Coronavirus testing slowly getting up to speed

  • A patient, below left, is tested by medical personnel at a drive-through coronavirus testing facility at a site in a parking lot, at Cape Cod Community College, in Barnstable, Mass., Tuesday, March 17, 2020. For most people, the new coronavirus causes only mild or moderate symptoms, such as fever and cough. For some, it can cause more severe illness. The vast majority of people recover from the virus. AP PHOTO/STEVEN SENNE

  • Dr. Estevan Garcia, the chief medical officer at Cooley Dickinson Hospital in Northampton. SUBMITTED PHOTO

  • A graph shows the total number of COVID-19 tests conducted in Massachusetts, both by the state Department of Public Health lab and private labs.

Staff Writer
Published: 3/25/2020 6:42:01 PM

NORTHAMPTON — Speaking at a press conference Tuesday, Gov. Charlie Baker acknowledged that the state needs to “ramp up the other stuff that other countries have proven makes a difference.”

“Which is far more testing than we’re doing now,” Baker said. ” (And) if we get to the point where we’re doing far more testing, doing the tracking and tracing and isolation that comes with that, and recognizing and understanding that that’s the only way to get ahead of this.”

In South Korea, to take one example, the country has managed to flatten the curve of new COVID-19 infections with unique success, reporting only 64 new cases Sunday after early worries about the virus overwhelming hospitals as it has done worldwide, according to The New York Times.

A big reason for that tentative triumph over the coronavirus disease was widespread testing before the virus became a crisis. The country of 50 million is currently producing 100,000 test kits per day, and opened 600 centers — including 50 drive-through stations — to test as many people as possible early on to limit the spread of the virus, the Times reported.

In Massachusetts, meanwhile, testing has been much more limited, though it is now ramping up. In total, 19,794 patients had been tested in Massachusetts as of late Wednesday afternoon, up from 13,749 on Tuesday and 8,922 the day before.

So what has kept testing from ramping up more quickly in Massachusetts? And where is the state in that process now? Who is getting tested currently and who is not?

For answers to those questions, the Gazette spoke to Dr. Estevan Garcia, the chief medical officer at Cooley Dickinson Hospital in Northampton.

There are several components to a test for COVID-19, Garcia said: a swab to take a sample from a patient’s nose, a screw-on transport tube that holds the sample, and a “viral transport solution” — a liquid inside the tube that keeps the virus testable as it is transported to a lab. And amid the crisis, there are shortages of the solution and the swabs, he said.

“That’s the challenge,” Garcia said. “Both the availability of testing — so the test kits — and the availability of the material to transport it.”

A nationwide shortage of personal protective equipment, or PPE, has also prevented more widespread testing, Garcia said. Health care workers need to wear PPE to conduct the tests so as not to become infected.

The amount of test kits available has improved, Garcia said. Previously, the state Department of Public Health, had to approve the administration of a test, given how limited the kits were. Now, Garcia said, those decisions have been relegated to local facilities, which are following criteria suggested by the DPH and the Centers for Disease Control and Prevention.

“A lot of it now, what we’re looking at now is admitted patients — patients who are sick enough to require admission and don’t have another diagnosis,” he said. “The next area for us are really those health care workers who have exposures.”

Testing health care workers and first responders is at the top of the state’s and CDC’s guidance, and the reason for that is clear.

“We don’t want to give COVID-19 to anyone,” Garcia said. “The other reason is because I need to get them back to work.”

After those first responders and health care providers, the hospital is trying to test people with significant “co-morbidities” — conditions that can make them more at risk, such as asthma, diabetes and COPD, or chronic obstructive pulmonary disease — as well as people over 60 years old.

Finally, the hospital is prioritizing those in congregate settings including long-term care facilities, shelters and prisons, where the virus can spread quickly.

Garcia said that testing previously took the DPH, which has been swamped with tests, as many as five days to get test results back to Cooley Dickinson Hospital. A spokesperson for the DPH said that the state public health lab is now able to test approximately 400 people each day, and that wait times have “consistently” been between 24 and 48 hours.

Longer waiting times can burden individual health care workers at the same time they strain the health care workforce. Those workers might be living in their basements, for example, trying to not to infect family members while waiting on a test result. Now that commercial labs have begun more testing, the hospital’s tests are being turned around in 48 to 72 hours, Garcia said.

In his press conference Tuesday, Baker said that in addition to the DPH lab and two other private labs that have been testing, 10 other labs have recently came online to boost the number of tests conducted in the state.

“This is big progress from where we were a week ago,” Baker said, adding that yet more testing is needed.

For that, Garcia said Cooley Dickinson and other facilities need to be getting the supplies they need. The University of Massachusetts has reached out to discuss possible production of viral transport solution, Garcia said, and overall the community has come together to support the health care workforce.

But Garcia said those conducting the testing need to have a consistent influx of materials so that they can know how much testing they can conduct daily. And testing needs to be done in centralized locations so that PPE can be conserved by testing many patients instead of just individuals.

Overall, people should be assured that the hospital is prioritizing testing, Garcia said, and that it is rolling out testing as expeditiously as possible given the limitations in the state.

“I think compared to a week ago, we’ve made tremendous progress,” he said.

Dusty Christensen can be reached at dchristensen@gazettenet.com.

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