Long waits for test results spark new COVID-19 fears

A dramatic slowdown in testing turnaround times is undermining the U.S. response to the coronavirus, rendering tools like contact tracing almost useless in some instances.

Quest Diagnostics, one of the main companies doing coronavirus testing, said Monday that “soaring demand” due to the surge in cases across the South and Southwest had pushed back their average turnaround time for getting results of a coronavirus test to at least seven days for all but the highest priority patients.

LabCorp, another major testing company, said last week that its turnaround times were only slightly better, at four to six days, because of “significant increases in testing demand and constraints in the availability of supplies and equipment.”

The longer delays from previous waits of around two days as recently as late June in getting test results make it much harder to slow the spread of the virus. The fundamental strategy to help contain the virus is to test people quickly so that those who test positive can isolate. Contact tracers can then reach out to people who have been in contact with those infected to avoid spreading the virus on to others.

A seven-day wait for test results, however, magnifies the risks that an infected person has already spread COVID-19, making it too late to effectively implement contact tracing.

“Unfortunately, it’s feeling a little bit like déjà vu at the moment,” Michael Mina, a professor at the Harvard T.H. Chan School of Public Health, said of the recurring testing delays, referring to early challenges in procuring tests during the onset of the pandemic.

Democrats and many public health experts have been calling on the Trump administration for months to more fully use its powers under the Defense Production Act to ramp up production of a wide range of critical testing supplies and to coordinate their distribution.

“We really do need the federal government to step in to coordinate supply chains and ramp up production,” said Crystal Watson, a professor at the Johns Hopkins Center for Health Security.

Senate Democrats introduced legislation in April to create a new executive officer to issue reports every week on needed supplies, use the Defense Production Act to order manufacturing and oversee the distribution.

The Trump administration has been distributing some supplies like swabs and reagents, but there are still major supply constraints. The number of tests per day has significantly increased from the early days of the outbreak, but now turnaround times are undermining their effectiveness. 

“From swabs, to reagents to machines to perform the tests to staff … it’s everything right now,” Watson said of the needs.

President Trump has repeatedly downplayed the need for testing, saying that more testing makes the country look bad by revealing more cases.

“It has to be an all hands on deck emergency operation. Unfortunately, we have a president who doesn’t admit there’s an emergency,” Kathleen Sebelius, the former secretary of Health and Human Services during the Obama administration, said on a call with reporters on Tuesday.

Speaking of the testing delays, she added: “You can have all the contract tracers you want, but if you can’t get a test result for eight days, it doesn’t really matter.”

Clay Jenkins, the executive for Dallas County in Texas, one of the hardest-hit states, said federal testing sites in the area are taking eight to 10 days to return results. 

“This is not useful,” he wrote on Twitter.

In a statement responding to Quest’s announcement of longer turnaround times on Monday, the Department of Health and Human Services pointed to the 4 million point-of-care tests it said were performed last month, where results are delivered within 15 minutes.

But the administration also acknowledged that rising turnaround times at commercial labs like Quest are a problem and said it is working to address them.

“For those commercial labs, we absolutely want to reduce those times,” Adm. Brett Giroir, the administration’s lead testing official, said on NBC on Tuesday. “We would like to get that to within 48 hours.”

He said the administration is working to increase point-of-care tests to reduce the demand on commercial labs and is working to increase “pooling” of tests, where multiple samples are tested at the same time.

Francis Collins, the director of the National Institutes of Health (NIH), told a Senate committee earlier this month that the NIH is pushing to develop new technologies to allow an additional 1 million point-of-care tests per day by the fall. He acknowledged that is “a white-knuckle goal because it’s never been done on anything like this kind of time table before.”

Watson, the Johns Hopkins professor, recommended steps be taken in the near term to try to cope with the long testing lag times, including that people who are symptomatic isolate themselves even before they get their test results back and that people they live with do so as well.

Even Mick Mulvaney, Trump’s former acting chief of staff, criticized the country’s testing efforts on Monday.

“I know it isn’t popular to talk about in some Republican circles, but we still have a testing problem in this country,” Mulvaney wrote in a CNBC op-ed. “My son was tested recently; we had to wait five to seven days for results.” 

As Congress prepares for another coronavirus response bill, Sen. Patty Murray (Wash.), the top Democrat on the Senate Health Committee, released a report this month with testing recommendations, including providing additional funding, and said she is “urging Republicans to work with me” to implement them.

“Timely processing of tests is critical, and we are looking into the issues raised by Quest,” said a spokesperson for House Energy and Commerce Committee Republicans. “While Congress has already provided robust resources to help support testing, we are constantly working with stakeholders to evaluate what, if any, additional resources might be needed.”

In some hard-hit areas, experts said there could be such an out-of-control growth in cases that testing and contact tracing alone may not be able to get a handle on the outbreak, and new restrictions on businesses or even full-scale stay at home orders could be needed to regain control.

Across the board, though, Mina, the Harvard professor, said ideally testing results would come back within a day, if not even less.

“In reality as we’re walking around, we want to know now: Am I transmitting this virus?” he said.