Testing demand explodes amid COVID- 19 spike
“We have had to play a little bit of catch up and adapt to what we’re seeing out there.”
Tom Kelly, president of AFC Urgent Care facilities in Danbury, Torrington, Vernon, New Britain and West Hartford
When Carol Kagdis needed to take a COVID- 19 test, she was told to bring a book.
The Fairfield resident waited 31⁄ hours at the
2 drive- thru site at St. Vincent’s Medical Center in Bridgeport.
“Once at the head of the line, the test took less than one minute and off I went,” said Kagdis, who needed to prove a negative result for a procedure. “The people were wonderful and very helpful.”
Long waits and challenges scheduling appointments have become the norm for people seeking a COVID test across the state and nation.
Some testing sites reported demand doubling or tripling recently as exposures rise, college students return home and families look to travel for Thanksgiving.
This could worsen if the virus spreads at holiday gatherings and as cold and flu season ramps up, experts said.
“The past few weeks have just exploded,” said Tom Kelly, president of AFC Urgent Care facilities in Danbury, Torrington, Vernon, New Britain and West Hartford.
“We thought it would increase, but we didn’t think it would get to the point that it is,” he added. “We have had to play a little bit of catch up and adapt to what we’re seeing out there.”
Major labs have noted the increase, too.
The Jackson Laboratory, which processes 23 to 26 percent of tests in Connecticut, has seen an 84 percent increase in tests in the past two months.
By the end of the month, Sema4 will have processed almost three times as many tests in October and November compared to August and September.
Nationwide, Quest Diagnostics reports a 50 percent increase in orders compared to the last week of September.
Sites are hiring employees, adding testing events and expanding hours to keep lines down, which experts fear could deter patients from getting tested and hurt the sick and elderly.
“The people who would have a hard time waiting in line are precisely the ones you want to test,” said Dr. Benjamin Oldfield from Fair Haven Community Health Care in New Haven, which recently brought in a mariachi band to entertain staff and patients in line.
In some cases, this has slowed results at labs, but many sites reported turnaround time has been about the same.
Causes and impact
The Community Health Center, which tests at about 20 permanent and pop- up sites across the state, this past week averaged 4,500 tests daily statewide, compared to 1,700 daily tests in October, spokeswoman Leslie Gianelli said.
The organization recently expanded testing to seven days at its permanent sites, which are drive or walk- up only, with no appointments. Cars— sometimes with several family members— line up before opening, Gianelli said.
The line could shut down as early as four hours before closing if staff see that not everyone will be swabbed in time, she said. Patients are told to return the next day.
“Every day and every hour is busy,” she said.
Almost triple the number of people compared to a couple weeks ago have sought tests through the Connecticut Institute for Communities in Danbury, said Katie Curran, chief operating officer and general counsel.
This past week, police were needed to direct traffic because cars spilled onto side streets, she said. The wait time is about 45 minutes to an hour.
“This week, in particular, people are trying to get tested for holiday plans,” Curran said. “We are really trying to reiterate the message from our public health officials, which is to try to stay home for the holidays.”
Walk- ups at Fair Haven Community Health Care in New Haven have tripled in the last two to three weeks, Oldfield said. Patients may need to wait a half hour or longer, he said.
Appointments are available but patients often need to wait a day, Oldfield said.
More groups, such as schools and police and fire departments, have requested testing at their facilities, he said.
“Everyone is noticing that the prevalence of the disease is going up,” Oldfield said. “What that means is that people are more interested in mitigating or containing the disease.”
Family Centers in Greenwich went from testing roughly 40 people a week in September to about 100 patients weekly, said Dennis Torres, chief health officer.
The center added a second testing day due to the increase, which he attributed in part to cold and flu season.
“Any symptom is causing people to get tested,” Torres said.
The organization offers walk- up testing by appointment at its clinic in Greenwich, but plans to open a non- appointment drive- thru site at its facility in Stamford by Nov. 30.
Southwest Community Health Center in Bridgeport has seen an about 60 percent increase in demand and wait times of roughly an hour for those who do not preregister.
“It’s been insane,” said Mollie Melbourne, president/ CEO.
The Hartford HealthCare system is trying to hire more staff and has added testing sites, including a second one at Bradley International Airport, which will open Monday.
Patients are recommended to call ahead, check wait times online and register when possible. The first two hours at its drive- in sites— 8 to 10 a. m. — for patients who require testing in advance of surgical procedures.
“As people plan their day and need to get testing, keep in mind that there will be a priority ( for certain patients) for the first couple of hours,” said Dr. James Cardon, Hartford HealthCare’s chief integration officer.
On Thursday morning about 11 a. m., most drive- through testing locations, including those for St. Vincent’s Medical Center and Hartford Hospital, listed wait times of two hours or more.
Staffing and supply
Many sites are hiring more staff and using existing employees to meet demand and add more locations or hours.
“We’re still able to keep up with that demand, but we are onboarding new people as we speak because if it continues at this volume, that will be challenging,” said Curran from the Danbury testing site.
The Community Health Center is looking to hire up to 100 fulland- part- time staff members, Gianelli said.
“This is a great potentially parttime job for college students who are coming home for Thanksgiving,” she said.
The National Guard is being used at locations like Danbury and Norwalk to supplement staff, she said.
Family Centers uses temporary staffing agencies and its regular employees for testing activities, on top of regular operations, Torres said.
“We’re still taking care of people with their illnesses and their heart conditions and diabetes and school physicals,” he said.
Hiring continues at The Jackson Lab, but there is a shortage of experts qualified to conduct clinical molecular diagnostic tests, said Dr. Charles Lee, professor and director of the lab.
“We’ve found people that have the raw skill sets and then train them in- house,” he said.
But sites said they have not been low on supplies, such as test kits, which was a problem in the spring.
“We are concerned that at some point there will be some concerns with swabbing supplies, but to date we have not experienced that,” Melbourne said.
The number of PCR tests should be able to “meet the moment” in the coming months, supply of rapid tests has been “hit or miss,” Kelly said.
The Jackson Laboratory has not faced supply shortages either.
“That’s a credit to the lab getting a little bit smarter about the supply chain and the vendors getting a bit smarter at making sure they keep up with demand,” Lee said.
Results time maintained
Sema4 has expanded hours and hired staff to return results to providers within 48 hours, said Eric Schadt, founder and CEO.
“We have also further optimized our processes in order to accommodate the growth and ensure we meet turnaround time commitments,” Schadt said in a statement. “Things do not always go perfectly and we have definitely hit some bumps but, by and large, we have been able to turn tests around in less than 48 hours.”
The Jackson Laboratory has stuck to a 24- hour turnaround time.
“It hasn’t been easy,” said Lee, adding the lab receives samples primarily from Griffin Hospital, Hartford HealthCare and UConn Health, in addition to about 40 clinical institutions and partners.
But Quest Diagnostics, which many centers use, has warned that result time has increased slightly to just over two days for most patients and up to two days for priority patients.
“While the increase is modest, assuming national trends continue, we expect COVID- 19 cases and corresponding orders for testing to increase for the foreseeable future, which may cause turnaround times to grow,” the company said in a statement on its website.
But places in Connecticut that use Quest have not reported issues.
The Community Health Center continues to see results in two to three days. Fair Haven receives results within 24 hours for tests taken at nursing homes and roughly 48 hours for other samples.
But if wait times became longer, it would keep negative patients in quarantine for longer and could lead to positive patients spreading the virus, Oldfield said. Contact tracing also becomes more difficult.
“People remember things better if it happened two days ago versus if it happened five days ago,” he said.
Food insecurity could worsen for patients who cannot work while they are waiting for results, Melbourne said.
“If they don’t work, they don’t eat,” she said.
Patients often view results on online portals, but many sites still call with results. That takes longer when there are more tests, officials said.
AFC typically got results in 48 hours, but now sees 72 hours, Kelly said. The facilities primarily use Enzo Life Sciences lab in New York.
More staff have been hired to call patients with results, and the facilities are working on an online portal, he said. Using rapid tests for patients with symptoms also helps because results are immediate, he said.
“Quarantining is a terrible thing,” Kelly said. “It’s a concerning, scary, lonely time and we all understand that. We try to lead with compassion and care and do everything we can do to get results back as quickly as possible.”