Virus testing, tracking still rife with reports of delays

ATLANTA (AP) – As part of the plan to restart its season next month, the NBA is preparing to test hundreds of players, coaches, and others for the coronavirus each night inside a “basketball bubble,” a space in the Disney complex near Orlando, Florida with additional protection from disease.

Test results are expected the next morning, before practices and games of the day begin. That kind of quick response is the gold standard for tracking a highly contagious disease that’s on the rise again. in parts of the country. However, an Associated Press survey of selected US states shows that the benchmark is rarely met for the general public.

Having access to the results of the rapid tests will play an important role in the resumption of sporting events, keeping businesses and factories open and returning to school in the fall. But the AP survey found that sometimes it still takes days to return results, despite an increase in the availability of tests across the country.

The situation is even worse in many hot spots around the world, including South Africa, where results have sometimes taken up to 12 days.

Judy Clinco, owner of Catalina In-Home Services in Tucson, Arizona, has had to evaluate about 30 of her 110 employees, who provide care and assistance to older people in their homes. They can’t visit clients until the results come back, which usually takes anywhere from a week to 10 days.

Up to seven employees have been sidelined at once, Clinco said.

“During that time, the caregiver is not working. We are subsidizing their wages, and it is a financial burden on the company, ”he said. “It leaves us with one less caregiver to be assigned, and that leaves us understaffed.”

Public health experts say delays in testing present a major hurdle in reducing infections and tracking down those who have been in close contact with someone who is positive for the virus.

That’s why researchers are working to develop rapid tests that can be produced inexpensively, self-administered, and provide immediate and reliable results. For now, most tests to diagnose COVID-19 require laboratory processing, which means built-in delay.

Guidelines issued by the Centers for Disease Control and Prevention recommend that states, by lifting final virus restrictions, have a response time of less than two days.

But it is unclear whether states have access to detailed data showing whether they comply with the CDC standard, including the time it takes to process tests in independent laboratories. Labs track their own response times, but the CDC said data such as the time it takes for a test to reach a lab and that a provider receives the result and notifies the patient is not tracked. That makes it difficult to determine a “significant average” of what patients are experiencing in each state.

In the absence of publicly available federal data, the AP earlier this month surveyed nine states experiencing a 14-day increase in new positive cases, plus New York, which has had the majority of COVID-19 cases.

It took up to three days for the New York State Laboratory to report the results to patients. California authorities said the response time across the state was 48 to 72 hours, depending on the laboratory. In Utah, anecdotal information suggested that the results took 24 to 72 hours.

Most of the 10 states surveyed said they had no data on response times for commercial laboratories in their state, creating another information gap. Health experts said this was not unusual, that state health departments generally have not been responsible for monitoring each laboratory’s response times.

“It is a good question who should be responsible for tracking this information and providing it to the public,” said Kelly Wroblewski, director of infectious diseases for the Association of Public Health Laboratories.

There are other factors that can cause delays, from the time of day the test is done to whether a laboratory closes at night. Personnel problems and a shortage of test supplies can also delay the process.

Even people who visit the same test site can have very different experiences.

Earlier this month, Jeff Barnes, a music therapist in the Atlanta metro area, went to the same test drive location a week after his wife and two daughters. They were still waiting when he received his results the next day. His would not come for seven days.

Barnes said he was concerned about what a similar delay would mean if schools reopened in the fall.

“They will have to make it more efficient,” Barnes said. “If I knew that (my daughter) was in a classroom with 20 children and 10 of them had pending results, I don’t know if I would send her.”

Until rapid tests are widely available, health experts say it will continue to take a day or two to get results under the best of circumstances. That creates more opportunities for people who may be infected but feel good to pass the virus on to others.

In late April and May, the Alabama state laboratory had trouble procuring reagents, the chemicals used to process the tests. That led to intermittent delays in the reporting results, up to five days from the time the sample was received by the laboratory, according to Dr. Karen Landers, assistant to the state health officer with the Alabama Department of Public Health.

Those problems have since been resolved, and the laboratory now has a response time of between 24 and 72 hours from the time it receives samples.

One of the largest commercial labs, Quest Diagnostics, recently reported that its average response time is one day for priority patients and two to three days for all other populations. The company said it expects higher demand to result in longer waits of more than three days.

Other countries face similar challenges. Waiting times in China vary by city, from just one day in Shanghai to four days in Wuhan, where the virus first emerged. In Japan, tests generally give results in two days. According to the health ministry, mandatory tests, such as those carried out at airports, usually take place earlier.

The results in India initially took around 24 hours. But as infections and testing increased, so did delays. Results now often take two to three days or up to a week, depending on location.

Waiting almost two weeks in South Africa “makes effective treatment almost impossible,” said Marcus Low, editor of South African health magazine Spotlight.

By contrast, South Korea was praised for its swift efforts to launch a program that included free test drives with results generally delivered within 24 hours.

Back in the U.S., Amazon plans to spend at least $ 300 million on a worker testing program that includes building its own lab. But even with the wealth and influence of the country’s second largest private employer, results are expected to take three to five days. Authorities said they hope to reduce the response time to 24 to 48 hours.

“We still don’t know exactly how it’s going to evolve,” Amazon said in a statement, “but we still believe it’s worth a try.”


Associated Press writers Joseph Pisani and Joyce M. Rosenberg in New York, Tim Reynolds in Miami, Mari Yamaguchi in Tokyo, Aniruddha Ghosal in New Delhi, and AP researcher Jennifer Farrar in New York contributed to this report.