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We need tests, we're getting geotracking
March of darkness
Art: Renoir, Luncheon of the Boating Party, 1880, before he started socially distancing
Ok, if we’re at the end of the world, we might as well examine the technology aspect of it. Except, I have to say, I haven’t been much feeling up to writing a newsletter lately. Literally every single time I go on Twitter (I know, I know, the news is bad, don’t go on Twitter), which has proven to be a very good source of coronavirus news, I leave learning an extra piece of actionable news and ten pieces of news or comments that convince me the American health system, economy, and the world are ending.
There is nothing I can write that doesn’t seem out of touch with the current, normal, reality. Startup news, complaints about Google Drive, memes (remember when I could write about memes?) all seem very small and insignificant at this point.
And, on Friday, I got a low-grade fever.
Well, we all know what a fever means these days, so I immediately sent my daughter to my parents’ house, and sequestered away from my husband and the baby for the weekend. The first day was luxuriously productive - I slept, I worked on a deep learning project, I worry-scrolled through Twitter.
I didn’t feel bad, but I kept monitoring my temperature, and it was always low-grade in nature, without any other symptoms whatsoever.
“Go get tested,” my mom said, worried. Except I knew I couldn’t get tested for coronavirus, because there are no tests in America, unless you play for the Utah Jazz.
Where could I go? What should I do? This was the thing I’d been warned and admonished about countless times. Here was the actual reality of the news, looking me in the face. I first went to the CDC website, which took forever to load. It said if I was experiencing any of the symptoms - fever, shortness of breath, and cough - that I could have it. But was a low-grade fever enough? What if I didn’t have any other symptoms? What else could it be?
I Googled low-grade fever, which gave me unhelpful results like meningitis. I waffled for a bit. I knew that trying to ask for a test was probably a hopeless endeavor, and I didn’t even know where to turn to at this point to do that. If I went in somewhere, like a hospital, were the chances worse that I would actually become infected than not? The WHO website was just as non-specific to me, and didn’t help.
I needed something more local. I looked at my local hospital’s website. They had a coronavirus section up, and I clicked through. It again said that if I had a high, spiking fever, or shortness of breath, I should come in.
But what if I was like the mayor of Miami, almost asymptomatic? What ARE the symptoms of coronavirus? Everyone seems to exhibit it in an extremely different way. And everyone is left to fend for themselves among the wasteland of the modern-day internet for the truth.
Finally - relief. I saw that my hospital offered a telehealth consultation with a doctor, without ever having to leave my house.
At nearby Jefferson Health, a 20-fold increase in virtual visits over the last six days has left administrators scrambling to supplement the supply of doctors able to perform services as they fine-tune protocols for dealing with suspected Covid-19 cases.
Jefferson Health is my system, by the way.
The way to access the system is, first you register, then, you put in your credit card information, and then the system processes your $50 like you’re buying something on Amazon. I’ve always hated the transactional M.O. of the American medical system, but never have I hated it more than now, when it’s obvious that the only people who can get treated are those who can afford it. What if you have symptoms but don’t have $50 for a consult? You go into the hospital and infect everyone there. Or you lay, worrying.
The first time I called on Saturday, a doctor said that, based on my symptoms, I probably didn’t have coronavirus, and that I should keep watching to see if my symptoms got worse or better after 3 or so days.
In a nebulous middle state, I worried, listened to my baby downstairs, who I couldn’t be with, and wondered what it was that I had that gave me a low-grade fever. After 3 days of no change, it didn’t seem like I had coronavirus, but I couldn’t be sure.
I asked my mom to bring my daughter back. If we got sick, we’d get sick together. I let our nanny go and cancelled daycare, and we started to self-quarantine on Sunday night.
On Sunday night, after no change, I called up our local urgent care, where I always go if we have pressing medical issues (we don’t have a primary physician.) Don’t come in if you have a fever and are in an area where there’s a lot of COVID, the site said. Well, that was our entire county.
“I don’t know what to tell you,” the nurse said over the phone. “If you have a low-grade fever you probably have some kind of viral infection, I’d wait 7 days. It’s probably not COVID.” “So can I come in and get checked out?” I asked. “No, because you fall under those two criteria,” she said.
On Monday, no change, so I decided to try telehealth again. It had been 3 days since the fever. Fortunately, no one in my household was presenting any symptoms, and the kids seemed fine. We continued our self-quarantine, taking care of the kids and tending to work emails, calls, and pull requests, and I kept checking my temperature.
Finally, I called them, forking over my Visa for $49 yet again. “Well, I don’t think you have COVID based on the criteria,” the doctor began. “Are you in an area with a lot of COVID?”
I was taken aback. The hospital was in our county. Shouldn’t he know? “Yes, there’s a lot of cases here,” I said. “How many, do you know?” The doctor asked me. I told him the total that day, but was shocked that I knew it, and he didn’t. “I think it’s just a viral thing and it’ll probably get better,” the doctor ventured. “So you don’t think it’s common to have just a low-grade fever as a symptom,” I asked, again thinking of the mayor of Miami. “Not from what we’ve been seeing,” he said. “Why don’t you try going to urgent care to get a swab?”
“I did,” I said, frustrated. “They told me I couldn’t come in because I fit the criteria for COVID,” and, I added, “ I checked the county website and their criteria is different - they say a fever has to be at least 100.5. I’m not there.” “Oh,” the doctor seemed surprised. “I didn’t know that about urgent care.”
“So basically I’m waiting for it to either get better or worse?” I asked. He nodded, and I disconnected the session.
I weighed my options. I could continue to wait it out. I could try to call the county to get a test, which seemed like it would be a futile gesture. I could try to call urgent care again. I could try to get an appointment at a physician, but which primary doctor was taking new patients at the moment, especially with a risk?
I decided to wait.
So here I am, waiting for the end of my fever or the end of the Western world, whichever comes first, and in the meantime, working, taking care of my kids, cooking, and disinfecting the packages of groceries that we get delivered, strategically timing deliveries four or five days out so we don’t encounter shortages and long Instacart wait times.
If I were the only one, it would make sense. But our whole country right now is just, to put it honestly, dumbfounded. For all our technical prowess, the bureaucracy of the healthcare system is so complicated that no one can get what they need. I’m not even the worst, by far.
Look at these:
These are women with legitimate health problems, up against our healthcare system and this trainwreck that is making their lives misery.
The problem, of course, is people. People put these systems into place, and people made these decisions that are now cascading through everyone.
Multiple anonymous sources told The Washington Post earlier today, government researchers are in “active talks” with executives from Facebook, Google and a wide array of other tech companies to discuss how the public and private sector could team up to combat the coronavirus’s spread—and using the location data collected by cellphones to do it.
Of course this is going to be offered as a solution, and of course it’s going to end poorly. Because all it takes is for people to coordinate the delivery of hundreds and thousands, millions, millions of tests to hospitals.
Once we have tests, we can start really collecting numbers on this thing, we can start doing data science and making dashboards, we can do it all because we’ll have real, true numbers of people infected and people recovered.
We can do random testing. We can do almost anything.
But we need the tests - having one would have honestly saved me, basically a week of worry at this point, and I’m the lowest level of concern on the totem pole as far as doctors are concerned.
And it seems that, like me, the country is waiting to either get better or a whole lot worse.
Stay healthy out there, everyone, and if you have some stuff to keep spirits up, send it my way.
What I’m reading lately:
Mostly just Twitter, honestly. Send me good news if you have it.
This newsletter’s M.O. is takes on tech news that are rooted in humanism, nuance, context, rationality, and a little fun. It goes out once a week to free subscribers, and once more to paid subscribers. If you like it, forward it to friends and tell them to subscribe!