Probably not.
State or federal laws may change in the future, but currently many patients are being denied routine coronavirus testing by state health departments. This March 12 article in Yahoo News showed that the CDC tested only 77 people in the week beginning March 8, 2020 and the CDC’s Stephen Redd, MD stated that coronavirus “is not a problem we can test our way out of.” One of the big problems with coronavirus testing is that there is currently an insufficient number of tests available. Until there is greater availability of tests, coronavirus testing is probably going to be limited to higher risk patients.
There is no cure for coronavirus, and currently the only treatment available for coronavirus patients involves supportive care (and isolation). At this point, coronavirus testing is performed to trend cases and to arrange for quarantine or isolation of infected patients and their contacts. Results for testing done through the CDC have a turnaround time of 2-7 days. The Cleveland Clinic recently developed a coronavirus test with a turnaround time of 8 hours. However, due to a delay in turnaround times, coronavirus testing will not affect a patient’s immediate care.
In the emergency department, EMTALA requires a screening exam to evaluate for an emergency medical condition and then to provide stabilizing treatment if an emergency medical condition is found. The presence or absence of COVID-19 does not, by itself, differentiate between a stable and unstable patient. Similarly, a diagnosis of strep pneumonia versus influenza pneumonia does not differentiate between a stable and unstable patient – the differentiation only matters for treatment purposes. Stability in a patient with a respiratory illness is almost always a clinical determination. With regard to coronavirus, recall news reports showing many relatively asymptomatic people quarantined on cruise ships and infected with coronavirus.
Consider the issue in a different way: If a patient with minor upper respiratory symptoms would not require additional testing before the discovery of coronavirus, why would a patient with the same minor symptoms require testing now?
When considering whether EMTALA may apply to requests for routine coronavirus testing, also consider that patients who come to the emergency department solely to request routine testing probably do not trigger an EMTALA screening examination requirement. The plain language of 42 U.S.C. §1395dd(a) states
In the case of a hospital that has a hospital emergency department, if any individual (whether or not eligible for benefits under this subchapter) comes to the emergency department and a request is made on the individual’s behalf for examination or treatment for a medical condition, the hospital must provide for an appropriate medical screening examination within the capability of the hospital’s emergency department, including ancillary services routinely available to the emergency department, to determine whether or not an emergency medical condition (within the meaning of subsection (e)(1)) exists.
I wasn’t able to find any legal precedent stating that a request solely for lab testing constituted a request for examination or treatment and therefore treated a screening exam requirement under EMTALA statutes.
If an individual comes to an emergency department asking only to be tested for coronavirus, a reasonable response might be that “We don’t perform (routine) coronavirus testing (on premises). Would you like to be evaluated by a physician?” If a patient wishes to be evaluated for a cough, fever, or other symptom, then they would be registered and placed in the triage queue.
The Bottom Line With Patients Who Request Routine Coronavirus Testing
Stable patients who are concerned that they may have coronavirus can always contact their state health department to inquire about testing. Patients can also be referred to the CDC website at www.cdc.gov/covid19. However, in most cases, whether or not testing is performed, stable patients who think they have coronavirus should probably be advised to self-quarantine for the recommended 14 day observation period or until they have been symptom-free for three days. If their symptoms worsen, they should be instructed to seek further medical care.