Alaska Keeps Changing How They Report COVID-19 Tests And Results

I've been tracking the COVID-19 tests and results here because I found the state website that posts "Case Counts" was just giving daily snapshots and the previous day's data were replaced with the new data.  So there was no way to see the progression of positive test results or even of how many tests were given out.

So today's report was totally different.  Here's what they've generally looked like:

Then yesterday - above is yesterday - they also added a table.  You can see that in yesterday's post.  

Today this box which summarizes the numbers is GONE.  Now we get this:

And . . .

Having the graph is an improvement to the extent that it shows the number of tests per day, since the beginning.  And from this we learn that they started testing on March 2, 2020.  The previous charts all said on the bottom "Cumulative since 1/1/2020" which didn't make much sense since clearly Alaska wasn't testing in in early January.  Today we see not in February either.  The two graphs make it hard to track the numbers over time precisely.  At least the top one has numbers for the last date.  We don't have that for the bottom chart.  And if these were really professional charts, you'd be able to run the cursor along the red and blue lines and see the number for each date.  These are just images.  

AND the cumulative State and Commercial lab test numbers now include positive tests whereas before they were only negative tests.  Making it impossible to continue my charts based on these charts. (Maybe not, but someone smarter than I am, needs to tell me how.)

Previously, the separated out the tests each day that were positive and negative.  Now you have to go up to the chart and get that information and add and subtract numbers from the graphs to keep regular numbers.  I'm also not sure what the importance of distinguishing between State tests and Corporate tests is.  But someone in the Department of Health thinks it's significant enough to make that distinction.  

And what we don't get here is the chart which shows the progression of positive tests.  We just get the cumulative positives.  (That's in the first chart from today, above.)

Melissa S. Green commented yesterday that in MY table, I ought to switch the columns and rows so they will be easier to read in this format.  It was a great suggestion and I'd been wondering what was going to happen as I got more dates and we moved further to the right.  But how big a job would that be?  Argh.  Google told me quickly that it was no big deal.  (I'm using Apple's Numbers rather than Excel)  Just open the file, click on the whole table, go up to the table tab, then click "Transpose rows and columns."  Done!  

So here's today's updates.  My cough and fever are still festering and so I hope I've gotten all the numbers right.  (subtracting the positives from the cumulatives for negative tests etc. - not hard math, but helps to have a clear head.)

Alaska Covid-19 Data by Steve on Scribd

I would note that there were three more positive test results announced this afternoon (after the website was updated.) Two were not immediately related to travel.  In the Governor's press conference this afternoon, I think they said that if these new cases were connected to previously detected cases that were travel related, then they would also be considered travel related.  I don't understand why, unless they just don't want any "community" cases which can't be blamed on people bringing the virus from elsewhere.  If these cases, for example, are listed as travel related, how will cases related to these new ones be classified?  It seems to me that if people who haven't traveled get the virus, then they got it through contact with someone in the community, whether those folks brought it from Outside or not.


[A personal note here.  As I was going through these charts and commenting on them and figuring out ways to improve them, it reminded me very much of reviewing graduate MPA (Masters of Public Administration) student papers, particularly capstone papers.  Our students had to suffer through these kinds of critiques, but most, ultimately said thank you when they could see how much better their papers were.  And this is the kind of written feedback they'd get from me so that they would understand how I thought they could make their papers better.  I hope none of my old students were responsible for these charts.  And I understand how hard it is to make great presentations of information - especially on tight deadlines.  This is really hard stuff to do right.  My sole intent here is  to help Alaskans get the best information they can.]


And thanks Mel.

What Do Evil And Plague Look Like?

Let's start with Evil.  I first learned Alex Gibney's name when Taxi To The Dark Side played at the 2006 Anchorage International Film Festival.  The story of the Afghan taxi driver who ends up tortured and dying in Baghram Air Force Base.  It was powerful and my favorite doc that year and probably my favorite film overall.  And it went on to win an Oscar for best feature documentary.  Gibney has made a lot of films since then.

Netflix has Slumloard Millionaire up now, a look at Jared Kushner's real estate world.  One section of the film looks at how Kushner bought rent controlled apartment buildings in NYC and then practiced all sorts of harassment techniques to get renters out - ceilings fall in from floods above, jackhammers all night, nothing repaired, toxic materials, etc.

Then there's the story of 666 Fifth Avenue which Kushner bought when prices were sky-high, just before the 2008 crash.  And how he then had to scramble to find money to pay his debts.  Among the schemes was squeezing low income tenants in his various buildings - and the film particularly focuses on the Baltimore area.  There are late fees, tacked onto rent that get deducted so that the renter hasn't paid the full rent which allows for more fees the next month.  Meanwhile the renter doesn't know any of this is happening and just keeps paying the regular rent and falling further behind. While this nickle-and-diming can't raise what Kushner needs, over thousands of tenants it adds up.  A reporter walks the neighborhood and shows us all the doors with shaming notices prominently taped onto people's door.  Then there's the lady who has complained about the lack of repairs in her apartment and gotten a signed waiver to leave her lease.  Three years later she starts getting notices from JKSomethingLLC.  She has no idea who that is.  They are demanding $3000 for cutting out on her lease three years ago. She no longer has the waiver, she never thought she'd still need it.  Fortunately, an investigative reporter finds her and writes about her.  That gets her an attorney who locates the housing records that prove her allegation she left legally.  And JK suddenly and magnanimously agrees to drop the bill.

This is just evil.  And this is one of the key people advising the president.   Some even say he's running a shadow coronavirus task force made up of business leaders.  But we don't get daily reports from them.  The behavior highlighted in the movie is fair warning for Kushner's task force is to help him and business campaign supporters figure out how to siphon off as much of the money earmarked to fight Coronavirus as possible.  helps himself and his father-in-law to every spare dollar they can get off the government.    Trump even referred to the head of Carnival Cruises today as his friend Micky who is offering cruise ships for non-COVID-19 hospitals.  I'm sure 'offering' as in I'll only charge twice what I would make if all my ships weren't sitting idle now.  (I'd note that Carnival owns Princess Lines.)


Now let's switch to Plague.  Here's a paragraph from an article by Jennifer Cooke, a plague expert.  She wrote her dissertation on the Bubonic Plague and then converted it to a book.  She writes about how she hadn't expected to experience one.

"What can I tell you about contagious epidemics? What will happen to us? Soon, we will see people scared of one another. Soon, a celebrity with COVID-19 will die. Soon, infected houses will display a sign warning delivery drivers and neighbours. Or non-infected houses will, attempting to reassure. Soon, there will be pets without owners, newly made strays fending for themselves. The most vulnerable will suffer even more. Domestic violence rates will sky-rocket. We will see armed forces patrol the streets. We will tell each other incredible stories we have heard of cruelty, of misery, but also of heroism, of generosity. There will be social unrest. There will be cult weirdos and strange beliefs, doomsters baying about the end of times. There will be exploiters, quacks, and fraudsters. But there will also be simple kindnesses, more phone calls between family members, between friends. We will all work less, if at all. There will be absurdity. And there will be incredible community support, for the people by the people. There will be ingenious new forms of entertainment and the revival of older forms that we have forgotten or stashed at the back of the cupboard. There will be incredible boredom and a lot of cleaning. This is what my knowledge tells me."

There's lots more there.  She also gets into Daniel Defoe's book on the plague, which ADN write Michael Carey also wrote about today.   There's also a link to the original Journal of The Plague Year for people who want a preview of what's coming.  (Times are different.  Science plays a bigger role now, but we still have many religious charlatans who use calamity to their advantage.  (As I recall, every natural disaster during he Obama years was a sign from God.  I don't see that so much not that the charlatan in chief is in office.)

Alaska COVID-19 Update 3 More Positives For A Total Of 6 Since Friday [Updated With COVID-19 Video Showing Progression of V]

NOTE:  Today's update says it was updated yesterday at 7pm instead of today at 12:30pm, so these added numbers don't reflect 24 hours since the last posting.

This chart and the one at the bottom from here.

[UPDATED March 18, 2020 8:20pm:  Since the announcement above is listed as being posted at 7pm on March 17, and there was no new one today when I looked after today's scheduled post - I used it and assume it would cover for today.  But since yesterday's was posted at 7pm, I thought I'd check.  And sure enough there's a new update from 12:30pm today.  I checked and I got mine at 12:43pm so there's might have been posted shortly after that.  It looks pretty much the same.

Maybe that just had the wrong time stamp on it and fixed it.  But it's really helpful to notify readers why you made a change - in this case the date and time have been changed.

Meanwhile, three more cases have been reported in the news today.  Based on the video below and other writers, I'm expecting the number of positives to jump pretty quickly in the next week or two.]

In the last few days we've gone from 0 positives, to 1 positive, to 3, then to 6.  Since only a tiny percent of our population has been tested, I expect that numbers will start to go up quickly once testing is more widespread.  Meanwhile people are out and about without knowing if they are positive or negative.

I saw a distinction yesterday between diagnostic testing (to determine a patient's treatment) and surveillance testing (to keep track of the overall spread of the virus in the community.)  It seems to me that Alaska has focused on diagnostic testing.

Here's my update from the numbers I put up yesterday.  I'm trying to track this on a continuous basis so people can see the daily and weekly increases in people tested and results.  As I do these, only the last column should change each day.  I'd note again, that 'today's' posting says it was posted yesterday at 7pm.  (The notice has said everyday they'll post at 12:30pm daily weekdays).  So, technically, there are two posting from yesterday, so the increase is only up to 7pm yesterday.  And the increase is more for half a day.

Alaska Covid-19 Data by Steve on Scribd

This report also had a new chart attached to it that gives overall numbers.

Region*	Travel-Related**	Close Contact	Total
Anchorage	2	0	2
Gulf Coast	0	0	0
Interior	3	0	3
Mat-Su	0	0	0
Northern	0	0	0
Southeast	1	0	1
Southwest	0	0	0
TOTAL	6	0	6

 *Economic regions definitions

**Exposure/source of the virus was outside of Alaska.

You'll see the state is perhaps trying to console us by pointing out that all the cases are people who traveled and brought the virus back to Alaska.  But we don't know how many people they interacted with before they were tested and isolated.


[UPDATE 5:44pm]

The video below does a good job of showing (based on Wuhan data) how many actual cases there are compared to the identified cases, for various reasons.  One could argue this doesn't apply so well to us here in Alaska because, so far, the cases were brought in from Outside.  (All the more reason to be screening passengers on Alaska bound jets.  Our geographic isolation makes it relatively easier to check on people entering the state.)  But as people bring the virus in and spread it before getting sick, we're going to see similar dynamics.

Did Health Experts Show These Predictions To Trump? Imperial College Report Summary

[You have to click on the embedded tweet below yo see the whole thread.  When you get to the original's Tweet, click on show thread.]

]
Trump seems to be taking COVID-19 more seriously - or at least how his response may reflect on him.  This Twitter thread summarizes the findings of the Imperial College predictions - if we do nothing, if we take moderate precautions, if we go to total self-isolation.

Many of us may not be here next year.

We can now read the Imperial College report on COVID-19 that led to the extreme measures we've seen in the US this week. Read it; it's terrifying. I'll offer a summary in this thread; please correct me if I've gotten it wrong.https://t.co/AwE2cHIbeJ

— Jeremy C. Young (@jeremycyoung) March 17, 2020

2 More Positive Alaska Tests - Trying To Track COVID-19 In Alaska

The state COVID-19 page replaces yesterday's data with today's data.  So unless you've been screen-saving or otherwise saving the data each day, there's no real way I've found to keep track of things.  So in this post I'm adding a table that allows you to see testing numbers and results over time.

But first, today's report:

Two new confirmed cases showed up in Fairbanks.  According to the State 334 people have been tested.  I have not been able to get an answer to the question:  how many tests does Alaska have and how many do we expect to have soon?   The original number that was bandied about was 500.  We're 166 shy of that number.  It's not clear why people are being cagey about numbers of available tests.

Anyway, here's my first stab at tracking the tests:

Alaska Covid-19 Data by Steve on Scribd

Is everyone who should be tested getting tested?  This Tweet suggests that access to doctors and cost is a factor that might be limiting who gets tested.

Talked to a friend today. She has coworkers who suspect have COVID. They have no health insurance, so won’t/can’t get tested. Oh yeah they work in food service industry

— Sam Snyder (@builditbiggerak) March 17, 2020

107 More Negative Tests In Alaska - Message From Italy On What To Expect

This was posted by the state Friday - 143 people had tested negative and one positive.  That was an increase of one positive and 84 negatives since the day before (I only know this because I had a screen shot from Thursday).  And the day before was the total since January 1.  So they had rapidly increased the testing - more than doubling the people tested.

So here's today's numbers:

They don't post these numbers over the weekend.  All we know is that since the Friday post, they've tested another 107 people all of whom tested negative.   Presumably this includes people tested Friday, Saturday, and Sunday.

In any case, the state is testing people at a much faster rate than they had been.  Though I didn't look at that page before Wednesday when only 60 people had been tested. Since then 4 times that many have been tested.

The only positive person was reported to be a foreign national cargo pilot who went directly to his hotel and then called for medical help.  He would have had contact with only a few people - other crew, customs, van or taxi driver, and the hotel check in desk.  A group small enough to have been contacted and tested.  But I'm only guessing at what should have happened.

Meanwhile I found out today that my email to the state public health department with my questions hadn't actually been sent Friday.  So I've resent it and got a confirmation they received it.

Some obvious questions that arise now:

1.  How many tests does Alaska have?  I was told 500 by a couple of people Friday.  No one could tell me if we got more.  If not, we've used half of them.

2.  Did more come?  I'm guessing there are more tests or they are on the way, since the testing screening has loosened up since I got turned down on Wednesday.

3.  Why test?  One of my questions is about the objective of testing in Alaska.  I couldn't find a stated objective on the website.  It seems there are several overlapping goals:
1.  treat the patient
2.  protect health care providers
3.  protect the general public

So did my doctor, on Friday, when they had ruled out flu and RSV,

1. decide based on her assessment of me as not likely to have COVID-19, turn down my second request for a COVID-19 test?  Or 
2. did she also consider the scarcity of tests and decide my taking a test would not be a good use of the tests?  (At that time I did mention that something had changed because they had tested over 80 people the day before, more than all the tests since they began testing.) Or
3. Was she considering the public health needs to test everyone who has any chance of having the virus to identify all carriers and then all the people they had been in contact with?   

Clearly the last one was not a highly weighted part of her calculation.  Since they were willing to test me for flu and RSV, I have to conclude the decision was made based on her assumption about the availability of tests.  But the model from other places is to test as many as possible to identify carriers and then all their contacts.  

Meanwhile, Anchorage is shutting down.  Schools have been closed.  University is only teaching classes electronically and the campus is pretty much closed.  Public buildings like libraries and museums are closed.  As of this afternoon, restaurants and bars are closed except for take-out and delivery.  Groups of more than 50 people are not allowed.  OLÉ classes I was signed up for at the end of March are cancelled.  The Alaska Press Club Conference in April is postponed.  

The only sporting event I'm aware of that has NOT been cancelled is the Iditarod race which began before people caught on.  The newspaper had an article about the village of Shaktoolik not allowing the mushers into the village, but set a checkpoint and rest place outside the village.  

What the article didn't include was mention of how the 1918/19 influenza wiped out - literally - many Native villages.  In some there were only a few survivors.  So their concern is not overblown.  In fact the report I linked to above says:

"This DHSS analysis also predicts, based on 2016 population data, how many people would die in Alaska if a similar pandemic were to occur today. If we had a flu season with the same rate of death as the epidemic wave in the late fall of 1918, the estimated number of deaths would be 11,970 Alaskans."

Does COVID-19 have the same rate of death as the 1918 flu?  It's complicated to figure out.

For those who are still skeptical about the reactions to the virus - or have family and friends who are still scoffing - I offer you this message from Jason Yanowitz who identifies six stages of the epidemic in Italy.  It was originally on Twitter, I'll just put up a few of the images as he walks through what people were thinking as things went quickly to terrible.

By Stage 3, 25% of Italy was under quarantine, but bars and restaurants were still open.

It's spread to the whole country.  

Stage 6 has everything shut down and people need registration papers to be out on the streets.  If you're out and positive, you can be charged with murder.  

There are so many people who have no concept of math beyond the simplest parts.  So graphs mean nothing to them.  The idea of exponential growth means, if anything, 'big growth'.  So maybe this Twitter thread can get people to understand that, NO, this is not big government ruining your lives, but big government doing what only it can do to save lives.  

Here's the link again to the article that has all these Tweets.

How To Make Quarantine Enjoyable And Productive

There are ways to put a little low cost luxury into your cocoons until we become post COVID-19 butterflies.  Instead of whining about what you don't have.




We started the day off with an out of the ordinary (for us) breakfast.  It was wonderful.  It's not hard to do.  But if you don't have a waffle iron, you can make pancakes or French toast.







And in these months of never-ending hand washing, get some really nice soap.  When we cleaned out my mothers house after she died, we found lots of wonderful soap.

We still have a few bars left.

On top is an I. Magnum French milled bar.  It smells so good, I may just keep it for sniffing now and then.  In the middle is Origins Lime and Geranium, and then the Yardley April violets.  The other three are soaps we bought in the San Telmo weekend market last summer in Buenos Aires.  A husband and wife make the soap, under the name Paskarito.  These are glycerin based soaps.

The price of many good soaps is less than what many people pay for a coffee these days, and a soap can last you several weeks or more.  For example










I went back and found this picture at the market where we bought the soaps.  She's mixing ingredients here.  (I also saw how many pictures I took that never got to the blog!)










And you can also go pull books off the shelves and read.  All those books you've never gotten too.  Or the ones you've promised yourself to read again.  And magazines too.  The only one I intentionally subscribe to is The Sun.  There's always one big interview (this month with Randy Blazak on why white supremacy persists), short stories, poems, a readers write section (a different topic each month and this month is 'shortcuts').  And there are black and white photos, "Sunbeams" (quotes on a selected topic, which this month seems to be 'masculinity').   I'm

"The American ideal of masculinity . . . has created cowboys and Indians, good guys and bad guys, punks and studs, tough guys and softies, butch and faggot, black and white.  It is an ideal so paralytically infantile that it is virtually forbidden - as an unpatriotic act - that the American boy evolve into the complexity of manhood"   - James Baldwin 

"I do like men who come out frankly and own that they are not gods."  - Louisa May Alcott, Jo's Boys

"There be certain times in a young man's life when, through great sorrow or sin, all the boy in him is burnt and seared away so that he passes at one step to the more sorrowful state of manhood."  Rudyard Kipling, "The Dream of Duncan Parrenness"

I've only just started Overstory by Richard Powers.  I love the The Echo Maker  which had sandhill cranes as an integral physical and metaphorical role in the book.  I'm not too far into Overstory but it's clearly about the importance of trees to humans and to the earth.

And for those of you who have little ones home with you, challenge their curiosity.  Make learning an adventure.  There's so much available online that even with the libraries closed, there's lots to do.  For example:

 http://www.sciencekids.co.nz/gamesactivities.html,

http://www.kidsites.com/sites-edu/art.htm

https://www.puzzle-maker.com/CW

https://www.tasteofhome.com/collection/easy-recipes-for-kids-to-make-by-themselves/


And don't forget - forced isolation means you can get your income taxes done on time this year.  Or you can clean out that closet you've been avoiding.

Lists are a good way to get more done in less time.  Just a thought.  While you're eating your waffles.

Beauty Break

Enough of this COVID-19.  Bright sunshine sparkling back from dazzling snow outside.  Small wonders inside.

Alaska Reports 84 New COVID-19 Tests Today - More Than Double The Total from Jan 1- March 12, But Not For Me

Today's state update to their COVID-19 Case Counts shows that since yesterday they have 84 negative tests back and 1 positive test.  You wouldn't know this just from looking up the page because it looks like this:

To know that they reported 84 more cases than yesterday, you'd have to have taken a screenshot of yesterday's page.  Which, fortunately, I did.

The day before that they had a slightly different format which included pending cases as well.  The March 11 page actually had one more case (60)  reported.  The new format now includes State lab tests and commercial and academic lab tests.

So this means that yesterday the state did 70 more tests than they had done since January 1, 2020..  And including the other state facilities, there were 84 more tests than had been done since January 1.  (I'm using January 1, 2020 because that's what's on their site, though it would seem a bit early for the state to have been testing that early in the game.)

The volunteer nurse I spoke to yesterday gave me a number to call to get answers to questions she couldn't answer.   I did that this morning.  I've talked to Jill Lewis, Deputy Director of Public Health.  She wasn't really able to answer the questions I was asking about the numbers that are posted and the ones that aren't posted (like how many people requested tests and were turned down?) and why things had changed so radically in the last day.  She asked that I email my questions and she would have someone get back to me.  I did right away.

I also got to my health care provider and she confirmed that I was also negative for the RSV test (I got the negative for the flu test right after they swabbed me.)

But, the doctor who saw me Wednesday said, based on how I looked Wednesday, she wouldn't send me for testing now.  I had assumed that  now that these two tests had eliminated alternative explanations for my symptoms, I would get the COVID-19 test.   The doctor saw me after the request was made for the test on Wednesday.  At that time she said I looked too healthy.  But, I responded, we're learning that people often have few symptoms or none at all.  And that's why the virus is so dangerous.  I'm guessing that if she's been in Alaska for the last couple of months, she hasn't seen any COVID-19 patients at all.  Maybe she's seen sicker patients who have tested negative.  But did they spend the last month in the Seattle area?

On the other hand, the state has tested 143 cases, people who must have met the criteria, and they've all tested negative.  Just the one person yesterday, who was a foreign national who arrived from an affected area with symptoms.   I got tested for Flu and HSV to eliminate those two possibilities.  Why not do the same for COVID-19?  Eliminate it as a cause.  Then I can go out and not worry about infecting others.  Or, if I do have it, I'll stay in longer.  If it gets worse, the doctors will know.  And if I just naturally get better, I'll know I've had COVID-19 and be less worried about catching it again.

Tests have been limited, but the president promised today that that the scarcity is now over.    Was the doctor still thinking about hoarding the tests for the seriously ill?

This leads to one of the questions I submitted to the State - Do they have a specific stated goal for testing?  Something that would guide how they make these decisions?   Is it to:

• Identify patients for care?
• Identify patients so that health care staff can take adequate precautions?
• To stem the epidemic by identifying the infected and then all the people they've been in contact with so they get isolated?

I imagine it's partly all three.  But the third option really is the most important in my mind and it  requires aggressive testing to find people who may not show any symptoms so they don't infect others.  That does mean lots of negatives, even mostly negatives, until you find infected people.  Then you test all their contacts, and isolate them.

I was given the option of walking into the ER on my own and asking for a test.  But X didn't think they would take me because I don't have a fever any more. (This is the first full day that's true.  I'm still close to 98.6, though my normal is closer to 96.8) I suspect they're right and I don't have COVID-19, though I don't remember ever quite having this set of symptoms before. Coughing got me out of bed several times last night. And they tested me for, and eliminated,  the two most likely alternatives.

I've been pretty much in isolation since Saturday.  I've moved around some snow and chipped some ice and I drove my car after I  got it started (easily) after a month or so in the cold in our neighbor's driveway.  I just drove it around to give it some exercise and juice the battery a bit.

And now it seems much of the population is going to join me in this new period of social introspection.  Those several days after 9/11 when everything stopped and there were no planes flying, people had a chance to glimpse 'the hard to imagine' strangeness of  stepping away from what we now consider normal.  I'm hoping people gain more insights into 'common wisdom' which says that the world has to work a certain way.  It doesn't.  We're just structured for it to work that way.  There are alternatives and it takes emergencies like this to remind us of that.

State Turns Down My Health Care Providers Request To Test Me For COVID-19; I Test Negative For Flu [UPDATED]

This is an update of my post Tuesday about my efforts to get tested for COVID-19 in Alaska.

My daughter, who's been monitoring this virus carefully, and has symptoms in Washington State, but can't get tested, is trying to see if it would be easier for me.  If I'm negative, then she can let her daughter go back to school.  If I'm positive, then she would meet the criteria of close contact with someone positive, so she can get tested.  (My granddaughter has no symptoms, just her parents.)

So she sent me a link to this State of Alaska Health Department Memo which includes this bit about Washington State:

"Testing Criteria for the State Public Health Laboratories  The patient has a clinically compatible illness ANDo Close contact to a laboratory-confirmed case of COVID-19o OR a history of travel within the past 14 days to an affected geographic area(e.g.,the patient just returned from Northern Italy a week ago or Kirkland, WA 3 days ago)without an alternative explanatory diagnosis (e.g., influenza) ."

So, the State of Alaska is acknowledging that the Seattle area is 'an affected geographic area.'

But first I had to eliminate "an alternative explanatory diagnosis (e.g., influenza)."


So I'd emailed this all to the clinic and yesterday morning I had an email back from another doctor acknowledging my concern and saying to come in for a flu test.

"Just walk in" didn't sound like he was taking this seriously as a possible COVID case.

I called the clinic to check that the lab had me down.  But as she got my travel info and symptoms again, she seemed to get more alarmed about my just walking into the clinic.  I said I agreed.  Could I just stay in the car and have someone come out and swab me?  She said she might do that.  But first she had to consult with the doctors.

She called back to say they want to consult with the state on my case.  She wasn't able to get through to a person and left a message.  I asked if I couldn't just get the flu test.  She said they didn't have the COVID and I might need both.  Then I'd have to go to the hospital.

She called back to say the state had said no to the test.

Let me remind you of the president's comments, "Anyone who wants a test can get a test."  I first emailed the doctor over the weekend.  But I'm closer than I thought I'd be.

She had me come in at closing time when there wouldn't be others there and said she'd get me a mask and she'd be in protective clothing.  My daughter had given us official masks as good-bye presents when we left Seattle, so I brought my own.

I got tested for influenza in one nasal passage and RSV in the other.  The influenza test results came back in minutes.  Negative.  The RSV will take a few days.

Then, since I'll have eliminated "alternative explanatory diagnosis," I should be able to ask again for a COVID test.

According to KTUU, the State of Alaska has 500 test kits.  Yesterday the State Website said there had been 60 people tested, 0 positive tests, and 14 pending since January 1, 2020.

Today's update shows a slight different reporting method.  Still 0 cases, but it doesn't mention how many are still pending, though there is one less test (59) than yesterday's 60 total tests given.  And the new one identifies tests by the state v. tests by commercial or academic labs.

from http://dhss.alaska.gov/dph/Epi/id/Pages/COVID-19/monitoring.aspx
note:  the info on this page changes daily

They don't tell us how many health care provider requests have been turned down.

And they don't tell us what they are saving the other 440 tests for.  They could do 40 tests a day for ten days (assuming there are that many legitimate requests) and still have 40 more tests.  In ten days there should be more tests available.

The point of testing is only in part to confirm that the high risk folks have COVID-19 and so health care workers can be protected when the patients come in for treatment.  But for prevention, they need to track down and test all those who have been exposed and to identify those with lesser or no symptoms who would be spreading the virus because they have no symptoms.

The World Health Organization Report on China makes this recommendation for "uninfected countries" which is more or less where Alaska is for now:

"Immediately enhance surveillance for COVID-19 as rapid detection is crucial to containing spread; consider testing all patients with atypical pneumonia for the COVID-19 virus, and adding testing for the virus to existing influenza surveillance systems;"

I have a call into the state to see if I can get some answers about how many tests requests they turn down and why.  But it doesn't look like they're calling back today, so I'll post this now.

[UPDATE March 12, 5pm:  Well as soon as you stop waiting, it happens.  I posted this and then a few minutes later I got a call-back.  The volunteer nurse I spoke to, L, was terrific (211 gets you to health and social service questions, and they gave my number to be called back).  Answered the questions she could and gave me another number to check on the ones she couldn't answer.  She confirmed the change in format today because of the use of non-state labs and the difficulty of keeping the 'pending' number current.  She couldn't tell me anything - other than the general criteria used to screen for testing - about the reasons people got turned down.  She emphasized everything is in flux, every answer is 'just for now' because things are changing so fast, and she mentioned this afternoon's announcement of the closure of Anchorage schools for a week.
Is there a limit on the number of tests they can give a day?  She didn't know.
Does the 500 tests include the 60 (or 59 today) already used?  She was pretty sure that 500 was what the State got total.
When I asked if the State has a specific goal for its testing program, she gave me reasons for testing - to help those at high risk know if they are COVID or not, to alert family members if they have a COVID patient at home, and to generally lower the risk.  When I pointed out that for public health stopping an epidemic, you needed to test lots of people until you find a few who were positive and then start testing all their contacts, she agreed.  We don't have enough tests.
She was very knowledgeable, very open about what she knew and didn't know, and I thank her and the others for stepping up and volunteering to fill in this need with (at least in her case) caring responders.  I'll try the number she gave me tomorrow]

[UPDATE March 12, 2020 6:56pm:  And Alaska's first case was announced after I posted the first update.]

Follow up post for Friday March 13, 2020 is here.