Virus testing, tracking still plagued with reporting delays

Virus testing, tracking still plagued with reporting delays

ATLANTA (AP) – As part of its plan to restart the season next month, the NBA is preparing to test hundreds of players, coaches and others for the corona virus in a ‘basketball bubble’ – a space in the Disney – each night. complex near Orlando, Florida, with additional protection against the disease.

Test results are expected the next morning, before workouts and matches of the day begin. Such a rapid turnaround is the gold standard for detecting a highly contagious disease that is emerging in parts of the country. Still, an Associated Press survey of selected U.S. states shows that the benchmark is rarely met.

Having access to quick test results will play an important role in resuming sporting events, keeping companies and factories open, and returning students in the fall. But the AP survey found that it sometimes takes days to return results, despite an increase in the availability of tests across the country.

Judy Clinco, owner of Catalina In-Home Services in Tucson, Arizona, had to test approximately 30 of its 110 employees, who provide care and assistance to seniors in their homes. They can only visit customers when the results are back, which usually takes a week to 10 days.

As many as seven employees were sidelined at the same time, Clinco said.

During that time, the caregiver does not work. We subsidize their wages, and it is a financial burden for the company, “she said.” It leaves us with one less caregiver to be on assignment, and that’s why we’re short on staff. “

Public health experts say that test delays are a major barrier to reducing infections and tracking those who have been in close contact with a person who is positive for the virus.

Therefore, researchers are working to develop rapid tests that can be cheaply produced, self-administered, and provide immediate reliable results. For the time being, most tests to diagnose COVID-19 require laboratory processing, which means a built-in delay.

Guidelines issued by the Centers for Disease Control and Prevention recommend that states, as they lift final virus restrictions, have a turnaround time of less than two days.

But it’s unclear whether states have access to detailed data that demonstrates compliance with the CDC standard, including how long it takes to process tests in independent labs. Labs track their own turnaround times, but the CDC said data such as how long it takes a test to go to a lab and that a supplier receives the result and notifies the patient is not tracked, making it difficult to get a “Meaningful average” of what patients experience in each state.

Lacking publicly available federal data, the AP examined nine states earlier this month that saw a 14-day increase in new positive cases, plus New York, which had the most COVID-19 cases.

The state lab in New York took three days to report results to patients. California officials said the state’s lead time was 48 to 72 hours, depending on the lab. In Utah, anecdotal information suggested that the results took 24 to 72 hours.

Most of the ten states surveyed said they did not have lead time data for commercial laboratories operating in their own state, creating an additional information gap. Health experts said this was not uncommon, that state health departments are typically not responsible for tracking the individual lead times of the lab.

“It’s a good question who should be responsible for tracking this information and giving it back to the public,” said Kelly Wroblewski, director of infectious diseases at the Association of Public Health Laboratories.

There are other factors that can cause delays, from the time of the day the test is taken to the moment a lab shuts down in the evening. Staffing problems and shortages of testing supplies can also slow down the process.

Even people who visit the same test site can have very different experiences.

Earlier this month, Jeff Barnes, a music therapist on the Atlanta subway, went to the same test site a week after his wife and two daughters. They were still waiting when he received his results the next day. Theirs wouldn’t come for seven days.

Barnes said he was concerned about what a similar delay would mean if schools reopen in the fall.

“They’ll have to make it more efficient,” said Barnes. “If I knew that (my daughter) was in a classroom with twenty children and ten of them were waiting for results, I don’t know if I would send her. I would like to know that everyone was tested and negative. ‘

Until rapid tests are widely available, health experts say it will take another day or two to get results under the best conditions. This creates more opportunities for people who may be infected, but enjoy passing the virus on to others.

As tests increased in the U.S., labs were congested in some places and short of supplies.

In late April and May, the state lab in Alabama had problems obtaining reagents, the chemicals used to process tests. That led to periodic delays in reporting results, up to five days after the lab received the specimen, according to Dr. Karen Landers, assistant state health officer at the Alabama Department of Public Health.

Those issues have since been resolved, and the state lab now has a lead time of between 24 and 72 hours from the time it receives samples.

One of the largest commercial laboratories, Quest Diagnostics, recently reported the average turnaround time of one day for priority patients and two to three days for all other populations. The company said it expects higher demand to result in a longer wait of more than three days.

Other countries face similar challenges. Wait times in China vary by city, from just one day in Shanghai to four days in Wuhan, the city where the virus first appeared. In Japan, tests usually yield results within two days. According to the Ministry of Health, results of mandatory tests, such as those at airports, often come out earlier.

To prevent COVID-19 from flooding its vulnerable health care system, India initially conducted limited tests and the results lasted approximately 24 hours. But as the number of infections and testing increased, so did the delays. Results now often last two to three days or even a week, depending on the location.

South Korea has been praised for its rapid efforts to launch a program of free drive-thru tests with results typically delivered within 24 hours.

Back in the U.S., Amazon plans to spend at least $ 300 million on an employee testing program, including building its own lab. But even with the wealth and influence of the country’s second-largest private employer, it will still take three to five days to get results. Officials said they hoped to reduce the turnaround time to 24 to 48 hours.

“We don’t know exactly what it will look like yet,” Amazon said in a statement, “but we continue to believe it’s worth a try.”

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Associated Press writers Joseph Pisani and Joyce M. Rosenberg in New York, Tim Reynolds in Miami, Mari Yamaguchi in Tokyo, Aniruddha Ghosal in New Delhi and AP researcher Jennifer Farrar in New York contributed to this report.

Copyright 2020 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or distributed without permission.

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