First, health officials said you should not get tested for the coronavirus unless you had symptoms. Then the message shifted: Mass testing was essential to trace and contain the pandemic.
Now there is more confusion as public health officials warn of shortages of testing supplies, soaring demand and long wait times for results, which have thwarted contact-tracing efforts in places with heavy outbreaks. At the same time, politicians in states where cases had fallen have urged people to get tested, whether they have symptoms or not.
“Go get a test,” Gov. Andrew M. Cuomo of New York said this month. “It doesn’t cost you anything. It doesn’t hurt.”
And in New Jersey, Gov. Philip D. Murphy said during a recent briefing on the coronavirus: “Getting tested gives you peace of mind that you are not unknowingly carrying this virus and can spread it among your family and friends. We just need you to go out and get tested.”
What is a conscientious person who already wears a mask and maintains social distance to do?
Is there a moral obligation to get a test?
Yes, said R. Alta Charo, a professor of law and bioethics at the University of Wisconsin-Madison.
“One of the most important things to keep in mind when discussing public health is the fact that this is fundamentally a community issue, not merely an individual health concern,” she said. “We are all in this together. What I do affects everyone around me, and what they do affects me.”
If public health experts want people to be tested, they should comply, especially if the goal is to gather critical information about how many people are infected at a given point, Professor Charo said.
Epidemiologists can use the data to determine how fast the virus is spreading and which measures are working, she said.
Taking a test, like wearing a mask, shows “a desire to be a part of the solution,” said Dr. K. C. Rondello, an epidemiologist at Adelphi University in Garden City, N.Y.
The virus has been difficult to control in large part because many infected people without symptoms have unknowingly spread it, he said.
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More testing will help identify these hidden cases, Dr. Rondello said.
But Candace L. Upton, a professor of philosophy at the University of Denver, said people should not feel duty bound to get a test. It can even be argued that it is morally wrong to go in for a test if you have no symptoms and are not at a high risk, she said.
“Until there is no longer a shortage of test kits, it is morally unjustified to test patients for Covid-19 solely for the purpose of collecting data,” Professor Upton said. “Because of the deficit, labs shouldn’t be offering them to people who are just curious.”
The priority should remain testing only those with symptoms or compromised immune systems, and essential workers and older people, she said.
Professor Upton added that testing should be done selectively even in locations where tests are readily available and where results can be delivered quickly.
“The whole system is unfair,” she said. “And so to take advantage of surpluses in certain places in the market is to add to the injustice to people who didn’t have availability in the first place.”
‘I don’t want to be the person to bring Covid here.’
The national failure to coordinate testing efforts shouldn’t cause people with no symptoms to feel conflicted about being tested for the coronavirus, said Dr. Andrew Diamond, chief medical officer at One Medical in San Francisco, a membership-based primary care practice with offices around the country.
“If there is a way for you to get tested that does not clearly and directly impair someone who is a priority, then you should get tested for sure,” he said.
Molly Wallace, 24, who grew up on Martha’s Vineyard, was tested after she moved back to the island from Boston in March.
She was furloughed from her job as a medical assistant and began volunteering at a testing site, Test MV, at Martha’s Vineyard Regional High School, where she went to school.
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Frequently Asked Questions
Updated July 27, 2020
Should I refinance my mortgage?
- It could be a good idea, because mortgage rates have never been lower. Refinancing requests have pushed mortgage applications to some of the highest levels since 2008, so be prepared to get in line. But defaults are also up, so if you’re thinking about buying a home, be aware that some lenders have tightened their standards.
What is school going to look like in September?
- It is unlikely that many schools will return to a normal schedule this fall, requiring the grind of online learning, makeshift child care and stunted workdays to continue. California’s two largest public school districts — Los Angeles and San Diego — said on July 13, that instruction will be remote-only in the fall, citing concerns that surging coronavirus infections in their areas pose too dire a risk for students and teachers. Together, the two districts enroll some 825,000 students. They are the largest in the country so far to abandon plans for even a partial physical return to classrooms when they reopen in August. For other districts, the solution won’t be an all-or-nothing approach. Many systems, including the nation’s largest, New York City, are devising hybrid plans that involve spending some days in classrooms and other days online. There’s no national policy on this yet, so check with your municipal school system regularly to see what is happening in your community.
Is the coronavirus airborne?
- The coronavirus can stay aloft for hours in tiny droplets in stagnant air, infecting people as they inhale, mounting scientific evidence suggests. This risk is highest in crowded indoor spaces with poor ventilation, and may help explain super-spreading events reported in meatpacking plants, churches and restaurants. It’s unclear how often the virus is spread via these tiny droplets, or aerosols, compared with larger droplets that are expelled when a sick person coughs or sneezes, or transmitted through contact with contaminated surfaces, said Linsey Marr, an aerosol expert at Virginia Tech. Aerosols are released even when a person without symptoms exhales, talks or sings, according to Dr. Marr and more than 200 other experts, who have outlined the evidence in an open letter to the World Health Organization.
What are the symptoms of coronavirus?
- Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
Does asymptomatic transmission of Covid-19 happen?
- So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Ms. Wallace said that she had never had coronavirus symptoms but that she had still felt obligated to be tested. “I don’t want to be the person to bring Covid here,” she said.
All residents and visitors to the island are encouraged to be tested at Test MV, where volunteers distribute free kits of self-administered nasal swabs, said Ms. Wallace, who is now the site’s outreach coordinator.
During her interview last week, Ms. Wallace said that people typically got their results within 72 hours, or more quickly if they test positive for the virus. At the time, Martha’s Vineyard stood in stark contrast to states like New York and Arizona, where lines for tests have sometimes stretched around blocks and the turnaround time for results has been days, if not weeks.
On Friday, she said the turnaround time for tests was now around seven days, because of the shortage.
Don’t feel guilty if you don’t want to get a test.
Wearing a mask should feel obligatory, Dr. Diamond said, but taking a test should not.
If tests were widely available and turnaround times for results were much faster, people would have a stronger sense of obligation to get tested, he said.
“Under the current circumstance, I would say it’s much more important to continue to do what you’re doing,” Dr. Diamond said. That is, wear a mask, keep six feet away from people and stay home as much as possible, he said.
Dr. Diamond added, “The behavior is really the thing that’s going to make the biggest difference.”
Remy Tumin contributed reporting.