I attended a 3 hour coronavirus meeting this morning discussing planning and response at the local government level. Our State (Idaho) has not had a positive test, and following the lead of our Commander in Chief, our current threat is deemed low despite our proximity to Washington, Oregon, and California.
An ER doc stated at this meeting that when he examines a patient with coronavirus symptoms, he can only take a sample, which he then sends to a private lab for possible testing. The private lab gets tests from the FDA and the CDC. Since there are only a limited number of tests available in our State (1,000 TOTAL), testing is prioritized by the lab to be done on only the most severe, heavily symptomatic cases. He estimated that due to this screening process, for every one patient presenting with coronovirus symptoms, which are often mild or moderate, there are hundreds who are not tested. He finally stated that when our State announces its first confirmed coronavirus case, it will be statistically likely that we have 1000-1500 actual cases statewide. This process and the significance of that first positive test was echoed by other State and regional health officials at the meeting.
Until we have a positive test in our State, the State is declining to make any mandates or even recommendations as far as travel restrictions, school closures, or public gatherings. Similarly, no federal mandates or recommendations will be forthcoming until then because we are considered "low risk". They know it's only a matter of time, but they don't want to create "panic" based upon a "lack of evidence and data", which, of course, is tied directly to the lack of tests being performed on symptomatic patients in an attempt to keep the number of reported cases low. Just wash your hands and don't touch your face kids.
In the meantime, local governments are free to do whatever they feel is necessary, which will result in disproportionate responses from city to city and county to county. The lack of available testing, information sharing, transparency, and a coordinated response is astounding and we are starting to see some "panic" amongst our more vulnerable populations. This is not what good leadership looks like.