In a recent week, a New Yorker got a free Covid-19 test one moment, with results the next day, while a Coloradoan got $50 for the test after a frantic round of pharmacy-hopping in two of his hometowns. had to pay. One Montanon drove an hour each way to get a test, wondering whether, this time, it would again take five days to get the results.
While Covid testing is much easier than at the start of the pandemic, the ability to get a test – and results in a timely manner – can vary widely nationwide. A fragmented testing system, complicated logistics, technician burnout and squirrel spikes in demand are contributing to this bumpy ride.
“We are still where we were 18 months ago,” said Rebecca Stanfels, a Montana woman who had to wait five days for test results in Helena last month after coming into contact with someone with the virus. .
The unexpected wait could be a problem for those trying to plan travel, return to school from quarantine – or even get monoclonal antibody treatment within the optimal window if they have Covid.
The White House said in early October that it plans to buy $1 billion worth of rapid antigen tests to improve access to difficult over-the-counter kits. But people are also finding it difficult to get molecular testing done, including the gold standard PCR tests.
Kelly Wroblewski, director of infectious disease programs for the Association of Public Health Laboratories, said public health laboratories are no longer affected by supply constraints on individual test components such as swabs or reagents. But they are still carrying a large test load, which it had hoped to transfer to commercial or hospital-based laboratories by now.
Testing laboratories of all stripes are also facing labor shortages like restaurants, said Mara Espinall, co-founder of Arizona State University’s Biomedical Diagnostics Program, which also writes a weekly newsletter monitoring national testing capacity and Serves on the board of a rapid test company. .
“Staff shortages are very, very real and hold people back from increasing capacity,” she said.
Something as simple as proximity still decides how quickly test takers get their results.
“Northern Maine is a good example,” Aspinall said. “Whatever you do with PCR is going to take an extra day because it has to be flown or operated in a way.”
Even in a location like Longmont, Colorado, near many laboratories and hospitals, PCR samples from a local mass-testing site are aired each evening to a laboratory in North Carolina.
This mass trial operation recently moved back to its original location at the county fairgrounds after a summer stint in a small church parking lot. Demand for PCR tests in the county quadrupled from 600 weekly tests in July to 2,500 per week in September. Boulder County Public Health emergency manager Chris Campbell has attributed heavy traffic to the reopening of schools, a surge in infections and difficulty obtaining over-the-counter rapid tests.
Campbell said it sometimes takes four or five days for residents to get their PCR results, although that has come down to two because the contractor they work with, Mako Medical, has built back up its lab capacity. .
“Having such a long turnaround time is very unforgivable. It really affects our ability to prevent transmission,” Campbell said. “And also, it has an economic impact on businesses, schools, childhood facilities. “
According to a statement from Chief Operating Officer Josh Arant, Mako’s lab operates 24/7 and the company uses private aircraft to expedite shipping. While Mako’s weekly average turnaround time last month did not exceed 72 hours, the statement said, in recent weeks it has returned results to area residents an average of 46 hours after sample collection.
Portable devices now exist that can eliminate the need for shipping samples. They can perform molecular analysis, including PCR, in less than an hour — a process that typically takes at least four to five hours in a lab. A Washington, DC, test truck holds three Cepheid machines, each about the size of a printer. Combined, they can deliver PCR results to a dozen people within an hour, at no cost to the test takers.
Still, the supply demand for such rapid molecular tests, largely due to case surges, continues to supply covid test components to labs across the country, said Doug Sharp, vice president of Lab Capital Sales with Medline Industries. Is. “I don’t think anyone thought we would be sitting here,” he said. “We are selling more assays in 2020 than we are in height.”
Gigi Quick Gronwall, an immunologist at the Johns Hopkins Center for Health Security who leads the center’s tracking of covid testing, suggested that given how long it takes to get results, it has created a seller’s market if companies hold up to a specific amount of time. can give results. “People are going to pay for that kind of guarantee,” she said. “People are likely to run away, for sure.”
Medrite offers PCR results analyzed in three hours in New York and Florida for those willing to pay more than $200 per pop. The company offers other tests, such as antigen tests and slow lab-based PCR tests, at no cost.
Celeste Di Iorio ran after spending a day driving from pharmacy to pharmacy in Fort Collins, Colorado, looking for a test that would respond in less than three days. As a musician, she was traveling out of state and wanted to know if she could be contagious before attending a memorial for a relative who died of Covid, among other things. She and her partner eventually found a rapid antigen test at a pharmacy in two cities.
“We just paid $50 for these tests, which bothers me,” she said. “Because, you know, we’ve all been out of work for a year and a half, and this state has money.”
In Helena, Montana, Stanfels has had a PCR test every week for several months as she takes immune-suppressing drugs for a rare condition called sarcoidosis. Her doctors told her to get tested regularly, because even if she was fully vaccinated—and received an extra “booster” dose—she would need treatment with monoclonal antibodies as soon as possible if she had a contracting covid to prevent the initial infection. “Something really bad is developing.”
When Stanfels learned that a friend she had visited later tested positive for COVID, she immediately got a test done at her doctor’s office. It took five days to learn that he had tested negative.
Montana’s public health laboratory is in the city of Stanfell, but state health department spokesman John Abelt said the volume of tests has routinely exceeded the laboratory’s capacity since early August. As such, they would have to prioritize tests of those hospitalized or symptomatic and send other samples to private laboratories, a process that could extend the waiting time for results to seven days.
In New York City, where mobile-testing vans are parked in every borough and in-person home testing is offered, residents are reporting a quicker shift to molecular tests as laboratories analyzing their samples are located nearby. Huh.
For example, in Manhattan, Justin Peck returned from a road trip to Canada on Tuesday night, walked about five minutes to the mobile-testing van on Wednesday, and had PCR results by Thursday morning, giving him time to leave. But got approved. Worked for the first time in 18 months as a dancer in “The Phantom of the Opera” on Broadway.
Espinall said the flu season is likely to increase demand for Covid testing as people with Covid-like symptoms seek answers about the cause of their illness, adding to existing staffing issues. “We are at a very precarious point,” she said. “It is not enough to proceed if the volume of testing continues as I expect it to be.”