How delays in covid-19 test results hamper virus control - TribLIVE

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Delays in the reporting of coronavirus test results are making it more difficult to control the outbreak, health experts said.

“If you’re waiting seven days for a test result, the value of that test becomes much less useful,” said Dr. Amesh Adalja, a Pittsburgh-based fellow with the Infectious Diseases Society of America. “If you’re a case contact investigator, you’re hearing about a case that happened seven days ago.”

For people who got tested, Adalja said, “If that person didn’t self-isolate because they were waiting, they didn’t know to self-isolate, that can increase the number of contacts that they’ve had a lot. This really destroys the value when you have that kind of a lag that’s happening nationally.”

Laboratory companies LabCorp and Quest Diagnostics say increased demand for tests and restrictions on testing supplies have caused a delay in the reporting of results. Western Pennsylvania’s two biggest health care providers, UPMC and Allegheny Health Network, both partner with Quest for testing, while AHN also uses LabCorp.

LabCorp previously had been able to get test results back to patients within one or two days from when specimens were picked up, but that has since changed to four to six days, according to the company. For hospitalized patients, the average time for results is faster, the company said.

Quest said its average turnaround time for reporting test results is about a day for high-priority patients — such as those in the hospital and symptomatic health care workers — and a week or more for others.

Both companies said they are working to address the challenges. LabCorp said it aims to go from processing roughly 140,000 tests per day to 150,000 tests per day, while Quest said it will go from performing about 125,000 tests a day to 150,000 tests a day.

To boost the number of tests processed daily, Quest said it is placing added technology in its network of U.S. labs and looking to partner with independent lab providers that have underused testing capacity.

That said, Quest said in a statement that it would “not be in a position to reduce our turnaround times as long as cases of covid-19 continue to increase dramatically across much of the United States. This is not just a Quest issue. The surge in covid-19 cases affects the laboratory industry as a whole.”

UPMC and AHN also have the ability to perform coronavirus testing in on-site laboratories.

AHN said its results are usually delivered in three to five days, though patients often get them sooner. UPMC said it can provide results for urgent, in-hospital cases within two to four hours and other higher-priority tests in 36 to 48 hours. About half of UPMC’s tests are handled by Quest, with turnaround times dependent on priority level and volumes.

Allegheny County on Tuesday reported 331 new covid-19 cases. Because of a backlog in reporting, some of the positive tests were conducted as far back as June 8. Wednesday’s report of 246 new cases included results from tests done as far back as June 30.

Allegheny County Health Director Debra Bogen said some of Tuesday’s backlog was caused when there was a delay in putting test results from California-based Curative into the National Electronic Disease Surveillance System.

The county health department partners with Curative for coronavirus testing. The company makes oral fluid swab tests that are used at the county’s federally qualified health centers.

The error didn’t delay when the test results were actually delivered to patients, Bogen said. Results are emailed or texted to patients and reported to the ordering clinic.

But, because they weren’t put into the National Electronic Disease Surveillance System, the health department was unable to perform contact tracing on those people in a timely manner, Bogen said. The health department is now working to get in touch with them.

Meryl Dreste, a spokeswoman for Curative, said the turnaround time for Curative tests is between 24 and 48 hours.

Curative hasn’t experienced a delay in testing because of increased demand, Dreste said.

“Curative manages the entire testing process end to end — from sourcing materials for the test and manufacturing the test — to running the test sites, processing tests and delivering results,” Dreste said.

New covid-19 cases reported daily by Allegheny County are the result of tests that were conducted days or weeks prior, meaning they’re not real-time.

“We ask people to remain at home while they’re waiting for their test results. That is the only thing we can do right now if there are (delays) in tests,” Bogen said when asked how the county can make decisions based on old data and delayed positive test results.

“We’re also working to try to identify laboratories that can handle more tests so that we can shorten the turnaround time,” Bogen said.

While more recent cases and test results are valuable from a public health intervention standpoint, improved turnaround times for outpatient tests is really what’s needed to get control of the outbreak, Adalja said.

“This is a problem that we’ve had since the beginning of this pandemic,” Adalja said. “I don’t think there’s a solution to this. This a national testing problem that we have that we just do not have quick enough turnaround times in the outpatient tests.”

Madasyn Lee is a Tribune-Review staff writer. You can contact Madasyn at 724-226-4702, mlee@triblive.com or via Twitter .

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