Labs running out of supplies
FIRST, some of the coronavirus tests didn’t work. Then there weren’t enough to go around. Now, just as the US government tries to ramp up nationwide screening, laboratory workers are warning of a new roadblock: dire shortages of testing supplies.
The shortages are the latest stumble in a botched effort to track the spread of coronavirus that has left the US weeks behind many other developed countries. Dwindling supplies include both chemical components and basic swabs needed to collect patient samples.
There are ‘‘acute, serious shortages across the board’’ for supplies needed to do the tests, says Eric Blank, of the Association of Public Health Laboratories, which represents state and local health labs.
Yesterday, Blank’s group and two other public health organisations recommended that testing be scaled back due to ‘‘real, immediate, wide-scale shortages’’. They said that only patients with Covid-19 symptoms who were elderly, had high-risk medical conditions or were medical staff should be tested.
Testing is a critical part of tracking and containing infectious diseases like Covid-19. But the US effort has been plagued by a series of missteps, including accuracy problems with tests the Centres for Disease Control and Prevention (CDC) sent to other labs, and bureaucratic hurdles that slowed the entrance of large, private sector labs.
The director of Missouri’s state lab says his facility is facing shortages of swabs, liquids to store patient samples, and kits to develop the results.
Many labs were having similar problems, said Bill Whitmar. ‘‘Quite frankly, 95 per cent to 98 per cent of the talk between lab directors has been about the shortage of supplies.’’
At this point, his lab had only 500 swabs available, with only enough supplies to last until Wednesday, he said.
The Jefferson City lab does only a fraction of the coronavirus testing performed in Missouri, with commercial labs now doing the largest share. But Whitmar’s lab is where tests are run on the people most likely to be infected in that state.
The shortages have become a central concern in increasingly urgent communications among governors and federal officials.
The Trump administration’s top health official suggested yesterday that the ‘‘anecdotal’’ reports of shortages were caused by confusion about how to find alternative supplies. Secretary of Health and Human Services Alex Azar said the federal government was purchasing and shipping swabs to states.
However, Whitmar said many suppliers did not have the products in stock. ‘‘An order is not a swab in hand.’’
New York City health officials yesterday directed medical providers to limit Covid-19 testing to people sick enough to require hospitalisation, saying wider testing was exhausting supplies of protective equipment. The city’s health department said unnecessary testing was contributing to a shortage of masks, gowns, collection swabs and other supplies.
The coronavirus test uses a chemical chain reaction to detect tiny traces of the virus’s genetic material and reproduce it many times.
State and local health labs follow the technique, first developed by the CDC, which calls for a specific genetic kit made by German diagnostic firm Qiagen. Labs around the globe are reporting shortages of those kits.
Qiagen said this week it was trying to boost production from normal levels, which were capable of testing 1.5 million patients per month, to amounts that would allow for testing more than 10 million patients by the end of June.
The White House has increasingly emphasised that testing should prioritise the elderly and health care workers who have symptoms of the virus.
The CDC tells people to seek testing if they have certain symptoms of the flu-like illness caused by the coronavirus – fever, cough and trouble breathing – and if they have travelled recently to an outbreak area or have been in close contact with someone who is infected. They should first be tested for the flu and other routine infections.
While doctors are supposed to decide who ultimately gets tested, many state labs have adjusted their guidelines depending on testing availability.
The Trump administration is expected to soon announce the rollout of nearly 50 communitybased testing centres across the country, including drivethrough sites.
But some experts worry that the introduction of convenient mass screening will divert supplies from people with severe symptoms to those who face lower risks.