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Clinical Pathology Laboratories employees gather samples during a UNLV Medicine drive-through testing clinic in Las Vegas on March 24, 2020. (Lonnie Timmons III/UNLV Photo Services/Courtesy)

This is an updated version of a story that first ran on March 14, 2020.

It has now been more than a month and a half since the first case of the novel coronavirus was confirmed in Nevada on March 5.

Experts say the state has reached a plateau in new cases — helped by the social distancing measures put in place in March that shuttered nonessential businesses and mandated people stay at home — though they say it’s too soon to tell if the number of new cases is trending downward. All the same, more than a hundred Nevadans are being announced as positive for COVID-19 most days, leaving many people sitting home wondering whether the tickle in their throat is a cold, the seasonal flu or coronavirus. And in the event that it might be the latter, what are you supposed to do about it?

Below, The Nevada Independent explores some commonly asked questions, based on interviews with Nevada’s health care community and guidance from the Centers for Disease Control and Prevention, about the coronavirus, including what to do if you’re experiencing symptoms, who is able to get tested and what you should be doing.

This story will be updated as the Independent learns more about the latest recommendations from federal, state and local health officials.

What are the symptoms of the novel coronavirus?

The most common symptoms of coronavirus are fever, cough and shortness of breath. Other symptoms include chills, repeated shaking with chills, muscle pain, headache, sore throat and the loss of taste or smell. Those symptoms typically appear two to 14 days after exposure to the novel coronavirus. If you need help determining whether your symptoms might be indicative of COVID-19, the Centers for Disease Control and Prevention has an online self-checker.

The CDC recommends you seek immediate medical attention if you develop any warning signs for COVID-19, which include difficulty breathing or shortness of breath, persistent pain or pressure in the chest, confusion or inability to arouse, and bluish lips or face. Call 911 if you are experiencing a medical emergency, notify the operator if you believe you may have COVID-19 and put on a mask or other cloth face covering before emergency responders arrive, if possible.

If you aren’t showing symptoms and want to skip ahead to what preventative steps you should be taking, click here.

How are health officials deciding who should be tested?

Right now, health officials are triaging who should be tested based on a number of risk factors. The latest guidance from the CDC divides patients into three priority groups for testing:

  • Priority 1: Hospitalized patients and symptomatic health care workers
  • Priority 2: People who have symptoms and are in long-term care facilities, 65 years of age or older or have underlying conditions, and first responders with symptoms
  • Priority 3: People who have symptoms and are critical health care workers or do not meet any of the above categories, health care workers and first responders and people with mild symptoms in communities with high rates of COVID-19 hospitalizations
  • No priority: People without symptoms

Nevada’s Department of Health and Human Services also has announced new criteria recommending that all symptomatic patients be tested, not just those who are severely ill and health care workers with symptoms.

It’s important to note, though, that the decision of whether you get tested will ultimately be up to your health care provider, and facilities may have different standards based on the supplies that are available to them. Some providers have reported not being able to test all symptomatic patients, while others have been able to expand testing to include all symptomatic patients, as well as the asymptomatic family members of patients who have tested positive.

What should I do if I’m experiencing symptoms and want to get tested?

You should start by calling either your personal health care provider or, if you don’t have one and don’t know who else to call, one of the help lines serving your county.

Do not show up to the emergency room unless you are experiencing a life-threatening emergency, as you could be putting health care workers and other patients at risk of infection.

The Southern Nevada Health District, the public health agency for Clark County, can be reached at (702) 759-4636 from 7 a.m. to 7 p.m., seven days a week. Clark County residents may also reach out to the UNLV School of Medicine, which is conducting drive-through COVID-19 testing by appointment daily from 8:30 a.m. to 4:30 p.m. To see if and when you should get tested, you may use the school’s online triage questionnaire — the results will be sent to the school’s call center to set up an appointment if you qualify for testing — or text “covid” to (702) 744-9722.

The Washoe County Health District can be reached at (775) 328-2427 24 hours, seven days a week. You may also fill out an online risk assessment online in English or Spanish. The health district is running a drive-through testing clinic at the Reno-Sparks Livestock Events Center on Monday, Wednesday, Friday and Saturday, which is only open to those who call the health district or fill out the online form.

Carson City Health and Human Services, which serves Douglas, Lyon and Storey counties, in addition to Carson City, can be reached at (775) 283-4789 from 8 a.m. to 4:30 p.m., seven days a week.

Elko County is also running a COVID-19 hotline — which serves Elko, Lander, Eureka, White Pine, Pershing and Humboldt counties — that can be reached by calling (775) 777-2507 or sending a text or email to [email protected].

Mineral County has offered two drive-up testing events. Residents are advised to follow the county Emergency Management Department’s Facebook page for future developments. Those with questions are advised to call Pat Hughes, the county’s emergency manager, at (775) 302-0097.

Nye County residents may reach out to their county’s information help line at (775) 751-4333.

Members of the public statewide with questions about COVID-19 are directed to contact the state’s coronavirus direct line at (800) 860-0620 or call 211. Churchill County is directing its residents specifically to that line. Esmeralda and Lincoln counties do not have help lines listed on their websites but residents may also call the state’s line if they require assistance.

On the call, you should be prepared to answer questions about your symptoms and any known contact with COVID-19 patients. Based on your answers to those questions, you will be instructed how to proceed — which could include any combination of quarantining at home while self-monitoring symptoms, being tested for other viruses such as influenza and strep throat, and being tested for COVID-19.

What should I do if I suspect I have COVID-19 but am told to stay home?

Do not leave your house unless it’s to receive medical care. You also should stay away from others as much as possible, such as confining yourself to a separate room and, ideally, using your own bathroom; if that’s not possible, you should wear a mask and clean and disinfect shared spaces often. 

The CDC also recommends that you limit contact with pets and other animals until more is known about the virus; if that isn’t possible, it is recommended that you wash your hands before and after interacting with pets and wear a cloth face covering.

The CDC has a full list of recommendations on what to do if you are sick with COVID-19 or suspect you have it here.

When can I stop self-isolating at home?

If you are not able to get tested again, the CDC says that you can leave your home if you have had no fever for at least 72 hours without use of medicine that reduces fevers, other symptoms (such as cough and shortness of breath) have improved and at least seven days have passed since your symptoms first appeared.

If you are able to get tested, you need two negative tests in a row, 24 hours apart, to confirm that you can leave your house, in addition to having had no fever for at least 72 hours without use of fever-reducing medications and other symptoms improving.

The CDC says all decisions to stop self-isolating should be made in consultation with your local health care provider and state and local health departments.

What does a COVID-19 test entail?

There are a couple of different types of samples your doctor can collect to test for COVID-19, but you can generally expect to have a swab taken through your nose, what’s known as a nasopharyngeal swab.

These tests are not available for purchase by the general public and first responders will not be equipped with them. The samples will only be collected by your health care provider.

Some facilities are also starting to roll out the use of COVID-19 rapid tests using Abbott’s ID Now machines. Nose swabs are also collected to be run on those machines.

Where are my samples going to be sent?

It largely depends on where you get tested. It could be one of the two public health labs in the state — the Nevada State Public Health Laboratory at the University of Nevada, Reno and the Southern Nevada Public Health Laboratory in Las Vegas — or a private lab. If your sample is sent to a private lab, it is likely to head to either Quest Diagnostics, LabCorp or Clinical Pathology Laboratories and will be flown out of state for testing. Where your sample is sent may depend on which lab the health care provider you are visiting has a contract with.

Providers report that samples sent off to labs for testing used to take several days to come back, but now are generally coming back in 24 to 48 hours.

If you are tested as a patient in the hospital, your test may be run in house. University Medical Center in Las Vegas, Renown Regional Medical Center in Reno, and other hospitals have developed the capability to run their patients’ samples on site. Some of those hospitals now have the ability to turn around tests in a matter of hours.

What’s the testing capacity like right now?

Both public and private labs have reported that they have the capacity to keep testing under the status quo, though they don’t have the resources necessary to expand testing broadly to asymptomatic individuals. 

The Nevada State Public Health Laboratory and the Southern Nevada Public Health Laboratory are able to process about 1,400 tests a day, while University Medical Center, the county-run hospital in Las Vegas, is gearing up to be able to run 10,000 COVID-19 tests each day by June. Quest Diagnostics, one of the private labs, is able to run 50,000 tests per day, nationally, while LabCorp is able to run another 55,000 to 65,000 nationally.

How much am I going to be charged if I need to be tested?

Most insurance companies nationally have agreed to waive all co-pays associated with testing for COVID-19, and some have waived co-pays for some or all kinds of treatment. You should check your health insurance policy for the details of any copays, deductibles or cost sharing you will be responsible for paying.

However, any insurance plans regulated by the state — which include plans purchased on the state’s health insurance exchange and small group plans — are barred from charging patients for the cost of a doctor’s office, urgent care or emergency room visit when the purpose is to be tested for COVID-19 under an emergency regulation from Gov. Steve Sisolak.

What is the status of antibody testing?

As of mid-April, antibody testing was starting to come online in Nevada. The Nevada State Public Health Laboratory is expected to soon begin antibody testing, while Quest Diagnostics and LabCorp have begun antibody testing. 

However, you still need a doctor’s order to get a COVID-19 antibody test. Doctors can either collect blood samples themselves, or send you to a Quest or LabCorp facility to have your blood drawn there.

It’s important to note that while the tests are designed to detect COVID-19 antibodies in the blood and will be able to show whether someone has been exposed to the virus at any point, scientists have not yet determined what that means as far as showing that a person has any sort of immunity to the virus. Additionally, there have been complaints over the accuracy of antibody tests.

What should I do if I’m not experiencing symptoms?

If you’re healthy, there are a number of things you can do to help prevent the spread of the novel coronavirus. The first one is, as Gov. Steve Sisolak ordered, to stay home unless you must leave the house for essential work or to run essential errands, such as shopping for groceries. When you must go out in public, health officials have recommended that you wear a mask or other face covering and maintain six feet of distance from others.

You should also practice basic hand hygiene, which includes washing hands with soap and water for at least 20 seconds, particularly if you have been in a public place — such as the grocery store — or after blowing your nose, coughing or sneezing. Hand sanitizer that is at least 60 percent alcohol can be used but only when soap and water are not readily available. Do not touch your eyes, nose and mouth with unwashed hands.

Though social distancing measures are disruptive to daily life, state and local officials have credited them with slowing the spread of the novel coronavirus in Nevada. That, in turn, has allowed hospitals in the Silver State to have enough capacity to treat those who have fallen seriously ill, giving patients a better chance of surviving the virus.

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