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Before Montana recorded any novel coronavirus cases that cleared most main streets and converted restaurants to carry-out, Kelsey Motes-Conners started to feel more tired than normal.

“At that point, coronavirus was top of mind for cruise ship passengers and people in Seattle, but I wasn’t immediately like ‘I wonder if this is what I’m dealing with,’” said Motes-Conners, a 35-year-old Missoula resident.

A few days before the World Health Organization declared COVID-19 a global pandemic, Motes-Conners developed some of its symptoms: a dry cough, a fever and shortness of breath.

Her husband, a nurse, started to worry. So did she.

Motes-Conners had just flown home from New York. She also just spent time with a friend visiting from Seattle — one of the nation’s first known COVID-19 hotbeds.

“I wasn’t trying to be an alarmist. It was more like, it feels inevitable that this will reach Montana, and if it’s me I just want to know and adjust my behavior accordingly,” Motes-Conners said.

As someone who is young and healthy, Motes-Conners is among the demographic researchers say would likely recover just fine.

But she thought of the immunocompromised kid at her son’s preschool, her husband’s patients, and the neighbor in his 90s who walks with an oxygen tank in tow.

Motes-Conners skipped walking into a hospital to avoid putting other patients at risk and wrote her doctor through an online portal to ask if she needed a COVID-19 test.

In that March 12 exchange, her doctor said given Motes-Conners’ recent travel and symptoms “it may be good to know if in fact you do have coronavirus or not.”

Her doctor directed her to another clinic. As instructed, Motes-Conners parked by the clinic’s back door the next day and waited for a nurse to meet her with a mask. After an exam, Motes-Conners asked if she should be tested for coronavirus.

“The doctor sort of hemmed and hawed and said I have a story consistent with concern for COVID-19, but I’m in a very low-risk demographic for serious complications,” Motes-Conners said. “And so he said ‘there really is no way I can imagine the health department would release a test for you. You just don’t meet the criteria.’”

Later that night, Montana’s governor announced the state’s first confirmed COVID-19 cases. More cases were announced the next day. Among them was a Missoula County patient in her 30s.

“It felt so contradictory to what I had been told only 12 hours earlier,” Motes-Conners said. “I got no follow up from the clinic or any other sort of official capacity...so I just did my best to stay away from others, just in case.”

Information about this virus — and how to respond — is changing rapidly.

A test doesn’t change a person’s treatment for COVID-19 because there’s no antiviral medication. The reason to test for the illness is to know where it is and to stop its spread.

But the U.S. has been slow to build a supply of COVID-19 tests, which left many states and providers limited on who gets one, including Montana.

That’s left people rejected for a test in limbo, worried about whether they could spread a disease they’re not sure they ever had.

The Centers for Disease Control and Prevention offers guidelines health officials look to when deciding who gets tested. But the guidelines have changed from week to week and sometimes from day to day.

In the meantime, no one is keeping track of those who were rejected. That could add to the issue of known cases not matching reality — a problem reported on a national scale.

Kallie Kujawa, incident command lead for Bozeman Health Deaconess Hospital, has said there’s also a lot of people asking for a COVID-19 test even though they don’t have any symptoms.

“This is a diagnostic test,” Kujawa said. “If the patients aren’t showing signs and we move forward with asking those patients to be tested, it might give them a false sense of security.”

People prioritized for a test right now are those who have symptoms and traveled to a place of concern or who have symptoms and have been in close contact with a known case.

During a Thursday conference call with Montana lawmakers, State Medical Officer Gregory Holzman said people hospitalized with the symptoms should also get tested quickly so health providers know whether they need to wear protective equipment or save the gear that’s in short supply.

“It’s not for the patient’s benefit, because the treatment is the same,” Holzman said.

To see if someone has COVID-19, providers typically swab a patient in a hospital or clinic. The swab goes to a lab for testing.

The state has ramped up testing. Montana’s lab went from testing a total of 55 samples as of March 13 to 947 samples as of Friday.

Part of that increase is because the state is able to perform tests at its own lab instead of having to wait for tests from the CDC. The state also increased how many people are picking up samples across Montana, which is happening daily. More private labs are also performing the test.

But health officials have another concern: whether lab equipment and staff can keep up.

Sidney Felstet, 18, works at a grocery store in Bozeman. Felstet said she called a clinic once her throat started to hurt and she developed a low-grade fever last week.

“They told me not to panic but said they would not test me for COVID-19 as I am not in a high-risk age group,” Felstet said. “I could just have a cold but because of how many people I’m in contact with every day at work and knowing that young people experience very mild symptoms, it is possible that I could have COVID-19.”

Felstet said she’ll stay home until she’s better to protect others. But she’ll soon run out of her paid time off and she’s worried not everyone in her shoes would make the same decision.

“If we’re not testing everybody who has symptoms, especially young people, those are the ones who could rapidly spread this without knowing they have it,” Felstet said.

As the nation tries to slow the spread of this new virus with so far limited resources, the advice to stay home while sick, wash your hands and keep a distance from others might be the most direct answer Felstet gets.

Holzman said during that Thursday conference call Montana is lucky. Unlike some areas, “we’re still in the containment mode.” That means as far as the state is aware, the virus is still coming into Montana from other places — not rapidly jumping from one person in the state to another.

“Prevention is the treatment right now,” Holzman said. “...The social distancing and number of other recommendations that have been said over and over again is what we as a whole community need to do to try and prevent further spread of the virus in the state of Montana.”

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Katheryn Houghton can be reached at khoughton@dailychronicle.com or at 582-2628.