask for a test get one, said Dr. Noah Nesin, vice president of medical affairs at Bangor-based Penobscot Community Health Care, a federally qualified health center.

“Without the kind of unlimited testing resources that we’d like to have and without a quicker turnaround time for the tests, we have to be more intentional with who gets the tests,” Nesin said.

Credit: Gabor Degre | BDN

Tests are offered to those judged to need them most

Most physicians are offering tests to people who appear to have had the most significant exposure to the novel coronavirus. These might include people who have traveled recently, have been exposed to a confirmed case of coronavirus, or are sick with flu-like symptoms and have significant risk factors — for example, seniors and people with chronic illnesses.

Typically, healthy people who don’t have severe symptoms will not get tested. The advantage of testing people without symptoms when tests are already scarce is limited, Nesin said.

Earlier narrow testing criteria provided for tests only for people who had traveled internationally, but Nesin said anyone who has recently traveled domestically — especially by air — and has flu-like symptoms should now also be prioritized for testing.

Reasons behind the test shortage

The Maine Center for Disease Control has a finite number of coronavirus testing kits, which it receives from the U.S CDC.

The CDC’s Health and Environmental Testing Lab has received supplies sufficient to test 1,000 people, said spokeswoman Jackie Farwell. The lab has the capacity to test samples for 100-200 patients per day, and those samples are processed within 24 to 48 hours of the state lab receiving them, she said.

While the coronavirus situation is changing rapidly, Farwell said Tuesday, the lab’s testing supplies are currently adequate to meet the testing demand.

Even as private labs ramp up their testing, health care providers still can’t offer tests to everyone who asks to be tested, Nesin said.

PCHC is also running out of swabs to do the tests, he said.

If you aren’t able to get tested, self-quarantine

People who need tests and have been told by their health care providers that there are not enough available should self-quarantine for two weeks, Nesin said. The same advice goes for people who are awaiting test results.

There’s still a 48- to 72-hour turnaround time during which people have to live with the uncertainty of not knowing whether they’ve tested positive for COVID-19. Further delays are possible due to an overloaded health care system.

“Because so many people are being tested, it’s a lot of time for the health care system to follow those results, communicate with the people and give them advice for the people that live in the home with them,” Nesin said.

If young and healthy people have the disease, it’s likely that they’ll have mild or moderate symptoms and that they’ll be able to manage at home with over-the-counter medication.

“The really critical thing is they need to work not to spread that disease,” Nesin said. “If it’s not COVID-19, it’s still better that they stay at home. Even if it’s just a bad common cold, if they infect other people, then those people are going to enter into the system, get tested and have to self-quarantine.”

Now is the time when social distancing is most effective

Maine finds itself in a likely short window of time during which social distancing can make a notable difference.

Since community spread of the virus in Maine is still limited compared with other states, the more people stay at home and self-isolate, the more they can drastically reduce the coronavirus’ spread, Nesin said.

Once people in the Bangor region are transmitting the virus to each other through contact, social distancing is no longer that effective, he said.

“If we stop one person from getting the disease today, it might mean a week from now, 10 fewer people get it from contact,” he said. “During this opportunity, overdoing is the best approach because it is most likely to help us flatten the curve.”

Limiting the spread of coronavirus by staying indoors and social distancing as a precautionary measure in the next couple weeks will reduce the burden on health care systems, limit the economic loss that businesses are facing and also simply means fewer people will die.