Monday, April 6, 2020

testing for cov-19 in USA--overview

4-5-20   https://www.technologyreview.com/s/615444/covid-19-test-results-faster-commercial-labs-delays-coronavirus/
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  “Many local communities are flying blind, making decisions in the absence of full information largely due to the failure of the federal government to provide sufficient testing capacity,” said Chrissie Juliano, executive director of the Big Cities Health Coalition, which represents executives in 30 urban public health departments, among them Boston, Chicago, Los Angeles, New York City and Seattle.  “This testing shortage, and lack of available information about the actual burden of the virus, has set our country’s response back by an order of magnitude we will never know.”…
  Adm. Brett P. Giroir, the assistant secretary of health who is overseeing the government’s testing response, said quick-response tests are being shipped around the country, and that the government is working closely with hospitals and other laboratories to ensure they have what they need. “I think testing is really in a good position right now,” he said….
Quest’s backlog is 80,000, according to the company, down from 160,000 on March 25. LabCorp says it has caught up, and now has a turnaround of four to five days from pickup….
Wendy Bost, a spokeswoman for Quest, which introduced its coronavirus tests on March 9, said the company had ramped up its testing and could now process more than 35,000 tests per day — over 200,000 each week — at its 12 labs around the country. Last week, Quest asked hospitals to identify health care workers and symptomatic patients for priority processing and she said the company was providing results now on an average of a day for that population.
  To date Quest has processed nearly 550,000 coronavirus tests, Ms. Bost said. The current turnaround time for other patients, she said, is now two to three days although she acknowledged there was a longer wait in the areas most affected, like Chicago, New York, New Jersey and Miami.
LabCorp has four labs running, also averaging about 35,000 to 40,000 coronavirus tests each day, the company said. Mike Geller, a LabCorp spokesman, said it had tested about 500,000 samples, and that the time for processing varied, based on demand.
  “LabCorp, along with other laboratories, is experiencing unprecedented and rapidly increasing demand for Covid-19 testing in the midst of this national health emergency,” Mr. Geller said.
The latest test approvals by the F.D.A. include one by Abbott Laboratories, called ID Now, which can provide results in a few minutes; and others, like Roche and Hologic, which perform automated, high-volume testing in commercial and hospital labs….
  Darcy Ross, a spokeswoman for Abbott, said the company had shipped its new, fast-turnaround test to 18 states, including those with the highest number of infections like New York, New Jersey, Michigan and California. In addition, the federal government is buying the Abbott test instruments for state public labs. Mia Heck, a spokeswoman for the Department of Health and Human Services, said it was sending 15 machines each to public health labs in all 50 states and the Pacific islands, and 250 to the Indian Health Service. Alaska will get 50. Twenty will go to the C.D.C. and 50 to the Strategic National Stockpile….
  Dr. Lubarsky said UC Davis was working on developing new tests that could be run on the Roche machine, which he said were expected to be approved in a couple of weeks.  Michael Weist, a spokesman for Roche, said the demand for materials needed to run its three-and-a-half-hour test was outpacing the supply. There are now 60 sites that have it….
  Dr. Figueroa said his hospital was sending fewer to LabCorp, which he said had an average return of four to five days. Instead, they are relying on the Roche diagnostic test, which they can do in-house. But, like Dr. Lubarsky in Sacramento, he lacks sufficient supplies to do as many of the tests as he would like.  “That’s another bottleneck in terms of testing,” Dr. Figueroa said. Dr. David Persing, executive vice president of Cepheid, which received F.D.A. authorization for a coronavirus test that analyzes samples in about 45 minutes, said its test could work with samples taken by swab or nasal wash.  “For an emergency room that has run out of swabs, that would be a good option,” he said.  https://www.nytimes.com/2020/04/06/health/coronavirus-testing-us.html
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  Nearly two-thirds of the coronavirus tests conducted in California are still awaiting results--in part due to an initial bottleneck at a single laboratory – leaving medical providers and patients in the dark, and health officials without the information they need to understand the disease’s spread.
Of approximately 94,800 tests conducted in California, about 59,500 results were still pending as of Thursday, even as the state’s governor, Gavin Newsom, promised to “substantially increase” testing this week.
…The nation’s most populous state has been among the worst hit by the virus, but testing efforts have been hampered not only by the processing backlog but by a shortage of testing kits themselves. California ranks 39th out of 50 states and the District of Columbia in per capita testing, according to data collected by the Covid Tracking Project….
  The major reason for the backlog has been a massive bottleneck at Quest Diagnostics, a large commercial lab that launched coronavirus testing at a facility in San Juan Capistrano, near Los Angeles. On Thursday the company reported a backlog of 115,000 tests, though it declined to say how many of the samples awaiting processing were from California.
  “But once you get behind, it’s very hard to catch up,” said Jennifer Doudna, a researcher at the University of California, Berkeley, who has transformed her 2,500-sq-ft scientific laboratory into a pop-up lab Covid-19 testing center. Doudna and her team are using robotics to process at least 1,000 samples a day, collected at the university’s student health center and other nearby hospitals and clinics, to deliver test results within 24 hours.
  “We hope that having pop-up labs like ours will really help bring down the backlog,” she said. “So we can help people quickly understand when they may have an infection.”  Over the past week, the standard tests that Contra Costa sends for processing at Quest are being processed within five to seven days, Shah said. “It’s not necessarily the worst thing,” she said. But especially with so many patients sheltering at home, often with family members to whom they worry they’ll pass the disease, “I do wish we could give them results faster.” https://www.theguardian.com/world/2020/apr/04/why-california-waiting-test-results-backlog-quest-diagnostics


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