WASHINGTON >> US labs are undergoing a wave of coronavirus testing, creating processing delays that experts say are undermining the response to the pandemic.
With the US infection count of 3.9 million today and new cases on the rise, bottlenecks are creating problems for workers who are out of work while waiting for results, nursing homes struggle for keeping the virus out and for the labs themselves, dealing with a crushing workload.
Some labs take weeks to return COVID-19 results, exacerbating fears that asymptomatic people may transmit the virus if they don’t isolate themselves while they wait.
“There has been this obsession with the amount of testing we do per day,” said Dr. Tom Frieden, former director of the Centers for Disease Control and Prevention. “The question is how many tests are being done with results that return within a day, where the tested individual is quickly isolated and his contacts receive an immediate warning.”
Frieden and other public health experts have asked states to publicly report test response times, calling it an essential measure to measure progress against the virus.
Delays in testing in the US occur when the number of confirmed people who are infected worldwide exceeded a staggering 15 million today, according to data compiled by Johns Hopkins University. The United States leads the world in both cases and deaths, totaling more than 142,000 across the country. New York, once the American leader in infections, has been overtaken by California, though that is in part due to strong evidence in a state with more than double New York’s population.
Guidelines issued by CDC recommend that states that lift virus restrictions have a test response time of less than four days. Recently, the agency issued new recommendations against the reevaluation of the majority of COVID-19 patients to confirm that they have recovered.
“It is clogging the system,” Admiral Brett Giroir, assistant secretary of health, told reporters last week.
Zachrey Warner knows this very well.
The 30-year-old restaurant server in Columbus, Ohio, had been sent home from work on July 5 with a high fever a few days after he started experiencing symptoms. He went to a test five days later at the request of his employer.
Almost two weeks later, he is still waiting.
Although Warner said that most symptoms, such as fever, diarrhea, chest tightness and body aches, stopped a few days after the test, he has not been allowed to return to work without the result. On Tuesday, he received an email saying the results were not yet available and that he should be quarantined until Thursday or until he gets his result.
“The story is always the same: Apparently the laboratory they send the tests to received more than 30,000 tests in one week and they are supported,” Warner said. “I have missed a full pay period.”
Beyond the economic damage that testing delays can cause, they also pose significant health risks.
In Florida, as the state confirmed 9,785 new cases today and the death toll rose to nearly 5,500, nursing homes have been under an order to screen all employees every two weeks. But long delays in results question the point.
Jay Solomon, CEO of Aviva in Sarasota, a senior community with a nursing home and assisted living facility, said the results took up to 10 days to return.
“It’s almost like, what are we accomplishing at the moment?” Solomon said. “If that person is not quarantined in those 7-10 days, is he spreading without realizing it?”
Test results that come back after two or three days are almost useless, many health experts say, because by then the window to track people’s contacts to prevent further infections has essentially closed.
US officials have recently called for scans to be increased to include apparently healthy Americans who may be unknowingly spreading the disease in their communities. But Quest Diagnostics, one of the nation’s largest test chains, said it can’t keep up with demand and that most patients will face waits of a week or more to get results.
Quest has urged healthcare providers to reduce testing for low-priority people, such as those without symptoms or any contact with someone who tested positive.
The United States tests more than 700,000 people per day, up from less than 100,000 in March. Trump administration officials note that about half of the tests in the US are performed on rapid systems that give results in about 15 minutes or in hospitals, which generally process the tests in about 24 hours. But last month, that still left about 9 million tests going through labs, which have been plagued with limited chemicals, machines and kits to develop COVID-19 tests.
There is no scientific consensus on the rate of testing required to control the virus in the U.S., which has the most cases and deaths of any nation. But experts have recommended for months that the US test at least 1 million to 3 million people daily.
Health experts gathered by the Rockefeller Foundation said last week that the US should scale to 30 million Americans a week by the fall, when school reopens and the flu season are expected to further exacerbate the spread of the virus. . The group acknowledged that their number will not be possible with the current laboratory testing system.
The National Institutes of Health have organized a “shark tank” contest to quickly identify promising rapid tests and have received more than 600 applications. The goal is to have new testing options in mass production for the fall.
Until then, the backbone of testing in the US remains in several hundred labs with high-capacity machines capable of processing thousands of samples per day. Many say they could be processing many more tests if it weren’t for the global shortage of tests for chemicals, pipettes and other materials.
Dr. Bobbi Pritt of the Mayo Clinic in Rochester, Minnesota, says that the hospital’s machines run at only 20% of their capacity. Lab technicians run seven different COVID-19 test formats, switching back and forth based on availability of supplies.
At Emory University Hospital in Atlanta, laboratory workers pressure test manufacturers weekly to provide more kits, chemicals, and other materials.
“There is no advance planning, we just do everything we can and cross our fingers to get more,” said Dr. Colleen Kraft, who runs the hospital’s testing laboratory.
