As the coronavirus enters a new deadly phase, Pa. Is behind in testing: here’s why

Michael spent four hours waiting to be tested for the coronavirus at a private lab in Hershey after realizing the pharmacy that offered free testing couldn’t schedule him.

“I help take care of my grandparents, so [it was] important to get tested, ”said Michael, who asked to be identified by his middle name. “[I had a] headache, sniffling and some stiffness.

After all this, Michael was billed for $ 110 because when he was fired he lost his health insurance. If he could have waited, he wouldn’t have paid anything.

This is the math that ordinary Pennsylvanians make, as growing demand and the surge in COVID-19 infections means they have to wait longer to schedule front-end testing and even longer to get results on the back-end.

And the patchwork system of testing that emerged from the first wave of this spring has produced very different results depending on where people live, how they are tested, and what their economic situation is.

A Bucks County dental hygienist was able to get tested the same day she had a fever. A few sick days and a negative result later, she returned to her normal routine. A Philly truck driver, exposed to COVID-19 by a family member, has stood in line for hours at a free clinic and is still waiting for the result. His employer won’t let him return to work without it.

A Lancaster grandmother shared her plan to make Thanksgiving go off without a hitch. Her adult children would be welcome as long as they tested negative and everyone ate in separate rooms. Masks had to be worn except at mealtimes.

But she soon realized that her plan had a potentially fatal flaw: None of them could pass rapid tests, and on Thursday most of her family were still waiting for the results of samples taken three, four or five. days earlier.

“I’m willing to take some risk, but not that much,” she said. “I just raised my hands: Thanksgiving has been canceled. We’ll be eating turkey sandwiches until Christmas.

Pennsylvania doesn’t see the 7-10 day delays that hampered its response to COVID-19 in the spring and summer, when officials rushed to get basic supplies like nasal swabs and chemical reagents. Some supply chain concerns persist, especially if the push gets worse amid holiday gatherings, but most labs are better equipped than they were earlier this year.

Marianne Downes, president of the Pennsylvania section of the American Society for Clinical Laboratory Science, said many labs now have multiple diagnostic tests. If a hospital has a problem with a test – perhaps a shipment of the chemical reagent for that test is delayed – it can quickly move on to another test.

Instead, much of the problem now revolves around the need for additional staff to meet demand.

“With increased demand comes increased delays,” she said. “Where you had several thousand tests a day before, people are now demanding double.”

READ MORE: Contact tracing offers a grim glimpse of Pa’s looming COVID-19 crisis.

Downes said many facilities have already moved more lab staff from routine testing to COVID-19 testing. Likewise, many retired technicians have been put back into service. But as these technicians fall ill, there is limited staff to replace them due to the specialization of skills.

“You can’t get people out of nowhere,” she says. “We don’t have a large number of unemployed people who can do lab diagnostics.”

There has been some movement to train people without medical training as temporary lab technicians working specifically on COVID-19, Downes said, but those efforts have their limits. On the one hand, these people need extra surveillance if they encounter a problem in the field, they are less equipped to deal with it. On the other hand, training newcomers requires bringing out an existing technician who could process the samples outside the laboratory.

“When you train someone, you cut your own productivity in half,” she says. “You pay two people to do half the work.”

Despite all the challenges, Pennsylvania at managed to increase its testing capacity.

The State Department of Health lab in Exton, for example, is now able to process about 1,200 tests per day, up from 750 in the spring. Statewide, meanwhile, the total number of daily tests has dropped from about 7,000 per day in April to about 58,000 per day currently.

Even so, Pennsylvania currently ranks second-to-last (ahead of Puerto Rico) in the country in terms of tests per 100,000 population, according to data from Johns Hopkins University.

Health Department spokesman Nate Wardle said the statistics presented a distorted view of the state’s efforts to expand testing. For example, it excludes multiple coronavirus tests reported on the same person as well as antigen tests, which show whether a person has specific proteins found in the virus.

Likewise, the Johns Hopkins ranking reflects testing rates throughout the duration of the pandemic, as the biggest expansion in testing has occurred in recent months. In the past week alone, the state has seen a 14% increase in tests performed.

Based on PennLive’s calculations, if repeat and antigenic testing were included, Pennsylvania would have a test rate of 41,653 tests per 100,000 population – which would still place it in the last 15 states and territories monitored by Johns Hopkins. And this ranking assumes that the change in methodology would only improve Pennsylvania’s position and not simultaneously lift all states uniformly.

There’s no clear reason Pennsylvania has lagged so far behind the rest of the country in the tests, but it’s likely a combination of funding limitations, geography, and politics.

Federal funding distributed through the U.S. state Department of Health and Human Services for testing and other responses to COVID-19 in April was unrelated to population. North Dakota received the equivalent of $ 6 per capita, compared to a paltry $ 1.95 per capita in Pennsylvania. North Dakota, perhaps to anyone’s surprise, currently ranks No. 1 in Johns Hopkins’ rankings for population testing.

Downes also noted that the state’s remote geography presented a unique testing challenge. Residents in more rural areas have limited testing options and these tests may take longer to transport to a lab for processing. The state has made progress on this front, partnering with private entities like Walmart to set up test sites in parking lots and pharmacies.

The latter factor is much more difficult to quantify, but public health officials are increasingly talking about the dangers of “pandemic fatigue” and the growing distrust of some residents of mitigation efforts – even among those who take the first step to get tested.

This makes it harder to enforce warrants to curb the spread of the virus, such as Governor Tom Wolf’s order requiring those traveling out of state to get tested before returning.

Michael Huff, the state’s director of testing and contact tracing, noted that 96 COVID-positive patients with contact tracers over the past week have refused to self-quarantine.

It is not clear what consequences these people could suffer from voluntarily exposing an unknown number of people to the virus.

“If an individual chooses[s] to not quarantine, we can force them to do so with a court order, ”Wardle said, in a written statement. “However, this is not a step the ministry has taken. When we work to educate people about the need to take these steps, they will usually do so as part of their collective responsibility to protect the Pennsylvanians. “

READ MORE: Penn State’s semester is coming to an end, but it will deal with COVID-19 in the long term

So far, just over 3 million of the 12.8 million Pennsylvanians have been tested since the outbreak began this spring.

Huff said the goal was to make sure anyone who wanted a test could get one, although he noted that the state was already prioritizing testing in counties with significant outbreaks – although this more and more each county. The department now identifies 63 of 67 counties as having significant spread.

Starting next month, he said, the department plans to launch a mobile testing program in each county to expand its existing testing capacity.

It’s instructive to think of coronavirus mitigation as a three-legged stool with legs being tested, contact tracing and public cooperation with masking, social distancing, and other guidelines. While the first two components are increasingly strained by the shortage of personnel, public health experts are increasingly asking residents to mobilize.

Allegheny County Director of Health Debra Bogen made it clear on Friday in an urgent appeal for people to take responsibility for curbing the outbreak in their community.

“If cases continue to increase at this rate, modeling predicts that our health care system could be overwhelmed within a month,” Bogen said. “We know it can take two weeks for the behavior changes to impact the spread of the virus and for the number of cases to decline, which is why I am asking you to start now.”

Wallace McKelvey can be reached at [email protected]. Follow him on twitter @wjmckelvey. Find PennLive is on Facebook.

Read it “The hunt for Ray Gricar.