The current surge of coronavirus cases in states like California, Texas and Arizona is being felt hundreds of miles away in Nebraska, where some health care providers and testing sites are starting to see shortages of testing supplies and longer wait times for test results.
On Saturday, a drive-thru coronavirus testing site at 50th and G Streets temporarily closed because of a shortage of testing supplies, even though it had been up and running for only a few weeks.
The site is a collaboration among the Douglas County Health Department, OneWorld Community Health Centers, Nebraska Medicine and the University of Nebraska Medical Center. No reopening date has been announced.
Nebraska Medicine is having trouble procuring enough processing plates and tips for pipettes (dropperlike instruments) used in laboratories to test samples for the coronavirus. Private labs like Quest Diagnostics and LabCorp are currently processing several hundred thousand coronavirus tests each day and have warned that backlogs could result in people having to wait longer to receive results.
“Since June 29, demand has continued to rise nationwide, particularly in the South, Southwest and West regions of the country, outpacing our capacity,” Quest Diagnostics said in a statement on Monday. “As a result, the average turnaround time for reporting test results is now 1 day for priority 1 patients and 4-6 days for all other populations.”
Priority 1 patients include those who are currently hospitalized and health care workers with COVID-19 symptoms.
Testing delays can create problems on both a personal and a public health level.
Anyone who has waited days to find out the results of a medical test knows how nerve-wracking it can be. And having a clear picture of who’s infected with the virus and whom they might have exposed is crucial to preventing and containing new outbreaks, as well as tracking whether cases are rising or falling in different communities.
“The sooner someone knows whether or not they’re infected, the more we can contain and track their contacts,” said Dr. Deborah Perry, the director of Methodist Hospital’s pathology center. “There’s a lot of anxiety in the general public right now: Do I have it, do I not have it?”
Sarpy County resident Kay Williams was tested on June 29 and waited more than a week for her results. She was told that the delay was caused by a shortage of pipettes at a Quest lab.
Nebraska’s coronavirus cases have been slowly trending downward, an encouraging sign even as other states grapple with a new wave of infections.
But the latest testing supply shortage is still a step backward, hearkening back to the early days of the pandemic, when shortages of testing kits, swabs and the chemical reagents needed to run tests made it difficult for many to get tested for the virus, said Dr. Kristine McVea, OneWorld’s chief medical officer.
Last week, the Federal Emergency Management Agency, which has been supplying nasal swabs for specimen collection, told the operators of the 50th and G testing site that some swabs were being diverted to other states where the need was greater.
About 3,500 people were tested there over the past three weeks. At the end of last week, before the site closed, about 13% of tests were coming back positive, McVea said, higher than the overall 7.8% positive rate in Douglas County for the week ending July 4.
“We are being completely overwhelmed by those states that have the surges,” she said. “All of the resources are going there.”
Methodist’s lab is running with only a three-day supply of reagents. The supply of chemicals hasn’t been consistent since the pandemic started, said Perry and Laura Brock, who helps lead Methodist’s pathology center, and only seems to have worsened in the last two weeks as new hot spots emerged.
Supplies have ebbed and flowed since the pandemic hit the United States. Areas where cases are spiking, like New York and New Jersey early on and the South and Southwest now, are often prioritized.
“We get it,” Perry said. “They have high incidents, and they needed to do a lot of testing.”
But she wishes that nationwide vendors had been able to produce or procure a more stable supply of reagents and other supplies. Some are exploring whether pooling testing specimens together can conserve testing supplies while still providing accurate results.
If testing slows down in Nebraska again, McVea worries that it could mask the true extent of the virus, making it harder to determine if cases are still declining or climbing as they are in other states.
Methodist continues to swab patients for the virus, but the in-house lab is currently running tests only for inpatient hospitalizations and emergency room patients. Other samples are sent to the lab at Nebraska Medicine.
“We have the instruments, we have the people, we have the collections,” Perry said. “We just can’t do the volume of tests we know we could do.”
Others said their supply chains and testing times are holding steady.
A spokeswoman for CHI Health reported no shortages at its labs and said testing turnaround times have remained consistent. The private-public state testing initiative is chugging along, too.
“Thanks to Test Nebraska, Nebraska has access to a strong pipeline of testing supplies,” Taylor Gage, a spokesman for Gov. Pete Ricketts, said in an email.
TestNebraska is swabbing people for the coronavirus this week in Omaha, Lincoln, Fremont, Columbus, Norfolk, Chadron and several other cities. It has not experienced any supply shortages, Gage said, and hasn’t heard of problems with other providers but is willing to help if needed.
“Since the beginning of the coronavirus pandemic, the state has been working with the Nebraska Public Health Lab to secure supplies,” he said. “The state stands ready to connect other labs to our vendor network to support resolving supply issues.”
Since the initiative began, TestNebraska’s lab has been turning around test results in about 1.7 days on average, Gage said. Last week, that waiting period was even a bit shorter, at about 1.3 days. The Nebraska Medicine lab and the Nebraska Public Health Lab are typically taking two days or less.
But private labs are starting to take longer to process tests in Nebraska, according to data Gage provided. Quest Diagnostic’s average turnaround time has been about 3.8 days. Last week, that inched up to 4.7 days.
LabCorp’s average turnaround time last week was five days, higher than its overall average of 3.67 days.
The North Omaha-based Charles Drew Health Center hasn’t had any problems with testing supplies, but spokesman Andrew Monson said patients seem to be waiting longer for test results from Quest.
It used to take about three days to get results, and now it’s more like five to six days. The turnaround time for tests run by the Nebraska Public Health Lab is unchanged, at about two to three days, and sometimes faster, he said.
McVea said one high-priority person tested at the 50th and G site waited eight days for results.
“When someone comes in and thinks they have COVID-19, a five-or-more-day turnaround time is just, it’s like agony for these people,” McVea said. “They can’t go back to work, they can’t be around their family, they can’t leave the house.”
Quest recently emailed OneWorld and other customers asking them to prioritize testing among those at highest risk: hospitalized patients, health care workers, first responders, patients awaiting surgery, nursing home residents and people with COVID-19 symptoms who are older or have underlying health conditions.
“While this will reduce the number of tests you are sending to us, it will ensure that together, we are focused on the most critical patients,” the Quest email said.
Williams, the Sarpy County resident, finally received her test results on Tuesday — eight days later.
It was good news: negative.Our best staff images from July 2020
Concerned about COVID-19?
Sign up now to get the most recent coronavirus headlines and other important local and national news sent to your email inbox daily.