Healthcare

Coronavirus surge puts renewed strain on testing capacity

The surge in coronavirus cases across the country has put a strain on U.S. testing capacity - again.

Six months into the pandemic, the U.S. has significantly increased its testing abilities. The Department of Health and Human Services (HHS) said the nation averages about 600,000 tests per week, and the country conducted about 15 million diagnostic tests in June alone, according to the COVID Tracking Project.

However, a surge in demand as states reopen threatens to erase that progress. And it's placed the White House on the defensive. 

President Trump has repeatedly sought to play up the U.S. testing program, attributing a rise in reported coronavirus cases to its success.

On Monday, he tweeted that the U.S.'s "great testing program continues to lead the World, by FAR!"

Vice President Pence last week said the country's "extraordinary" testing capacity has helped the administration respond to states' needs as the number of COVID-19 cases has climbed.

Pence also touted the ability to test asymptomatic patients.

"Early in this process, we focused testing exclusively on people that were vulnerable or were health care workers or people that had symptoms. Now we literally test anyone who comes to a testing site or comes to their local pharmacy," Pence said.

But as infections increase in nearly 40 states, and soar to record levels in Texas, Arizona and Florida, demand for testing has outstripped capacity. 

Turnaround times for results are increasing, in some cases coming well over a week after the test was administered.

Experts say one of the best ways to control the pandemic is to rapidly test large groups of people, and then isolate and quarantine the positive cases as quickly as possible. The lengthy turnaround times make that incredibly difficult.

Delayed results can have a major impact on the rest of the public health response, including contact tracing.

"People need to know their status so that they change their behavior," said Will Humble, executive director of the Arizona Public Health Association.

By the time the results come back, the infections have already spread because very few people isolate between the time their sample is taken and they get their test results back, Humble said. 

"If you're getting results back in seven or eight days, it doesn't matter how good your testing is, how good your contact tracing capacity is, how well-trained your people are," he added.

Some cities, like Austin, have reverted back to only testing symptomatic patients as a way to manage the crush.  

The supply shortages that plagued clinical labs early in the pandemic have returned, and threaten the ability for states, especially those in the South and West experiencing the most extreme surges, to contain their outbreaks. 

Quest Diagnostics, one of the country's largest testing companies, said the average turnaround time for reporting test results is now four to six days for most populations, except "priority one" groups, which include hospitalized patients, patients facing emergency surgery and symptomatic health care workers. 

Those prioritized groups have a one-day turnaround.

The American Clinical Laboratory Association (ACLA), which represents commercial labs like Quest, said labs are doing everything they can to avoid supply chain disruptions. 

"All across the country, clinical laboratories are increasing the number of labs processing tests, purchasing additional testing platforms and expanding the number of suppliers to provide critical testing materials," ACLA President Julie Khani said in a statement.

"However, the reality of this ongoing global pandemic is that testing supplies are limited," she said. "Every country across the globe is in need of essential testing supplies, like pipettes and reagents, and that demand is likely to increase in the coming months."

The shortages have led local officials to cast blame on the Trump administration for lacking a coordinated national testing strategy. 

"The United States of America needs a more robust national testing strategy," Phoenix Mayor Kate Gallego (D) told The New York Times in a recent interview.

The administration issued guidance for states to develop their own plans, but has left the design to individual governors and state health departments. 

States have had to compete with each other for supplies throughout the pandemic. In the spring, numerous governors called on the administration to use the Defense Production Act to force additional production.

Administration officials, however, said states have enough supplies to meet their testing goals.

"The states are getting all the upstream supplies that they asked for, the tubes, the media, the swabs," Adm. Brett Giroir, the administration's testing czar, told reporters Tuesday. 

To help bolster local efforts in some of the hardest hit areas, the administration is launching new "surge" coronavirus testing sites in three communities in Florida, Texas and Louisiana.

The locations will be Baton Rouge, La., Edinburg, Texas, and Jacksonville, Fla. HHS said all three places have a "recent and intense level" of outbreaks.

Jacksonville is the site of next month's Republican National Convention.

The surge will last between five and 12 days, and the sites will be able to conduct 5,000 tests per day in each city, for free. It should take between three and five days for someone who is tested to get their results.

Giroir said the administration was able to very quickly detect where the current outbreaks were happening, but cautioned that "we can't test our way out of this."

The technology just isn't available to test every single person every single day, he said, so personal responsibility is critical.

"When we're having a steep rise in cases, testing can really help you," he said. "But the most critical factor is going to be personal discipline. It's the physical distancing. Wear a mask. And if you think you had dangerous exposure, go get tested."

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