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If I were a certain sort of woman, I’d blame it on The Patriarchy. If I were another sort, I’d blame it on A Culture Insufficiently Supportive of Life. (And, if I were a very specific sort, I’d do both.) Instead, it was the understandable result of The Powers That Be in our neighborhood hospital system not having leeway to make more fine-grained distinctions in a crisis. Which is how pregnant women, who aren’t permitted to receive any in-person prenatal care right now if they have the least little sniffle but no negative lab result for Covid-19, must go through a lengthy, frustrating, and high-exposure screening process to see if they qualify for Covid-19 testing, while the nonpregnant may simply waltz – or rather drive – through safer, low-exposure Covid-19 testing in about 15 minutes.
If you’re pregnant, though, the screening process might take hours, during which you hear, at each step along the way, that you may be ineligible for the lab anyhow – and that’s just your time spent at the walk-in screening center. It doesn’t count the hours (days) you may have spent trying to find a walk-in screening center that hasn’t run out of swabs for the day, and finding out whether you’re even eligible to visit it.
Like many Americans, I’m not just trying my best to avoid putting others at risk right now, I’m also trying to avoid unnecessary medical expense, including “no show and late cancellation” fees. So, as soon as I lost hope of being over a cold in time to make my prenatal visit symptom-free, I asked the prenatal office what to do: cancel the appointment now before I incurred the fee, or make the appointment, after all, since my nasty cold had no symptom specific to Covid-19?
The office directed me to fill out our hospital system’s “Covid-19 e-visit” online form immediately, then do whatever it said. The form said I was at high risk and may be eligible for a walk-in test, though it warned that whether walk-ins even get a test is subject to further screening. Please call the hotline number before walking into a testing center, it advised. I did and found out all testing centers were out of swabs for the day.
That night, I had trouble sleeping. Perhaps because I skipped the Tylenol in order to prove I wasn’t masking a fever, thereby unmasking a raging sinus headache. Perhaps it really was anxiety – though I didn’t feel anxious, just grumpy. Anyhow, I didn’t sleep until I raided All The Nasal Sprays. When I woke up at dawn to call the screening hotline before testing centers opened for the day, my congestion was so cleared the hotline nurse told me my going in for screening was now a waste of everyone’s time.
I wasn’t too put out by the news. I wasn’t wild about walk-in screening, anyhow:
Would walk-in screening be worth the risk? What if I showed up just to hang around a crowded waiting room with a bunch of other Covid-19 suspects, only to find out I didn’t deserve a swab after all? Does a responsible mom expose her unborn to such a risk for a benefit that’s not even guaranteed, especially when she already has lung trouble?
Then I had What I Thought Was A Bright Idea. Mr. R has a mild heart abnormality and woke up quite juicily suffering from the same cold I had. What if he did an e-visit to see if he qualified for testing? He did, and he did. Moreover, he got none of this guff about walking in for further screening to see whether he’d be swabbed. He could do drive-thru testing, with a swab reserved for him. So, off he went. His drive-thru test took 15 minutes.
Several hours later, when regular doctors’ offices opened for the day, I played phone tag with the prenatal folks. That afternoon I heard back from the doctor that I’d definitely have to be tested for Covid-19 – myself: my husband’s results wouldn’t do – before resuming in-person prenatal visits. Moreover, restricting me to televisits for the remainder of my pregnancy would go against their standard of care. So, off I trundle to a testing center with my e-form saying I may be eligible for testing.
At first, I try the drive-thru testing line, figuring the worst they can do is refuse me and send me to walk-in screening anyhow. Plus, who knows, maybe they’ll see “pregnant with lung trouble” on my form and decide exposing me to the walk-in waiting room wasn’t worth the risk? Nope, it’s worth the risk – and out of their hands, anyhow. My e-form says “walk-in”, not “drive-thru,” so walk in I must do.
Getting to walk-in screening proves slightly puzzling since the traffic-cone maze set up for drive-thru testing cuts off the walk-in clinic driveway. Once I’ve solved the puzzle and parked, I walk into the clinic, complete with N95 mask (the only mask we had in the house, left over from DIY projects) since my instructions say walk-ins should wear masks if they have them. The receptionist asks me the same questions whose answers already appear on my e-form, then tells me the wait for screening takes about two hours. I can wait in my car to avoid the crowded waiting room, though, and they’ll phone me when it’s time to come in.
As soon as I get back to my car, I get a phone call. Not one saying it’s time to come in, but from a nurse asking me the same questions the receptionist just asked, and whose answers, I know, are already in my chart. Caught off-guard, I blank on the answers, protesting, “But they’re already in my chart!” Because they are.
“I’m just doing my job,” says phone-nurse. And she is. Everyone is. I apologize for protesting.
The wait in the car is peaceful. It’s raining. After two hours, I do get a call. It drops as soon as I answer it, but it looks like a hospital-system number, so I run into the clinic, hoping not to miss my screening.
Hurry up and wait, as they say. They did call me in, but they need a few more moments before they can screen me. A few moments turns into an hour. Fortunately, the waiting room is less crowded than it was before, meaning now I can observe the six-foot rule by huddling in a corner, behind a potted plant. When I first walked in, it was like sardines. No way to keep folks six feet apart. Even thinned out, the waiting room hosts several miniature dramas:
I die a little inside when a receptionist tells some poor sap he’s at moderate risk and thus eligible for immediate drive-thru testing, while those like me e-triaged as high-risk sit around in the waiting room, festering, wondering whether we’ll qualify for a precious swab after further screening. But 15 minutes later, the poor sap is back: he’d just gotten the runaround, and he, too, will have to wait…
Two more poor saps got swabbed yesterday but got a call today saying their swabs were lost because their names got misspelled. So the poor saps are back, and the receptionists are bargaining with their bosses to let them get swabbed again without going through the whole goldurn screening process all over.
Someone else approaches the receptionists, not for Covid-19 screening, but because during his shift at a nursing-home job where coronavirus transmission is a special risk, he OD’d on antiviral vitamin packets and now feels chest pain because of it.
Meanwhile, an ever-more-hopeless nurse occasionally pops into the waiting room from the wings, crying out, “Patrick? Patrick?…”
After an hour, a skinny dude who’s apparently Patrick appears, and I return to the receptionists to remind them I haven’t been screened yet, though I got my call an hour ago. “You mean you’re still here?!” they reply, surprised. I guess I.. wasn’t… supposed to still be here?…
But here I am. After a few more minutes in the waiting room, I get called back to wait in a cubicle instead. Eventually, a nurse comes in to ask me the same questions already answered on my e-form. By now, I know it’s just their job, asking these same questions over and over again. Perhaps it’s a security measure. In any case, I find out I do qualify for a precious swab. But, once it’s taken, I can’t leave yet. They want the doctor on-call to see me.
Why? Because the doctor has a fetal heart monitor and needs to check the baby’s heartbeat before letting me leave. Which is perfectly reasonable. But not the reason they gave me for putting me through a four-hour walk-in screening: up till that magic moment I got to gag on a swab, the reason given was always that I may not qualify for one.
“That’s what they tell everyone who does walk-in testing,” the doctor says. “They can’t tell walk-ins they’ll get a swab for sure, even when they will.” That would have been nice to know a day and a half ago, but now is not a time for our hospital system to worry about publishing fine-grained distinctions. Every walk-in gets the same instructions, saying they may not be tested, even walk-ins prioritized for a swab on the back end. Frankly, we’re lucky to have walk-in instructions, much less drive-thru testing for those who don’t need a doctor to check something else like fetal heartbeat. A week ago, we had neither, and neither my husband nor I would have been swabbed at all.
We are negative, incidentally. We’re still advised to self-quarantine for seven days, just to be sure: after all, the walk-in screening I went through was a pretty good way to be exposed to the virus, despite all other precautions! And I still have a chesty cough which would earn me funny looks if I went out in public. None of the delay and confusion during my swab quest was an injustice, even if it was pretty crazy-making. Everyone was doing the best they could. Even me. The runaround I got makes sense, in hindsight, and, even if it would be better to avoid exposing pregnant women like this, “better” is not an option right now. Instead, we’re lucky to have what we have – especially when what we have is not Covid-19.Published in