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Private, public clinics with few coronavirus tests must choose most at-risk

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(Missourinet)– The Missouri Department of Health and Senior Services says around April 1, the state will begin testing all Missourians who have a fever over 100.4 degrees and a cough. That will give more accurate numbers for who actually has the coronavirus.

Dr. Adam Wheeler of a mid-Missouri practice called Big Tree Medical Home says we only know the extreme cases right now and not the full scope of the coronavirus.

“Over 99 percent of people who have coronavirus have a fever and if you have a fever, you shouldn’t be going to work anyway, whether it be coronavirus or something else. So, we’d like to be a lot more precise than that and hopefully, eventually, we will be more precise than that. But at this time, that’s all we’ve got,” Wheeler says.

A private lab has stocked Wheeler with 20 test kits, and his clinic has 4,000 patients, which means tests are not administered to all patients with the symptoms.

“It’s going to depend on clinical judgment on a case by case basis, of course. In general, people who are low-risk and who don’t have a lot of exposures, testing is not going to help them much.”

The Kansas City Star reports Congressman Emmanuel Cleaver is frustrated with the few tests available at some Kansas City health clinics and the 10 kits available at the Samuel U. Rodgers Health Center.

Wheeler, like many doctors and hospitals, gets his tests from a private lab and they cost him about 90 dollars each.

Big Tree has gone to what he calls Sonic-style appointments– that is, drive-up visits for tests, treatment, and medications he supplies at the clinic.

“We’ve been stocking up on the antibiotics to treat the inevitable post-viral infections. Most of the deaths that have occurred from coronavirus, about 85 percent, have happened due to the virus affecting the lung itself. But just like with any upper-respiratory-tract infection, we would expect to have post-viral pneumonias, ear infections, sinus infections, that kind of thing,” says Wheeler.

If patients are self-monitoring, Wheeler says the most common symptom is a fever.

“That’s a really big warning sign because in adults hardly anything gives you fever that’s not significant: influenza, now coronavirus, then other significant illnesses. Then there’s shortness of breath.”

Like many providers, Wheeler is doing many of his visits through telemedicine.

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