■ Confusion surrounds process of testing. Here are some answers.
As the coronavirus pandemic sickens hundreds more people in Illinois each day, much confusion surrounds the process of testing for the new virus. The Tribune asked public health and medical experts for answers to some common COVID-19 testing questions.
Q: How many people in Illinois have been tested?
A: Not very many. So far, 21,542 Illinois residents have been tested, according to Illinois Department of Public Health statistics as of Friday. More than 3,000 of the results have come back positive for infection.
Q: Who gets tested?
A: State health department labs are restricting testing to the most severe cases, citing a national test kit and supply shortage.
Initially, the only patients who received state lab tests were symptomatic, had contact with a known patient and first had other illnesses ruled out. The state’s guidelines were widened earlier this month to include residents of nursing homes or other facilities, patients deemed to be “public health concerns,” those hospitalized with unexplained respiratory problems, and individuals at a higher risk of complications.
Other laboratories, though, can run tests outside the state’s parameters. For example, NorthShore University HealthSystem performs tests in-house and says it is now testing patients who are showing symptoms of COVID-19 and have a doctor’s order.
Some doctors who send their tests to private labs say they’re not adhering strictly to government protocols.
“It’s a dilemma I had to go through personally,” said Dr. Rahul Khare, founder and CEO of Innovative Express Care on Chicago’s North Side. “Some people have four kids, and they need help from their moms. Or you have a patient with a high fever, and her mom is 80. We need to know in these cases.”
Q: Why is testing important?
A: Medical experts say mass testing is key to understanding and getting ahead of the new virus.
“The tragedy from the last few months is we’ve been flying blind because of the delay in testing,” said Dr. Thomas Tsai, an assistant professor in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health. “Let’s not repeat that tragedy going forward for the next three months. That information is going to guide the appropriate response.”
Testing can also affect social behavior, said Dr. Ngozi Ezike, director of the state health department.
“If you knew you were positive, I think you would be sure to really withdraw, make sure you stay away from others,” she said at a news conference Friday. “And so it is a part of flattening the curve and dealing with the pandemic.”
Q: Then why are authorities limiting who gets tested?
“In an ideal world, we would have widespread testing,” said Dr.
Allison Arwady, commissioner of the Chicago Department of Public Health.
But necessary testing materials — laboratory machines, solutions used to preserve and ship nasal swabs, protective gear for those performing the tests — remain in short supply, she said. So medical authorities are trying to limit testing to the people most at risk of becoming acutely ill or spreading the virus to others.
Some Illinois hospitals have curtailed their COVID-19 testing programs in the last week or so. Others are continuing to test but carefully monitoring supplies.
“We’re working with what we’ve got,” Arwady said. “Across the board, what we have has to go to places where it’s going to make the biggest difference for protecting everybody in Chicago.”
Q: Does lack of testing affect treatment of the coronavirus?
A: Because there is no cure or certain treatment regimen for COVID-19, lack of testing doesn’t change how people are cared for, Arwady said. Doctors simply do as much as they can to alleviate patients’ discomfort so they have a better chance of recovering.
“It does not change your clinical scenario one bit,” she said.
Q: When can we expect more testing in Illinois?
A: Gov. J.B. Pritzker acknowledged that testing — while increasing — remains inadequate. He has placed much blame on the federal government for claiming it would coordinate mass testing.
“The truth is, even now, that’s not true,” he said at a news conference Friday. “If I knew then what I know now, I would have gone out and bought … many more machines so we could do it ourselves.”
The state two weeks ago began purchasing machines to use and to provide to outside labs, he said. Unfortunately, there are still shortages of all the equipment involved in testing, he said.
Ezike added that state labs are increasing to two shifts a day to run more tests.
“We’re aggressively working to increase testing; that’s an important part of this COVID-19 response effort,” she said.
Q: Once a patient is tested, how long does it take to get test results?
A: This varies by medical provider as well as the lab running the test.
Some Chicago-area residents have described lengthy delays of eight days or more. Media from other U.S. cities reported similar lags, citing overwhelmed labs.
Pritzker described this problem as “a bottleneck that’s very difficult to overcome.”
“Even if you buy more machines, even if you get the swabs … if you’ve got all that, you still need the lab technicians who are trained on the machines,” he said Friday. “And guess what? Those are in short supply too.”
Some hospital systems that offer their own testing are achieving much faster turnaround times. NorthShore is typically delivering results to patients in about 24 hours, said Dr. Karen Kaul, chair of the NorthShore Department of Pathology and Laboratory Medicine. Amita Health also moved to in-house testing this week and has been getting results to patients in about 24 hours.
Q: What does the future hold?
A: Medical professionals are eager for development of a blood test to detect antibodies to the coronavirus, which would be easier to administer than a nasal swab and could also show whether a patient was previously infected with COVID-19, said Dr. Robert Gallo, co-founder and director of the Institute of Human Virology at the University of Maryland School of Medicine.
That information could determine who should be quarantined, whose contacts should be tracked down and tested, and whether the patient is at least temporarily immune to the virus.
“I think now we’re close,” Gallo said. “I think there are many companies that are going to be coming out with something very soon.”