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By Laura Tucker, Staff writer; Image: COVID-19 test (Image source: Public domain)
One of the more frightening aspects of the coronavirus pandemic is that even if you believe you may have COVID-19, you may not be able to be tested to be sure because of a short supply of tests along with a backlog of processing the tests, sometimes taking up to 10 days. Documents obtained by CNN show that one lab had a backlog of 160,000 tests.
An internal document for Quest Diagnostics, based out of New Jersey, showed that on March 25 the company had about 160,000 coronavirus tests waiting to be processed. This was about half of the total orders the company had received up to that point.
Quest's testing is being done at a dozen labs across the United States. They referred to the waiting orders as a "significant amount of backlog."
While there is a large network of labs at public health departments and universities also testing for COVID-19, the Trump administration has relied on Quest and other commercial labs, as they have a greater capacity. These labs have expanded their testing capacity over the last month, and Donald Trump said on Monday that more than 1 million people had been tested for the novel coronavirus.
However, the testing process in the U.S. has been criticized by health-care workers, state officials, and others for being insufficient for quarantining patients in a timely manner and obtaining an accurate look at the scope of the virus. On Tuesday the White House Coronavirus Task Force warned the total number of U.S. deaths could be 100,000 to 240,000 before it's all over.
A member of the task force and director of the National Institute of Allergy and Infectious Diseases, Dr. Anthony Fauci, said on Sunday that safely loosening restrictions on social distancing depends on the speed of testing.
"So that when you identify someone who's infected, that person doesn't go out into society for a few days, infect a bunch of people, and then you bring them back because the test is positive," he said.
Quest spokesperson Wendy Boost said the lab has expanded its capacity to processing more than 30,000 tests in a day, shrinking its backlog. "Much of the backlog was due to huge demand in the early days of testing when we were primarily offering a lab-developed test we developed at a single laboratory," she said. "In recent days, our capacity has exceeded our demand, allowing us to reduce the backlog."
Other commercial labs are dealing with the same delays. LabCorp said its turnaround time is approximately four to five days, depending on different factors, such as transport time. ARUP Laboratories was initially accepting tests from outside its home state of Utah but stopped because of "supply constraints in the face of extraordinary demand," said the company.
Leaders from Quest, LabCorp, and other labs met with White House officials in March to discuss expanded testing. Trump boasted of a "new partnership with private sector to vastly increase and accelerate our capacity to test for the coronavirus."
Health-care workers are still complaining testing is not leading to results quickly enough. New Orleans E.R. doctor Joseph Kanter, the assistant state health officer for the Louisiana Department of Health, said the longer wait times for results force hospitals to use more protective gear that is already in short supply across the country. It must be used on patients who have been tested until it's confirmed they are negative.
Michigan nurse Megan Schlanser said limited testing has prevented those on the frontline, including some of her colleagues who are feeling sick, from knowing if they themselves have the virus. "We're not getting tested," she said. "The scary thing is that we could potentially all be carriers and not even show symptoms ... so I could be potentially infecting all of my coworkers."
38-year-old attorney Shannon Mason from northern California said she's still waiting for the results from the test she took on March 18. She has an immune dysfunction so is particularly at risk and became sick with a cough and fever in February, which later turned into a respiratory infection.
She went to the University of California-Davis Medical Center in Sacramento and had negative results on a flu test. "I was feeling really bad. That's the worst I've ever felt," she said. She's still waiting on results for her COVID-19 test and has repeatedly called to get her results, but no one knows.
Some hospital systems have begun implementing their own internal testing system, cutting down the wait time with no need to ship specimens out. The Yale New Haven Health System does in-house testing for the sickest patients and critical health-care workers but sends the rest to outside labs.
"Initially, we sent out a lot of samples to Quest, but their turnaround times were quite delayed recently, sometimes over a week," said the health system's chief quality officer, Steven Choi. "We're now transitioning to the Mayo Clinic Labs for our outpatient specimen testing."
A spokesperson for the RWJBarnabas Health hospital system in New Jersey said in-house testing can produce results in just a few hours, but the majority of tests are sent to private labs with waiting times of five to 10 days. The Henry Ford Health System in Michigan said test results are returned in 24 hours for patients who are admitted, but outpatient samples are sent to an outside lab for results in about a week.
Medical officials at multiple state departments said in March they needed more swabs and reagents, as well as other materials for COVID-19 testing. A University of Nebraska spokesperson said on Tuesday the two campus labs testing for the virus have been able to get results in four to six hours, but they have a limited capacity now due to a lack of reagents.
A spokesperson for Vanderbilt University Medical Center in Tennessee said the same. Overall volume of testing went from 48 to 72 hours to five to seven days because of a reagents shortage. "We have the reagent back in stock, but it took several days," said John Howser. "During that time we had samples accumulate in the queue."
Associate professor of epidemiology at the Harvard T.H. Chan School of Public Health, Caroline Buckee, said until the U.S. health system develops a way to widely test patients, including those with mild symptoms, the full scope of coronavirus COVID-19 cannot be determined and addressed.
"Right now we are not testing enough people, so we don't know what's happening with community-level transmission, and we're almost certainly missing many cases," she said.
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