As people across the country were unable to get tested for COVID-19, a Santa Monica pediatrician emailed the parents of his patients with a pricey but tempting offer.
For $250, they could buy a cheek-swab test for the virus to be administered at home, Dr. Jay Gordon wrote. The tests could be purchased by his patients’ parents even if they showed no symptoms or had no other reason to fear they were infected. Insurance most likely wouldn’t cover the cost, he wrote.
Because he was getting only 100 kits, he asked that testing be limited to family members and “household staff.”
Gordon said he sold out almost immediately and has ordered hundreds more.
“People really wanted them,” he said.
Though California is ramping up tests, a continuing shortage means that many people with symptoms are still desperate to get tested.
But some private physicians and “concierge” doctors are offering tests to their patients at a price. It’s hard to know how widespread the practice is, but it has sparked outrage as celebrities and professional athletes without symptoms have gotten tested while others of lesser means wait.
Gordon acknowledges that his offer underscores inequities in the healthcare system.
“There’s no way in hell it should be so,” Gordon said. “This represents a massive failure of the federal government, of the healthcare system.”
Gordon said he is selling the tests to his clients because he has a duty to give them the best medical care possible. “I think it’s in the best interests of my patients,” he said.
Gordon — who has drawn criticism for defending the rights of parents who want to delay or refuse vaccinations for their children — said he believed the lack of testing was going to get “much much worse.”
Some physicians are skeptical that all the tests being offered are effective and criticize doctors who are charging fees for clients who want to be tested and have the money to pay. The Food and Drug Administration on Friday publicly warned that it has not authorized any at-home tests for COVID-19, the disease caused by the novel coronavirus.
“I think that it’s pretty horrible,” said Dr. Stanley Perlman, a pediatric infectious disease specialist at the University of Iowa who studies coronaviruses and their treatments. “You don’t want people who have more money to be able to get tested for something that everybody is worried about. It makes it seem like people who are rich are getting a break. I can’t think of anything good about this.”
State Sen. Richard Pan (D-Sacramento), a pediatrician who has strongly criticized Gordon and other doctors over their position on vaccinations, said he believed the practice was not widespread but denounced selling the tests at high prices to whomever can afford them, saying it was unprofessional conduct that the Medical Board of California should investigate.
Doctors, he said, should be following the Centers for Disease Control and Prevention guidelines that prioritize testing for people who have COVID-19 symptoms and are hospitalized; have compromised immune systems or other factors that put them at high risk; or recently traveled to countries with major outbreaks or had close contact with someone who has the virus.
“So in a crisis, this is how we handle it? We auction these tests? Is this how we want our society to operate?” Pan asked. “Our response should not be based on auctioning off scarce resources to the highest bidder.”
In Beverly Hills, Dr. David Nazarian, a primary care physician, said he’s been receiving an influx of calls since the coronavirus outbreak hit the U.S.
But because he has a concierge medical practice — meaning he limits his clientele to “influential people, A-list celebrities, and CEOs” in exchange for more personalized care — he has been granting tests only to his existing clients.
Nazarian’s yearly membership fee starts at $5,500 and can go up to $10,000.
About a month ago, when COVID-19 cases were still primarily occurring overseas, Nazarian began looking into obtaining extra nasopharyngeal swabs and viral transport mediums — the materials needed to test for the coronavirus. As a result, he had about 50 available for his patients, which were administered during house calls by nurses wearing protective gear.
Because of a “massive shortage” of testing kits, however, Nazarian decided to place an order for the rapid-test kits he said have been used in China and South Korea that produce results in a matter of minutes instead of days.
Nazarian said he expects the rapid tests, which involve taking blood samples, to arrive from China this weekend, at which point he hopes to open a drive-through testing option available to any person willing to pay about $500 or $600.
“We have had a lot of new patients contact us who money wasn’t a factor for; they were willing to pay whatever was needed,” he said. “But we’re not looking at this time in regards to ‘How can we make more money doing testing?’ or ‘Who we can charge more to do a test.’ It’s actually really trying to take care of the patients we already have and then figuring out how we can increase testing and do things for the good of the community.”
Andrew Pekosz, a biologist at the Johns Hopkins Bloomberg School of Public Health, said there has been a surge of foreign companies rushing to develop new coronavirus blood tests in recent weeks. He said he personally would not take such a test because of his concerns about their reliability.
A blood antibody test can indicate only if a person has had the virus, whereas the CDC-approved nasal swab tests can detect a current infection, Pekosz said. If patients aren’t made aware of this key difference it could lead them to seek additional treatment, he said.
“The last thing hospitals need right now are people who are healthy going in saying they need medical care,” Pekosz said.
The CDC recommends nasal swabs for coronavirus testing and says oral swabs are a lower priority and should be collected only if a nasal test is not available. Oral swabs run a higher risk of people coughing or exposing the tester to the virus, Pekosz said.
Some doctors whose private practices treat celebrities and the wealthy say they are following the CDC guidelines on tests.
Dr. Gary Cohan, a Beverly Hills internal medicine physician, said he’s had to turn away numerous patients seeking testing.
“Right now, I have to take care of my sickest people who could die,” Cohan said.
Cohan said that roughly every 30 minutes, he checks with his nurse — “she’s got friends everywhere” — about when his office will be provided with additional testing supplies. “She rolls her eyes and says that Quest [Diagnostics] and LabCorp tell her, ‘any day now,’” he said.
He said he doubted the reliability of some of the tests that are being offered to private patients and said doctors should not charge extra for them. Federal legislation passed this month would expand access to free COVID-19 testing to the public.
Gordon, the Santa Monica pediatrician, said he is charging clients only $50 more per test than it costs him from the lab.
He said he had been trying for a while, for the most part unsuccessfully, to get some of his patients tested for the virus.
But then the parents of one of his patients told him about a lab in San Dimas, KorvaLabs, that was selling COVID-19 tests. Gordon said he vetted the lab and the test, and determined it was legitimate based on a small group study that he said showed the mouth swab test had the same results as the nasal sample.
The test can be self-administered at home. Gordon said he sold the tests to clients whether or not they had symptoms but asked them to wait until they suspected they might be sick to use them.
Dr. Jeffrey Klausner, who said he was a voluntary clinical consultant with KorvaLabs, said the tests meet standards set by federal regulations. KorvaLabs did not return a call for comment.
Klausner said the lab was part of a broader effort to “scale up” testing capacity for COVID-19 in the U.S. He said if more testing were available, the country could “end this ill-informed, misguided, misdirected shut down.”
He also said that notions about free testing being available are an “illusion” and that Americans have been unwilling to fund a healthcare system that might have been better prepared for the crisis.
“We need to rely on the free market for our health response,” Klausner said. “That’s America.”