Cars snaked for miles in 100-plus degree heat, hoping to get swabbed and not turned away as COVID-19 spread wildly in Arizona.
A testing site in New Orleans reached capacity before it opened its doors as staff realized the people in line outnumbered the facility’s tests. In the nation’s capital, a query about confusing wait times for D.C. testing on a popular blog sparked dozens of posts about Kafkaesque confusion and “total incompetence.”
In Georgia, health officials said top testers such as LabCorp and Quest Diagnostics are turning around tests in five to 10 days, compared with two to four days before a July surge. California is tightening its testing criteria to focus on hospitalized patients, the symptomatic and people who work in high-risk settings as it deals with shortages and long turnaround times.
From coast to coast, demands are straining capacity as Americans looking to travel or return to normal life try to get checked for infection from the coronavirus. Even as President Trump boasts about the volume of testing, getting a result can take a week or so, making it almost useless as a public health tool.
Administration officials said Thursday that they are trying to reduce the wait times as much as possible.
“There are only so many [tests] you can run with the laws of physics on a specific machine,” said Adm. Brett Giroir, the U.S. coronavirus testing czar. “We know that some of that burden is from nursing homes and prisons because of the surge testing.”
The administration said it hopes to alleviate that pressure by sending hundreds of rapid, point-of-care machines to nursing homes so they can test residents regularly.
For now, though, the delays are flummoxing people who thought the nation would have a better grip on diagnostics six months into the pandemic. Its testing crunch is multifaceted, though it is driven by an explosion of cases in the South and West and efforts to restart commerce.
“The testing increase is due to a number of things, including community spread of COVID-19 and the surge of infections,” said Nancy Nydam, a spokeswoman at the Georgia Department of Public Health. “Additionally, people are getting tested before they travel, more children attending camps are being tested, businesses reopening. It is all of those things.”
Testing, isolating positive cases and reaching the contacts of the infected are the building blocks of fighting any disease, but the delays are throwing that process into disarray.
“The main drawbacks are, of course, is that people go undiagnosed and they may or may not quarantine themselves if they are without symptoms or have only mild symptoms, so they are spreading the virus,” said William Schaffner, an infectious disease specialist at Vanderbilt University.
The delay can also be confusing for people who are cautious and isolate at home while waiting. Federal guidelines recommend that people who never develop symptoms wait 10 days after the date of their test before being around others. If someone waits seven days before receiving a positive test result, they should isolate for three more days and ensure they don’t develop symptoms of the disease.
For those who do feel symptoms, the Centers for Disease Control and Prevention says they should wait 10 days after symptoms first appeared, plus ensure they have gone three days without a fever and that respiratory problems have improved.
Adm. Giroir said it is important to know that about half of all tests in America are point-of-care checks in hospital settings and that those results are typically delivered within a matter of hours.
To help the rest, he said, the administration is working with commercial labs on “pooling” samples, a technique in which five or more tests are run at once to clear them faster.
The administration also pleaded with people who have tested positive to follow CDC guidelines on when it’s safe to reemerge instead of getting tested again to produce a negative result. Those tests might pick up inconsequential remnants of the virus and waste resources that could be used elsewhere.
Adm. Giroir said about half the states can turn around tests within three days, on average, which he characterized as reasonable, though “there may be an outlier that’s 10 days or 12 days. We can’t deny that.”
“We will work to improve that as much as we can,” he told reporters on a Thursday conference call.
President Trump is focused on the volume of tests run in the U.S., now at 45 million, and complains that other countries don’t report as many cases because they aren’t testing as much. He said he prefers on-site testing — the type used for people around him at the White House.
“It might not be as accurate, by the way, but I like it the best,” he told CBS this week.
Asked how he can fast-track that testing, he again focused on the array of options compared with other countries.
“No country in the entire world is doing what we’re doing. We’re going out to all areas of this country, in parking lots where cars line up to get tested. Nobody’s doing that,” he said.
The scramble to improve capacity and turnaround times comes at a critical juncture. School districts across the country are sizing up transmission rates in their communities as they figure out how to keep their teachers and students safe. Major League Baseball has begun testing athletes and top-tier staff every other day as they start a truncated season.
Dr. Schaffner said pro sports leagues have the resources to secure lab capacity and will point to downstream jobs created by their games to justify its use of resources.
The sports CEOs will say “if we can’t test the players, we can’t play ball. If we can’t play ball, all of these people won’t have a job,” he said.
“The contract comes in, and the largest bidder who can guarantee work is going to be accommodated,” Dr. Schaffner said. “We’re supposed to be the richest country in the world, and we don’t really have a national plan to expand testing. It’s all being done as ‘catch as catch can.’”
Being a high-profile figure doesn’t guarantee service. Atlanta Mayor Keisha Lance Bottoms said it took over a week for her family to get results.
“We FINALLY received our test results taken 8 days before. One person in my house was positive then. By the time we tested again, 1 week later, 3 of us had COVID. If we had known sooner, we would have immediately quarantined,” she tweeted.
Ms. Nydam said Georgia has a contract with a state-based company, Ipsum Diagnostics, that can turn around tests in two or three days. Georgia’s public health lab takes 24 to 36 hours, and commercial labs are taking up to 10 days.
Pennsylvania Health Department spokesman Nate Wardle reported similar disparities, with state and academic labs taking 24 to 36 hours.
“However, for the commercial laboratories, the wait time does seem to be considerably longer, up to and perhaps even over a week, which is concerning,” Mr. Wardle said.
Quest Diagnostics said it can run 125,000 tests a day — double its capability from eight weeks ago — and expects to run 150,000 a day by the end of the month.
“Despite that dramatic increase, demand for testing is increasing even faster,” the company said.
It said the average turnaround time for high-priority patients is one day, “however, our average turnaround time for all other populations is seven or more days.”
It cited several drivers of the demand, including the surge in the South and West, surgeries, the need for tests in high-risk populations in nursing homes and prisons, and people seeking tests at drive-thru centers.
The company said it’s trying to expand capacity by tapping referral labs, but global supply chains aren’t able to keep up.
LabCorp reported similar limitations.
“Until recently, we have been able to deliver test results back to patients on average between 1-2 days from the date of specimen pickup,” said LabCorp. “But with significant increases in testing demand and constraints in the availability of supplies and equipment, the average time to deliver results may now be 4-6 days from specimen pickup. For hospitalized patients, the average time for results is faster.”
In the District of Columbia, which works with LabCorp for public testing, officials said people can expect to wait an average of five to seven days.
“However, nationwide demand for LabCorp’s testing capacity can increase wait times,” D.C. Health Department spokeswoman Kimberly Henderson said.
Senior Democrats are calling on Mr. Trump to use war-scale powers under the Defense Production Act to procure more testing supplies.
“It takes a week to get a test back because we don’t have the equipment, enough equipment to get those results in a timely fashion that really makes a difference. So in a week, it’s probably obsolete anyway,” House Speaker Nancy Pelosi, California Democrat, told MSNBC.
It’s not only Democrats who are griping.
Former White House Chief of Staff Mick Mulvaney diagnosed the situation in a CNBC op-ed describing his own children’s struggles to get test results.
“I know it isn’t popular to talk about in some Republican circles, but we still have a testing problem in this country,” wrote Mr. Mulvaney, a former congressman and the U.S. special envoy to Northern Ireland. “My son was tested recently; we had to wait 5 to 7 days for results. My daughter wanted to get tested before visiting her grandparents, but was told she didn’t qualify. That is simply inexcusable at this point in the pandemic.”
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