High demand for COVID-19 tests leads to lab logjams hindering fight against pandemic
In the early months of the coronavirus pandemic, public health officials and hospital administrators delivered one overriding message: that only a vast increase in testing could halt the spread of the virus.
By most accounts, tests are now readily available in Johnson, Wyandotte and Jackson counties. But as the volume of testing grows, laboratories and the supply chains that sustain them are overwhelmed, according to health professionals. Results once available to Kansas Citians in 3-to-5 days can now take as much as a week-to-ten days.
The lab logjam has serious implications for the fight against COVID-19. Without timely reporting of positive cases, contact tracing is less effective. Each additional day it takes to process a test increases the likelihood that an infected person is unwittingly exposing others.
“The impact is that as things are working their way through process, more people are getting infected,” said Kansas City deputy health director Frank Thompson, who likened the situation to a bridge with testing, lab processing, and contact tracing as essential structural pieces. If one is compromised, he said, the bridge fails.
Dan Gotskind, who was tested at Church of the Resurrection in Overland Park on June 26, said he waited nearly two weeks for his results — almost the entire recommended quarantine period for someone exposed to the virus.
He was negative. But 25 other Johnson County residents who tested the same day at the same location — and who also waited nearly two weeks for results — were positive.
Gotskind, 54, said he worried that the young people who were tested weren’t careful while they waited on results.
“From what I’ve read younger people are more apt to be asymptomatic than older people,” Gotskind said. “Knowing my child as a reference I don’t think many of the young people would be too careful in those two weeks waiting for results.”
This comes as the Kansas City area is continuing to see rising numbers in new cases. As of Saturday, the city’s seven day rolling average of new COVID-19 cases was 273. One week ago. it was 242. Two weeks ago, it was 157.
As schools open, Thompson said, more people will be seeking testing. If the “bottom of the funnel” isn’t expanded, delays will only get larger and backlogs will grow, he said.
Thompson said the situation also underscores a broader reality.
“We are not going to test and treat our way out of this pandemic,” he said. “The thing that is going to get us through this wave and delay and reduce the next wave is people adhering to the science and the public health advice.”
Right now, Thompson said, that advice is to wear masks. It is sometimes hard to know if you’ve been exposed to the virus and a mask can help keep you from spreading it further.
Higher demand for testing
As testing capacity increased in the Kansas City area over the past several months, residents eagerly took advantage of the opportunities.
Until recently, only those with symptoms or confirmed interaction with a COVID-19 patient could obtain a test. Free screening is now available at hospitals, CVS and through local health departments. Some testing opportunities are open to those without symptoms or exposure. Response has been heavy.
Those who sought tests did so for any number of reasons. Some employers insisted as a condition of returning to work. Others were prompted by an abundance of caution after a trip, worrisome allergy symptoms, or in reaction to the daily numbers showing a spike in new infections.
“We are seeing higher demand for testing because we are seeing more spread of the virus,” said Janell Friesen, spokeswoman for the Wyandotte County Health Department.
Thompson said the city is confronting a “worried well” who aren’t truly at risk.
“Folks need to be doing an honest evaluation of what their risk is,” Thompson said. “At this point in time we’d like to be targeting our tests to those members of the public who are at greatest risk.”
Lab Capacity
Lab Corp and Quest Diagnostics, two major national testing chains, have each reported increased delays as a result of escalating demand. Viracor, based in Lee’s Summit, said in an email Friday that the company is currently working through a test backlog.
Since March, clinical labs nationwide have increased capacity from less 100,000 tests per day to more than 600,000. But that hasn’t been enough to handle the surge in cases that has followed the reopening of states, said Jim Flanigan, Executive Vice President of the American Society for Clinical Laboratory Science.
Demand for testing is growing exponentially, Flanigan said, but capacity to process tests is increasing at only a linear rate.
“Realistically what we need is more than a million-test capacity (per day),” Flanigan said. “There are not any immediate solutions beyond finding a way to dramatically scale production of reagents and test kits.”
Reagents are substances that break down a sample for testing. However, Flanigan said, this sort of molecular testing is not often employed at the scale of the coronavirus effort. Those supplies are becoming more expensive and difficult to obtain.
He said this is a result of supply chain issues and lack of a centralized national strategy. Earlier this year, the federal government authorized the defense production act to accelerate creation of materials to collect testing samples. The act, however, did not do the same for the supplies needed to process those tests.
“The need is so great and is increasing at such an incredible rate the manufacturers are simply unable to keep up with demand,” Flanigan said. “At any given time there’s no coordination of where the capacity is.”
The issues are being felt at the hospital level.
Jennifer Schrimsher, an infectious disease physician at Lawrence Memorial Hospital, said the hospital has seen “multiple setbacks” where testing is concerned. One private lab, Schrimsher said, told the hospital it could no longer take any tests from them.
“I suspect this is due to both the backlog and their focus on diversification, offering more profitable testing,” she said. “As we move into the next several weeks, access to testing across the nation will only get worse. “
HCA Midwest spokeswoman, Kimberly Stern, reported delays experienced at the system’s Kansas City area hospitals as well.
State-run labs describe a somewhat different situation.
A spokeswoman for the Kansas Department of Health and Environment said the state lab currently has no capacity problems. While officials are aware of the concern about private labs, she said it is not impacting the state’s response to testing.
In Missouri, average wait time for reports is 4 days, said Lisa Cox of the Department of Health and Senior Services.
Cox said that, while turnaround times at national labs are increasing, that has not been seen in local and regional labs.
Health departments and hospitals are searching for solutions. Kayla Parker, spokeswoman for the Jackson County Health Department, said the agency is constantly shifting what labs it uses in order to ensure that the tests will be run as quickly as possible.
The University of Kansas Health System, which has its own testing lab, currently isn’t experiencing delays but has received requests for help from other area hospitals that are struggling. Rachel Liesman, director of microbiology, said in a statement that the health system is evaluating its lab expansion options.
Thompson, in Kansas City, said the city is looking into upgrading its in-house lab to run tests. Because of budget cuts over the years, Thompson said, the lab doesn’t currently have that capacity.
Parker said her main concern with backlogs is for the people tested themselves. The longer they were asked to wait for results, Parker said, the more likely they are to go out in the community before they know if they are sick or not.
The Star’s Lisa Gutierrez contributed to this report.
Correction: An earlier version of this story incorrectly named the University of Kansas Health System. The story has been updated to reflect the correct name.
This story was originally published July 12, 2020 at 5:00 AM.
