By Mallory Moench | SF Chronicle
Delays in coronavirus test results from some Bay Area sites worsened this week, taking up to 19 days in the worst cases and frustrating officials trying to contain the summer’s surge in cases.
The local lags in processing results, more frequently at commercial than public health labs, stem from increased demand, limited lab capacity and supply shortages across the country. Testing nationally continues to struggle as well.
Delays aggravate patients left in limbo about their health and public health officials who say that longer wait times cripple efforts to stop the spread of the disease.
“Demands are outweighing the supply at this juncture,” Napa County Health Officer Dr. Karen Relucio said during a presentation Thursday. Delayed test results mean the county can’t identify cases in a timely way and trace their contacts. The opportunity to prevent more people from getting sick is lost, she added Friday.
In early June, as the virus surged in the U.S. and more people went back to work, driving an increased need for testing, the country’s biggest commercial labs became inundated and wait times lengthened.
Frustration nationwide with a lack of a national testing strategy, which some argue would help states and counties address the backlogs, has bubbled up. Recently, some state governors banded together to take testing solutions into their own hands as an alternative to the currently disjointed public and private patchwork of options nationwide.
In the Bay Area, the time it takes to get back test results can differ drastically depending on where you live, who’s running the site and which lab is processing the results.
“There’s a general lack of timeliness in testing in the United States, a great failure of the system,” said Warner Greene, a senior investigator with the Gladstone Institutes. “In terms of testing, we have been behind the curve the entire time. We never have been out in front of this problem.”
In the Bay Area, longer wait times have been reported this week at sites run by Verily, the life sciences arm of Google parent company Alphabet that provides state-funded testing in dozens of California counties.
At a state site run by Verily at the Napa Valley Expo, results are taking up to 19 days to come back, compared with 10 to 14 days last week and three to five days when it opened, Relucio said.
The county depends on the mass test site for most of its testing. The county’s Public Health lab can turn around results in 24 to 48 hours, but is limited to 125 tests daily that are reserved for outbreaks, symptomatic people and close contacts in congregate facilities, and contacts of infected people, Relucio added.
“Verily has been a little bit frustrating, because it takes time to get back, but it is the testing venue that gives us the most volume, but we need that volume so we can get many people tested,” Napa County Supervisor Brad Wagenknecht said during a presentation Thursday.
A statement from Verily said demand due to the national surge was stressing supplies.
“COVID-19 cases have been rapidly rising across the country, putting immense pressure on reference laboratories, like the ones we partner with, to process a high volume of tests,” the statement read. “We recognize that the timely return of results is critical.” The company said it is onboarding two additional labs to improve capacity and turnaround times, hopeful to return to a previous average of closer to two days and up to five days.
Verily currently contracts with lab Quest Diagnostics, which saw test orders exceed capacity from early June until three weeks ago, a news release this week reported. The most significant hurdle was limited chemical reagents to perform testing, the company said. Two weeks ago, turnaround time lagged from one to two weeks, but the situation is improving, a spokeswoman said.
Quest’s national average turnaround time is now five days and is expected to be three days next week, the company said. Priority cases, who are symptomatic health care workers and hospital patients, get results back in two days. National averages don’t always reflect the local situation.
Chloe Meyere, who lives in San Jose with an essential worker, recently was tested for the third time at a state site run by Verily at the Santa Clara County Fairgrounds because of recent exposures to the virus. The first two times, it took no more than five days. This time, she was still waiting for her results on Friday — 15 days later.
She had planned to stay home, but after a week and a half, needed to go to the grocery store to get food.
“Now, the test is useless,” she said Friday, since it would be more than two weeks old. “It’s frustrating because it feels like it’s not really going to help us get back into the swing of things if we can’t get tested and know our results.”
County public health departments that rely on a mix of commercial and public labs said turnaround times are stable.
Santa Clara County’s test sites generate about 3,000 tests a day, the Public Health Department said. Most are processed by county-run Valley Medical Center, which delivers results in two to three days. The county did see a temporary increase up to four to five days for a week in mid-July, but things are back to normal now. The county also keeps contracts with private labs to increase capacity on short notice and currently has one active.
In Marin County, test turnaround time “really varies by the site,” spokeswoman Laine Hendricks said. A state-run site takes up to a week to return results while mobile testing teams in partnership with UCSF average three to five days, slightly longer recently, she said. The county recently partnered with the company Color, which has an integrated process running its own sites and lab. Those results can be as quick as one to two days.
San Francisco also uses Color for its testing processing in addition to its own public health labs, which usually return results in two to four days. While demand increased over the past month by 50%, 90% of results were returned within 48 hours and nearly 50% under 24 hours, Color spokesman Ben Kobren said.
Alameda County’s Public Health Department saw turnaround times from commercial labs increase from three to five days to a week or longer starting at the end of June, spokeswoman Neetu Balram said. Because the county also uses public health labs to analyze results from its community testing sites, which give faster results, the average time in the county is 72 hours.
In lieu of quick results, officials urge people who get tested to act as though they are sick, staying home and self-quarantining. But this can be hard, especially for the most vulnerable — low-income essential workers who are more likely to be people of color disproportionately affected by the virus. For these people, quarantining at home for more than two weeks could mean missing work and vital income, or struggling to separate from family members in tight quarters.
Public health officials and health care providers have been frustrated by unpredictable results from different sources and sometimes long wait times. Experts said quick turnaround times are critical to stopping the spread of the disease and to catch cases and their contacts when they are infectious.
“If you don’t have test results, how can you contact trace?” said Greene of the Gladstone Institutes. “Contact tracing is a lost opportunity.”
