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Funding shortfalls threaten ramping-up of virus testing

Funding shortfalls threaten ramping-up of virus testing
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Laboratories across the country are warning that funding shortfalls are jeopardizing their ability to increase coronavirus testing capacity, a key step in starting to reopen the economy.

Labs that conduct coronavirus tests say they need federal funding to make the investments needed to increase the number of tests they can perform, but so far Congress has not provided any dedicated funding directed at labs in the trillions of dollars it has approved as part of its coronavirus stimulus.

Adding to the financial crunch on laboratories at a time when they are being called on to dramatically ramp up coronavirus testing, their usual bread and butter business of routine tests has fallen dramatically as people stay home and avoid their usual doctor visits.

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Quest Diagnostics, one of the largest testing companies in the country, said this month it would start furloughing some of its workers because overall testing volume is down 40 percent, despite the increase from coronavirus tests.

The company said the furloughs would not reduce the number of coronavirus tests it can perform, but it is a sign of strain on the industry.

Louise Serio, a spokeswoman for the American Clinical Laboratory Association, said labs already face a shortage of supplies, comparing it to a situation where “there are cars in the driveway ready to drive but there’s no gas available.”

In the next phase of the country’s efforts to slow the spread of the coronavirus, labs will need to ramp up testing even more, she said.

“It won’t just be about the gas; we need more cars,” Serio noted.

Labs are therefore asking Congress to provide a pool of funding in the next coronavirus response bill. That funding could be used to help them purchase additional testing machines, in addition to needed supplies that have faced persistent shortages, like swabs and reagent, a chemical needed to conduct the tests.

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The stakes are high, given that experts say the United States needs to dramatically increase its testing capacity to be able to safely reopen the economy.

Experts say millions of tests per week are needed, but in the past week the country performed about 860,000 tests, according to the COVID Tracking Project.

There needs to be enough testing so that infected people can be identified and isolated and people they have been in contact with can be identified as well, similar to the efforts adopted by some countries such as South Korea.

Ashish Jha, the director of Harvard’s Global Health Institute, said he has been talking to congressional staff about increasing funding for testing by an amount that he said pales in comparison to the hundreds of billions being spent on economic measures and would still attack the underlying issue of the outbreak itself.

“A couple of billion dollars is probably all it would take to fix the testing problem,” Jha said.

“Some states can’t get enough swabs,” he added. “Other states, it’s not enough reagents.”

Another problem labs have identified is that Medicare does not pay enough per coronavirus test to make investments in testing financially viable for some smaller labs. Jha said he thinks that problem could be fixed relatively easily, if policymakers would take action.

“Medicare reimburses $51 dollars for a test,” he said. “If Medicare just reimbursed $100 it would get fixed. ... Surely that can happen.”

William Morice, president of Mayo Medical Laboratories, said he has concerns about the sustainability of his labs’ coronavirus testing given low payment rates.

He said there could come a point when “we start needing to cut back on our expenses and that would limit capacity.”

“I would say it’s coming soon,” he added, saying Medicare should pay at least 50 percent more for a coronavirus test to be sustainable.

Labs say they do have access to some funding out of the $100 billion pot for hospitals in the most recent relief bill, but what they really need is a designated fund directed specifically for lab expenses. They are also calling for government support for paying for new tests that detect antibodies in the blood to determine if someone has had coronavirus in the past.

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Asked about funding for labs and testing, Henry Connelly, a spokesman for Speaker Nancy PelosiNancy PelosiSpending deal clears obstacle in shutdown fight Ocasio-Cortez, Cruz trade jabs over COVID-19 relief: People 'going hungry as you tweet from' vacation Rep. Rick Allen tests positive for COVID-19 MORE (D-Calif.), said the administration should be putting more focus on using some of the $100 billion already appropriated for hospitals for testing needs.

“Supporting increased testing and lab capacity ought to be a top priority for the emergency funds already appropriated by Congress, but the Trump administration keeps refusing to give the continued testing shortfall the attention and resources it demands,” Connelly said. “The Trump administration must put forward a concrete national plan to accelerate testing and Democrats will continue to make testing a top priority in each coronavirus response bill.”

Deborah Birx, the White House coronavirus task force coordinator, has said some testing machines are sitting unused in labs and has called on lab directors to make sure they are using all of the machines they already have.

The Association of American Medical Colleges, which represents labs at academic medical centers, responded to Birx in a letter Monday, saying that the reason some machines are sitting unused is because of a lack of needed testing supplies such as swabs, reagent and specialized components used with some machines.

The letter called on the federal government to “take a clearer role in the assessment and management of the supply chain for key testing reagents and supplies.”

A spokesman for Senate Health Committee Chairman Lamar AlexanderAndrew (Lamar) Lamar AlexanderThe Hill's 12:30 Report: Trump holds his last turkey pardon ceremony The Hill's Morning Report - Presented by the UAE Embassy in Washington, DC - Trump OKs transition; Biden taps Treasury, State experience The Memo: Trump election loss roils right MORE (R-Tenn.) said the senator is working to make sure “America has the resources it needs to conduct tens of millions of tests to determine whether you currently have COVID-19 or whether you have had it.”

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New York Gov. Andrew CuomoAndrew CuomoNew York City to add COVID-19 checkpoints at bridges, crossings Don't let 'experts' ruin your Thanksgiving Cuomo reverses on in-person Thanksgiving plans with family MORE (D), whose state is at the center of the outbreak in the U.S., has called for the federal government to go even farther and use the Korean War-era Defense Production Act to direct companies to increase production of testing supplies.

President TrumpDonald John TrumpMinnesota certifies Biden victory Trump tells allies he plans to pardon Michael Flynn: report Republican John James concedes in Michigan Senate race MORE has used the law to increase production of other supplies, like ventilators, but not for tests, and on Thursday Trump downplayed the need for widespread testing.

“Do you need it? No,” he said. “Is it a nice thing to do? Yes.”

“We have 9 million people we want to get back to work,” Cuomo said Friday. “We need more than several thousand tests per week if this is going to happen anytime soon.”