“If we don’t recover the test results in a period of time that allows [isolating infected people and tracing their contacts]There’s almost no point in doing the test first, “said Jennifer Nuzzo, an epidemiologist at Johns Hopkins University.
Increasing delays increase urgency as many schools and colleges plan to reopen in the coming weeks and rely on aggressive and regular evaluations of students and staff. In addition to this perfect storm, the approaching flu season is likely to further stretch the system as people with flu-like symptoms look for COVID-19 tests to rule out that infection.
“I think the demand for testing will remain high and will increase in any event during the fall,” said Dr. David Hamer, an infectious disease expert at Boston University and a doctor at Boston Medical Center.
North Carolina-based LabCorp and New Jersey’s Quest Diagnostics, two of the largest laboratories nationwide to process COVID-19 tests, said in statements that they have significantly increased capacity since the first months of the pandemic and expansion efforts continue. But they said those increases have not kept up with recent and rapidly growing demand.
And while Quest opened a laboratory in Marlborough, Massachusetts, in March as part of its effort to expand capacity, it is not necessarily shortening wait times here because that laboratory is also processing tests from across the country, the company said. She acknowledged that the wait for results, both in Massachusetts and across the country, averages at least a week for patients who are not hospitalized or who are health workers suspected of being infected. On Monday night, the company reported that national average response times have worsened and that “a small subset of patients may experience waiting times of up to two weeks.”
Hoping to ease the delays, federal regulators authorized Quest on Saturday to start pooling their test samples across the country, allowing up to four samples to be run in one batch instead of running each test individually.
If one group is negative, none of the four individuals is infected with COVID-19. If a group is positive, it means that one or more of the individuals in that group may be infected. At that point, each of the samples in that group will be separated and re-analyzed individually, and infected individuals will be identified.
Because samples are pooled, fewer tests are expected to be performed overall, meaning fewer test supplies are used and more tests can be performed at the same time, allowing patients to receive their results more quickly in most cases, according to the Food and Drug Administration.
But many local public health officials in Massachusetts have yet to see an improvement in response times, said Sigalle Reiss, president of the Massachusetts Association of Health Officials and director of health for Norwood.
“We definitely still have a problem,” said Reiss.
“Most of the test results, touching wood, will be negative because the positivity rate is very low right now in Massachusetts,” he said. “But the anxiety of waiting is only increasing people’s fear right now. With the reopening of the schools, if we don’t have a quick change in testing, the system doesn’t work. “
Earlier in the pandemic, the Massachusetts Department of Health reported the daily output of many of the labs across the state. But it stopped doing it months ago, and does not include response times in the data it reports daily. Nor did it include any mention of response times in a recent report to federal regulators about plans to expand testing capacity in Massachusetts.
The state health department said in a statement Monday that the current state average for response times in Massachusetts in July is 2.2 days and that the state is monitoring the situation. However, there may be significant variation within that average, as it includes both generally faster facilities that have internal testing capabilities and those that rely on supported national diagnostic companies.
Some states require tourists to submit negative COVID-19 tests, and some companies seek regular employee tests, further contributing to the backlog of orders. Johns Hopkins’ Nuzzo said policymakers should consider prioritizing people who have symptoms of COVID-19, who need to be hospitalized or treated, or who have spent time in places where infection rates are high, restrictions Trials that were widely used in the early days. days of the pandemic when the shortage of tests and related supplies were acute.
“We just have to think nationally about the optimal testing strategy, particularly given that I don’t think our resources are ever totally restricted,” he said. “It is unrealistic for me to think that everyone can be evaluated every day.” . . and there will be some bottlenecks, so we really need national responses. “
A bright spot for Massachusetts is that many of its research and medical institutions are in better shape than their counterparts in other states that did not increase internal testing processing capacity in the spring, said Hamer, the infectious disease specialist at BU.
But those institutions don’t usually process tests for employers and other organizations, so they are unlikely to ease their burden, he said.
A notable exception is the Broad Institute of MIT and Harvard, which has negotiated test contracts with various colleges and universities to process thousands of tests daily.
The Broad recently expanded its daily capacity to 35,000 tests and can turn them around in less than 24 hours, a spokesman said in a statement last week. The laboratory has the capacity to increase to 100,000 daily if necessary, the spokesperson said, but declined to comment further on its new university testing program.
The Broad, which opened its testing lab in March, has so far not processed more than approximately 8,000 tests in a day, according to the website where it publishes its daily output.
Dr. Michael Mina, an assistant professor of epidemiology at TH Harvard TH Chan School of Public Health, said it is time for leaders to reconsider the nation’s COVID-19 testing system. The current system, which is based on diagnostic tests sent to a laboratory for processing, was never designed to handle the massive burden it now faces.
“We are trying to insert a square peg into a round hole,” said Mina.
Instead, he said, it’s time for leaders to invest time and resources in advancing inexpensive tests that consumers can perform and process at home, unlike the fingerstick blood tests that diabetics use to keep their blood sugar intact. .
“We have the technology, the money and the knowledge,” said Mina, “and we have the biggest problem compared to other countries.”
She can be reached with Kay Lazar at [email protected] Follow her on Twitter @GlobeKayLazar. Dasia Moore can be contacted at [email protected]. Follow her on Twitter @daijmoore
