Labs struggle with testing load
Delays mean infected people might not know it
America’s testing system is again strained and labs are struggling to keep pace as coronavirus rages faster than ever in the South and West.
From Florida to California, large and small labs running 24/7 can’t process samples quickly enough from millions of Americans tested every week. That means COVID-19 test results are delayed a week or longer in hot spots, undercutting public health efforts to track, isolate and prevent spread.
The number of daily tests reached an all-time high of more than 719,000 on July 3 and averaged nearly 640,000 each day in the past week, according to data from the COVID Tracking Project.
Testing centers in Sun Belt cities such as Tallahassee, Florida, and Phoenix routinely attract long lines and at times turn away people. Other than hospital patients, who get priority at labs, delays are widespread in the South and West at drive-thru and walk-up testing centers, urgent care centers, doctor’s offices and government-supported testing sites.
“We are seeing across the board this very significant increase in demand,” said Julie Khani, president of the American Clinical Laboratory Association, which represents the nation’s largest commercial labs. “That demand in many cases is now exceeding the number of tests that the labs can perform in a single day.”
The absence of testing to detect SARS-CoV-2, the virus that causes COVID-19, left Americans unprepared in February and March as the deadly virus swept across the nation. Congress authorized billions of dollars to help, and private-sector labs provided widespread clinical testing that public health labs could not complete on their own.
But as states have reopened amid a resurgent virus, millions of Americans want to get tested. New cases surpassed 63,000 for the first time Thursday, and as of Saturday there were more than 3.2 million U.S. cases and 134,000 deaths, according to Johns Hopkins University.
Assistant Secretary for Health Brett Giroir, who oversees the Trump administration’s testing efforts, said last week that the nation’s testing system is nearing limits and commercial labs are taking longer to complete nonemergency COVID tests.
“We did anticipate that the lab capacity would at some point in time come close to reaching a max,” Giroir said. “I’m not saying it’s at a max now, but we’re certainly pushing the frontiers.”
Giroir said new “point of care” testing platforms, which deliver quick results at doctors’ offices and clinics, should add 10 million to 20 million tests each month by September. He urged Americans to demonstrate “personal responsibility” by wearing masks, distancing from others, washing hands and shielding vulnerable people such as older adults or those with underlying health conditions.
Commercial labs envisioned a demand spike when they joined the coronavirus testing effort and urged White House officials to adopt strict test-ordering criteria so the most vulnerable people get tested first, Khani said.
Labs have worked to expand testing capability, but there are limits. They must secure testing materials such as chemical reagents, swabs and pipettes from suppliers that serve labs worldwide. They also need to acquire the machines that perform high-volume tests.
“We know we have a responsibility to deliver those results as quickly as possible,” Khani said. “That’s why we’re doing absolutely everything we can to continue to expand our testing capacity and increase our ability to perform tests.”
In Phoenix, long testing delays are not unusual. The website for the region’s largest commercial lab, Sonora Quest, said most COVID test results take eight or nine days.
Quest Diagnostics, which serves about half of the nation’s doctors and hospitals, said demand for COVID tests surged 50% in a three-week period in June and continues to rise, especially in the South, Southeast and Southwest. The lab can process 120,000 tests each day and plans to add 30,000 by the end of July.
LabCorp said that “until recently” it could deliver COVID-19 test results within a day or two.
“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 four to six days” for non-hospital patients, LabCorp said.
Testing and delivering timely results is critical to slow the spread of the virus. People who get a test but must wait a week or longer for a result don’t know whether they have the disease. It also delays public health efforts to isolate infected individuals and trace their contacts to prevent further spread, experts said.
“If it takes days and days to get a result, additional transmission may have happened before contact tracers get involved,” said Dr. Joshua Sharfstein, vice dean of public health practice and community engagement at the Johns Hopkins Bloomberg School of Public Health.
The Centers for Disease Control and Prevention has set federal testing guidelines, but does not have enforcement power.
In May, the CDC awarded $10.25 billion to states, local governments and territories to fund testing plans. The federal government procures and sends testing supplies such as swabs to every state once a week, Giroir said.
“The technology is not here to test every single person every single day,” Giroir said. “The most critical factor is going to be personal discipline. It’s the physical distancing. Wear a mask. Avoid crowds ... that is absolutely critical and is the most important thing we can do right now across the country.”