Test labs, at the center of efforts to track the spread of Covid-19, expect to see record demand in the coming weeks as their staff is depleted by the very virus they are researching.
Public health experts and testing company executives are concerned that a growing variant of Omicron could undermine efforts to use Covid-19 testing to keep schools open, treat patients, and make public gatherings safer.
Biden’s administration relies on testing to save the country and help avoid a return to stricter public health restrictions. But the workers may not be enough to handle the avalanche of tests. Vault Health CEO Jason Feldman, whose company runs Covid testing programs, said about 40 percent of employees in one of the company’s northeastern labs recently fell ill, increasing the time it takes to process results.
“What I think is going to happen is that as this thing spreads to states with large populations like Texas and California, shit will really amaze the fans, because there just aren’t enough people, technicians, to keep these labs running.” said Feldman.
While the supply chain of once-scarce equipment, such as test kits and pipette tips, remains untouched, the demand for testing itself puts a strain on sample collection sites and laboratory staff. A source in the pharmacy industry told POLITICO that problems with laboratory personnel are already limiting the testing capabilities and timing of tests conducted at major retail chains.
“The question is how well they are doing,” said Celine Gunder, an infectious disease specialist who advised Biden’s transition on the Covid-19 response. “If you get to the point that – as we’ve seen in some cities – the lines for a PCR test will stretch for hours and you go to every retail pharmacy in your area and they are all sold out from rapid antigen tests in which -that moment people will give up and say that this is just a disaster. It’s not worth it”.
According to tracker maintained by Johns Hopkins University… But public health experts warn that millions of home test results are missing due to widespread public underreporting and inconsistent data collection by health departments across the country. CDC data show shows that more than 554,000 cases of Covid-19 infection are registered every day – a number that experts say is a significant underestimate.
The White House “is actively monitoring the problem of staff shortages and is currently exploring ways in which we can help,” a senior administration official told Politico.
Laboratories may need to increase their staff and add shifts to get more information in real time. But it can be difficult because so many technicians are sick.
“We haven’t had anything special in the laboratory where we would have to do any emergency,” said William Maurice, President of Mayo Clinic Laboratories. “But for the healthcare system overall, we are definitely seeing an increase in the number of employees who test positive.”
Quest Diagnostics said Tuesday that turnaround times are now averaging two to three days, up from one day at the end of December due to a surge in testing demand driven by Omicron. Rival Labcorp said the average processing time for PCR test results is one to two days.
“I think staffing is the limiting factor for laboratories of all kinds,” said Public Health Laboratories Association CEO Scott Becker. “It doesn’t seem like the Biden administration could simply use [Defense Production Act] for people.”
Another potential bottleneck in the coming weeks will be the number of sample collection sites where people can get tested. The Biden administration is trying to solve this problem by increasing the number of collection sites.
Additional sites open this week in Washington DC, Philadelphia, Maine, Maryland, Nevada, Delaware, Texas and Washington, White House spokeswoman Jen Psaki told reporters Wednesday.
Testing company Curative has had to limit the number of proposed testing appointments and even temporarily close some of its collection points due to widespread infections among staff, according to spokeswoman Miranda Gottlieb.
“Last year, we still counted on some of the meetings to be able to keep up with the deadline, but we didn’t have to shut down early or close the site due to illness of the staff,” Gottlieb said.
Barriers that hampered testing for Covid-19 at the start of the pandemic, such as a shortage of pipette tips and reagents needed to scale up laboratory testing, are now under control, Qiagen CEO Thierry Bernard told POLITICO.
“HHS in the US has scenarios where this could increase to more than 2 million PCR tests per day required in January – they even say it will be between two and four,” Bernard said.
“We can probably swallow the increase in the number of tests that HHS is simulating.”
Mara Aspinall, an advisor to the Rockefeller Foundation and a member of the board of directors of OraSure Technologies, agreed that the lab supply chain has benefited from extensive government investment, but noted that lab staff are concerned with more than just the volume of Covid tests.
“People are returning to doctors’ offices,” Aspinall said. “They have biopsies, mammograms, physicals, and blood tests. So the problem labs are facing today is that they have a huge number of tests for Covid. But besides, they have general tests, which were not available a year ago, when so many doctors’ offices were closed. “
Arvind Kotandaraman, Managing Director of Specialized Diagnostics at PerkinElmer, said that labs using the company’s instruments and reagents still have turnaround times of about one day, but noted that some are seeing a five-fold increase in positive results along with a doubling of sample volume.
“If the volume of testing is consistent with the trend of positive results, we may have problems in the future,” said Kotandaraman. “Without knowing when Covid will disappear, it will be even more difficult for them to hire and retain staff. This was the main task. “
High positive rates are a particular problem for screening programs in schools and workplaces that use pooling strategies in which samples from multiple people are tested at the same time. When the pool tests positive, individual samples must be evaluated. And too many positive pools increases the demand for tests and can increase latency.
George Benjamin, executive director of the American Public Health Association, said the US needs to figure out how to make the best use of its testing capabilities as Omicron cases reach more countries.
“We need to sit down and rationalize how we use tests and try to figure out how we prioritize them so that we have a rational system so that people don’t test in ways that don’t necessarily help our productivity and our ability to engage with society.” Benjamin said.