Hawaii is gloriously secluded seated serenely in the Pacific Ocean. The Big Island, free of the busy city climate found on Oahu, feels even more distanced from the turmoil often stirring on the mainland. We feel unburdened by the political chaos, city crime, and traffic.

The Big Island is, however, hugely dependent on tourism for keeping its economy running smoothly. For this reason, our governor has waited til the last possible moment to implement precautions to prevent the spread of COVID-19 on the island for fear, I believe, of announcing to the world people may need to cancel their trips to the island. Similar to other locations around the world, information regarding the spread of the virus has been released slowly – delayed, in effort to maintain a sense of control of the situation and to prevent misinformed panic. The lack of transparency has left the public feeling helpless, agitated and afraid.

Although my knowledge of how our politicians think is limited to what I read online and see on TV, my work in a community health center has given me a first hand account of the sad situation the Big Island’s health care system works with.

It wasn’t until three weeks ago that we were informed what to look for as possible symptoms of COVID infection. Even then, if you had not traveled to Wuhan China, or had been in contact with someone whom had tested positive, you would be turned away or viewed as paranoid. A viral swab would be taken and sent to the lab to then be sent to Texas for testing. To my recollection, no samples were sent due to not meeting the strict criteria. As of last week, we received test ‘kits’ which consisted of a fancy nasal pharyngeal (in through the nose, to the back of the throat) swab, a vial with an official looking label, and instructions. The fact that these were the kits we were waiting for was absurd. We could have been testing for over a month had the criteria been more realistic.

Developing Symptoms

If you have read my blog before you may already know I seem to catch anything and everything that’s floating around. In the last year working at the community health center I have come to believe I truly am immunocompromised as a type one diabetic – a fact I have been very reluctant to accept. I stay active, exercise as often as I can and eat well. So when I was quickly becoming short of breath on my runs, I attributed it to left over congestion after my back to back flu and pneumonia (2020 was already off to a rough start). In the last week the breathlessness did not improve as it should have but rather became unmanageable. I became winded while shopping. It became hard to take deep breaths. This last weekend the chest pressure, constriction and aching began with a fever.

At work I am in close contact with 20+ people a day to take vitals signs. Any one of those people could have been infected, but more importantly, if I was infected, I could have given any one of those patients the virus. Most of us can have the virus and recover with no ill effects – but if I were to infect our 94 year old COPD patient or the 70 year old with heart failure, there is a significant chance they would not survive. It was time to be tested.

I first contacted the local ER, a very small office in a very small town closest to my home. When I asked on the phone if they conducted the test, there was obvious confusion, followed by a hold with the staff looking for protocol on a possible COVID-19 case (PUI, person if interest). They did not have the testing capabilities (remember those fancy tests kits I mentioned) so they recommended I contact my PCP. My PCP suggested I contact the ER in one of the two larger towns closest to me. The large ER I contacted informed me there was drive through testing available in the attached building which was apparently closed but opened at 8:00 am. Fantastic, I thought, we’re not as behind on the testing curve as I feared! When I spoke with administration who I was told would have more information – all they could tell me was that I needed a doctor’s order. Ok, I can work with that. Where would I send the order, I ask. Fax number? Can it be called in by phone? Crickets. They have no idea. They instruct me to contact my provider who will know where to send the order. I am starting to feel like I’m loosing my mind here. I call my provider – they instruct me to go to the ER.

I drive to the ER and call from the parking lot, where upon they instruct me to go to the drive through. I explain I do not have a doctor’s order and they instruct me to come in. They direct me to the quarantine section – an area blocked off by a wall and finally get me in. Once I’m in I’m treated courteously, promptly and tested for the flu and a second swab taken for the coronavirus should the flu come back negative. Large cotton tipped applicators were pushed through each nostril to the back of my throat and left there for a full minute.

I was informed the flu test would be done by that afternoon, and if it came back negative, the second swab would be sent to Texas to test for COVID-19. Either way I would be notified through my provider of the flu test, then the COVID test if done, in three days.

My employer was very understanding and with the note from the ER, allowed for me to stay home to await the test results.

Today is day four. No results. Not a big surprise. I am a big fan of the ‘squeaky wheel gets the grease’ method. I have called my provider multiple times, the ER, the lab, the hospital, medical records. Not only is there no results for my flu test, there is no estimate on when my COVID test results will be available. And so I wait. Luckily my fever is down and my chest pressure has stopped but I still become breathless with the slightest exertion.

In the mean time, I am enjoying curling up with a pup and a good book, and spending quality time with my family as we all quarantine until my test results return.