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It seems that the COVID-19 testing protocol is to rule out other things first (such as the regular old flu, which my brother did test positive for). I understand it is possible to have both the flu and COVID-19 at once - do we have any idea of what the impact is of not testing people who tested positive for something else?

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Great question! This has been plaguing me for a while; in DC, the first known case of community transmission was a man who first tested positive for the flu, and then a few days later also tested positive for COVID-19.

I see two main dangers of not testing for COVID-19 in the presence of other illnesses:

1. the person could become more ill and not know why, and

2. they could spread it to others.

For #1, I would hope doctors are encouraging people to follow up if their symptoms don't get better (which is a pretty standard line for docs, so I don't think there's reason to worry there). If they do get better - great! Either they didn't have COVID, or it ran its course safely.

If they don't get better, though, there's the risk the patient will wait too long to follow up again. There's no cure for COVID, of course, but there is a treatment for severe cases -- oxygen in various concentrations and delivery methods. If you can help people breathe when their lungs aren't working, that can help their survival rates immensely.

So, if someone continues to be sick even after taking Tamiflu or antibiotics, depending on whatever else they had, I would strongly encourage them to get back in touch with their doctor sooner rather than later.

(This is complicated, of course, by alarming rates of uninsured and underinsured people, especially since millions have been laid off and many lost their employer-backed insurance plans. I can only hope our leaders take decisive action on this extremely pressing issue.)

#2 has a lot of scary implications. At this point, 9 in 10 Americans are taking social distancing seriously, so hopefully people will self-isolate no matter what they have. (In China, the flu season was way better than normal because so many people were forced to stay home.)

But there's still a risk for doctors and pharmacists, for example, who are coming into contact with "flu+" patients and don't know it. I'm really worried for medical staff who don't have enough PPE -- I'm terrified of what this virus is going to do to our health workers. Again, I really hope we see decisive action soon to help save lives not only of patients but also of the heroes who are going to work every day to treat them.

In order to be on the safe side, I would basically treat any illness as a possible COVID infection, and take tons of precautions -- including wearing a cloth mask or bandanna to the doctor's office, if that's feasible. And anytime you feel your symptoms worsening, like chest heaviness or shortness of breath, call your doctor *immediately*.

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