‘Seattle Coronavirus Testing’ Twitter Thread

On March 2 2020, as six patients in Washington state were reported to have died of a novel coronavirus, a Twitter user going by @into_the_brush shared a thread about their purported attempts to be tested for the virus in Seattle.

In the first tweet, the person posting said: They were a resident of Seattle, had “a history of chronic bronchitis,” and also claimed they had “all symptoms of COVID-19.” Moreover, they indicated their workplace was a clinic frequented by people over the age of 65, adding they did not wish to potentially spread coronavirus should they test positive for the strain:

For clarification, the Centers for Disease Control (CDC)’s Coronavirus Disease 2019 (COVID-19) “Symptoms” page listed the following three extremely common features to many illnesses as the known symptoms of COVID-19:

• Fever
• Cough
• Shortness of breath

We would also note the user described a “history of chronic bronchitis.” A list of symptoms for bronchitis was a bit longer, but it included all known three COVID-19 symptoms:

• Cough
• Production of mucus (sputum), which can be clear, white, yellowish-gray or green in color — rarely, it may be streaked with blood
• Fatigue
• Shortness of breath
• Slight fever and chills
• Chest discomfort

Based on the first and most viral tweet of the thread, it wasn’t immediately clear why the user believed that their symptoms were attributable to COVID-19 or novel coronavirus versus bronchitis, the latter of which they claimed to contract with regularity. It was possible to guess at some possible circumstances behind their reasoning, such as:

• The user visited a location also visited by a known carrier of COVID-19;
• The user read about symptoms of the illness in the news and believed their then-current symptoms differed from bronchitis in their experience;
• The user was generally concerned about a spate of cases in Seattle or Washington state;
• The user believed they might have bronchitis but wished to rule out coronavirus out of an abundance of caution;
• The user was acting solely out of concern for patients over the age of 65 at their workplace, but could not extend that concern to a point of open-ended, self-imposed quarantine.

On March 3 2020, CBS News reported that four of the six deaths in Washington state were in the same nursing home:

[Novel coronavirus or COVID-19] has killed six people in the [United States], four from one nursing home near Seattle and two others in the same county. The cluster of deaths at the nursing facility in King County highlights the serious threat the disease poses to the elderly and infirm. There were just over 100 cases in 15 states as of Tuesday morning, with New Hampshire and Georgia being the most recent to join the battle against the virus.

As we were referencing CBS News’ reporting, the page updated to show that there had been at least three additional deaths in the United States, bringing the total number up to nine. The additional three fatalities were also in the state of Washington. That article was formatted with live updates, and just two paragraphs down the page, only two deaths had been reported.

That section was about the risk of asymptomatic carriers in Washington (and possibly beyond):

While their research has yet to be peer-reviewed, a team of scientists in Washington said the state’s [first] two deaths could be the tip of an iceberg: They said hundreds more people in King County, where Seattle is located, may already have been exposed to the disease.

The potential for mild or even asymptomatic cases to go undetected but still spread COVD-19 has been noted repeatedly by health officials as one of the biggest challenges in fighting the disease. It makes the virus a deceptive enemy and, in spite of assurances from officials that the risk to the general public is low, the stockpiling and last week’s stock market losses show that, like the disease itself, fear is still spreading.

However, much of that reporting was on March 3 2020, and @into_the_brush’s thread was shared a day prior. In their next 10 tweets, they described purported efforts to connect with public health resources and get tested for COVID-19.

First, the user said they attempted to use a “coronavirus hotline,” eventually giving up due to an excessive wait. Then they visited the CDC’s website, but failed to locate any information on COVID-19 testing for patients. They then described making several additional calls and receiving conflicting information, ultimately getting transferred back to the “coronavirus hotline.” At that point, they reported connecting with a hotline worker:

I called the Corona[virus] hotline, was on hold for 40 minutes and gave up.

So I looked at the CDC and Washington public health websites. They told me to see a primary care doctor, but there’s no information about testing.

I called 2 primary care doctors. One told me they don’t know where to get testing, and that I should not to seek out testing. The other one told me to go to an urgent care or ER.

I called the Urgent Care, they also had no idea where tests are, but told me to call the hospital.

I called the hospital. They do not have tests, but transferred me to the COVID-19 hotline to “answer my questions”. Since I was transferred on a medical provider line, I actually got through. Progress!

The user did finally connect to an individual dispensing information on coronavirus but claimed they did not “qualify” to be tested for coronavirus, concluding in several tweets:

The lady with the hotline was very kind and professional and understood my concern about my own health and those at my clinic. (Which is currently being sanitized). However, I was told I do not qualify for testing. And I was not given a timeline or info on current resources.

So. Who does qualify? Those who have been out of the country in the last 14 days, and those who have had contact with one of the few people who have been tested and come up positive. That’s it.

The only way I can get treated is if my symptoms get so bad I develop pneumonia or bronchitis, which is very likely in my case. Then I’ll be in the ER and quarantined for several days while waiting for a test and for the results to come back.

This is all incredibly frustrating because I am trying to do everything right in a system that punishes moments of “weakness” like taking days off.

It’s also scary to know that I won’t be able to get help until I need life support.

To sum up: this is not contained. No one knows what the fuck is happening. I can’t work. WASH YOUR FUCKING HANDS.

Ah fuck! Didn’t realize there was a hashtag just for lil ol’ me! Check out above thread ☝️ #CoronaVirusSeattle

Since this is getting attention.

COVID-19 HOTLINE: 1-800-525-0127

DON’T CALL unless you are experiencing all symptoms or have been exposed to a case. Leave the lines open to people who need it most. Any other questions can be answered on the CDC, WHO, or WA public health sites.

In the last tweets of the original thread, @into_the_brush asserted:

• They made affirmative contact with an individual answering coronavirus-related calls via a hotline;
• They were unable to get tested for coronavirus, per the staffer’s assessment or information;
• They were informed coronavirus testing was limited to people who had been out of the United States for 14 days or more or people who had come into contact with anyone who tested positive for COVID-19.

However, directly thereafter, the user said:

The only way I can get treated is if my symptoms get so bad I develop pneumonia or bronchitis, which is very likely in my case. Then I’ll be in the ER and quarantined for several days while waiting for a test and for the results to come back.

That statement partly conflicted with the one directly above it, as it appeared to show that testing was available to symptomatic patients in the emergency room. It also seemed indicative that the hotline worker may have advised the user to visit an emergency room for suspected coronavirus, noting that patients tested for COVID-19 in the ER would be quarantined while the test was pending. With that in mind, it seems possible that the actual information provided was that patients showing symptoms who had a reasonable risk of infection were quarantined after being tested, and that the user was instead seeking a form of coronavirus testing that did not involve a quarantine.

Subsequently, the user continued as if they were infected, further claiming they would be unable to access treatment unless they became gravely ill. The thread’s final tweets concerned getting “treated” (not “tested”), and the user seemed to assume not only that they had been infected, but that no treatment would be rendered at all until the illness had progressed to be life-threatening:

• “The only way I can get treated is if my symptoms get so bad I develop pneumonia or bronchitis, which is very likely in my case. Then I’ll be in the ER and quarantined for several days while waiting for a test and for the results to come back”;
• “It’s also scary to know that I won’t be able to get help until I need life support.”

Those final assertions and the general tenor of the thread was oddly juxtaposed with a final tweet amplifying the “coronavirus hotline” number to a national audience, and advising Twitter users to keep “the lines open to people who need it most” and not to call it “unless you are experiencing all symptoms or have been exposed to a case.”

That same phone number was shared on two subreddits, r/CoronavirusWashington and r/Seattle; the second thread linked to the Twitter thread above:

A top comment on the thread in r/Seattle indicated the tweet had been repeatedly shared in that subreddit, and voiced suspicion of the user’s claims in general:

Please don’t keep posting this. The account is anonymous, mostly retweets political news and never mentioned Seattle or healthcare before today AFAIK.

A reverse search for the phone number indicated it was in use by the Washington State Department of Health (DOH), until recently as a one of two “consumer assistance” lines. It also appeared on the DOH’s dedicated coronavirus page, “2019 Novel Coronavirus Outbreak (COVID-19.)”

A big blue box at the top of the page advised the line might be “temporarily unavailable” due to a high volume of calls, possibly in part due to the thread’s viral spread on Twitter, Facebook, Reddit, and other sites:

The Washington State Department of Health has established a call center to address questions from the public. If you have questions about what is happening in Washington, how the virus is spread, and what to do if you have symptoms, please call 1-800-525-0127 and press #. Note: The DOH coronavirus hotline (1-800-525-0127, press #) is experiencing high traffic and may be temporarily unavailable.

That page did lack information about testing as it concerned the general public, but included a section: “What’s the current risk?” In that section, the DOH alluded to hotline protocols for assessing risk and triaging callers based on their level of personal risk. Factors identified by the DOH included recent travel to and from affected regions, healthcare workers directly exposed to coronavirus patients, residents of areas with community spread, and individuals who had contact with patients who tested positive:

• The general American public is unlikely to be exposed to the virus that causes COVID-19 at this time, so the immediate health risk from COVID-19 is considered low.
• The risk of exposure is increasing for people who live in communities in Washington state with reported spread of COVID-19, though risk is still relatively low.
• Healthcare workers caring for patients with COVID-19 are at elevated risk of exposure.
• Those who have had close contact with persons with COVID-19 are at elevated risk of exposure.
• Travelers returning from affected international locations where community spread is occurring are at elevated risk of exposure.
• Our knowledge of COVID-19 is still rapidly evolving. The risk assessment will be updated as needed.

In the Twitter thread, the user did not make any statements indicating they were exposed to COVID-19, and it seemed likely if they contacted the DOH’s hotline, they were assessed to be at low risk of contracting coronavirus based on current information at the time of the call. Also, by their own description the user did not appear to fit any of the DOH’s stated criteria for elevated risk of COVID-19 exposure. The DOH referred website visitors to review CDC guidance in assessing exposure risk for COVID-19.

It was also clear all of the information dispensed to the caller was readily available on the DOH’s coronavirus page. Individuals not in the elevated risk of exposure categories were advised that risk of exposure for them was low. It seemed evident that if the user did accurately relay the call, they received information consistent with the above-quoted portion, and may have emphasized their personal fear of exposure — prompting the hotline worker to advise them to visit an emergency room to report symptoms, and explaining that people with suspected cases of coronavirus were tested and quarantined.

On first glance, @into_the_brush’s Twitter thread appeared to describe a concerning lack of information available to people in Seattle and/or Washington State, as well as a poor public health response involving bureaucratic bungling — foretelling an inevitable rise in coronavirus infections. On closer inspection with all available information and alongside Washington State DOH’s COVID-19 guidance for residents, the thread seemed to possibly illustrate an efficiently operating coronavirus response.

If the tweets were accurate, the caller cited no personal risk factors or exposure to coronavirus, even based on their location. They seemingly reported being assessed as low risk and advised to seek emergency treatment if they developed coronavirus symptoms or their reported symptoms worsened. Perhaps the best takeaway for the hundreds of thousands of Twitter users engaging with the thread was its final message: Do not to sponge up limited public health resources for COVID-19 or novel coronavirus by unnecessarily calling hotlines for the same information offered freely on DOH webpages.