I’m trying to prevent COVID from getting “non-functional” in “Oregon” due to test result delays. Coronavirus

Sale — In two months, the novel coronavirus passed through Malheur County, a 10,000-square-mile ranch, onion farm, and a small town on the border with Idaho.

On July 1, the Malheur County Health Department proposed to drive-through test people with viral symptoms at the county fairground and promised results would return in about five days.

For many in Malheur County, drive-through events were the only easy way to take a test. Local hospitals have the ability to quickly return results for inpatients only.

However, 5 days turned out to be an optimistic estimate. The county’s public health department sent a swab to Quest Diagnostics at FedEx. QuestDiagnostics is partnering with Oregon’s National Laboratory to improve statewide testing capabilities. It took 14 days for the county to return the final result from the quest.

Further compounding the problem is that approximately 16% of the samples collected during the test run were positive for COVID-19. County public health staff had to call people to let them know they were infected with the coronavirus. In some cases, a few days after the person’s symptoms disappeared, the call came after the US Centers for Disease Control recommended 10-day isolation period had already expired.

“It was almost meaningless.” Sarah Poe, Director of Public Health at Malheur, said: “It definitely does not meet the need and purpose of testing in the first place.”

Coronaviruses are often and sometimes undetected in all Oregon communities almost five months after a pandemic.

Testing should lay the groundwork for state efforts to control the virus.

However, local and national supply shortages, delayed processing results in out-of-state laboratories, and competing demand from smashing states such as Arizona and Texas provided close contacts to those who track and test the virus. Oregon’s efforts to find and quarantine are undermined. It was positive before they unknowingly spread the virus to more Oregons.

The Maltonoma County Public Health Clinic also uses Quest Diagnostics to test and experience long delays.

According to Dr. Jennifer Vines, a health official in Maltonoma County, the virus’s fast-moving and contagious nature, like COVID-19, could contribute to the growth of the community by delaying testing. There is.

“There is a big preventive window opportunity that has been overlooked,” she said. “Contacts are much harder to track and much less effective.”

National issues that have a big impact on Oregon

In Oregon, a COVID-19 test usually requires doctoral instruction. Many state hospital systems, including Kaiser, Legacy, and Providence, have their own laboratories to expedite testing.

The Oregon Institute of Public Health can also handle coronavirus testing, but due to its limited capacity, the National Institute of Health Care is not suitable for people living or working in particularly vulnerable environments such as nursing homes, prisons, and day care. Focus on rapid inspection.

The state has contracted with Quest Diagnostics and LabCorp, the two largest commercial laboratories in the country, to provide testing in locations like Malheur County.

Quest warned last month that the nationwide demand for coronavirus testing has once again outstripped supply.

“Despite the rapid expansion of capacity, the growing demand for COVID-19 molecular diagnostic tests across the US is slowing the time it can deliver test results,” a statement on the company’s website on July 20 said. Read

The company cites restrictions on tester capabilities and chemical availability.

According to Quest, the average treatment time, including inpatients and symptomatic healthcare workers with the highest priority patients, doubled from a month ago to two days. For all other patients, Quest says processing results can take 7-14 days.

Delays in commercial labs such as Quest have led many counties to place more stringent restrictions on who can test COVID-19 in clinics.

In Maltonoma County, some medical systems provided tests to workers heading to Alaska, which requires a negative test for travelers from 48 states.

Some local workplaces require employees to have a negative COVID-19 test result before returning to work.

Dr. Weins urged Multnomah County to lower the test priority for travelers and not require employers to request negative tests for people returning to their offices, leading to a slower turnaround time for tests. Both replies said.

“For now, you can’t get the most out of your testing resources by thinking collectively,” she said.

Test too late

Due to the lack of testing, confusion about who is being tested also causes delays with serious consequences.

Steve Brewer, who lives in Cottage Grove, fevered for a COVID-19 test after a family vacation in Montana.

Liu was enrolled as a patient at Nova Health, which operates a drive-through test center in Lane County. It took about 48 hours to complete the paperwork and get a telemedicine appointment.

I was told to wait 5 days before taking the test to be “more accurate”.

While Liu was waiting, he worried: he called his parents to let them know they might have been exposed to COVID-19. He found out that his 15-year-old son also coughed when he called his child’s mother to inform her. Both the child and the mother working in the long-term care facility eventually tested positive.

By the time Mr. Liu got the results, his wife had a positive reaction.

Dr Marc Schnapper, Medical Director of Nova Urgent Care, told Liu that he should never have to wait.

“If you have been in contact with a known contact and have no symptoms, the best time to have a test is 4-7 days after contact, but you should come immediately if you experience any symptoms,” he said.

Counties with a robust hospital network that often do their own in-house testing are not impacted by test delays.

Like Steve Liu, some of these delays are due to communication errors.

“As dean of medicine, we announced the protocol, but the situation is changing rapidly and we are inundated with phone calls,” Schnapper said.

Test delay means trace delay

In Lane County, most COVID-19 tests have a 2-7 day delay.

“The delay can have a huge personal impact and not knowing is very frustrating. But it also has a big public health impact,” said Lane County spokesman Jason Davis. It was

Delays complicate the work of contact tracers as the virus spreads exponentially. The same goes for contacts of sick people as well as contacts of contacts.

Public health leaders in rural Oregon say their communities are particularly vulnerable to testing delays and other issues.

“We don’t know the supply. We don’t have access to the lab. We’re at the mercy of someone,” said Leslie Odgen, CEO of Samaritan North Lincoln Hospital and Samaritan Pacific Community Hospitals off the coast of Lincoln County. Said.

Lincoln County is in the midst of a major COVID-19 outbreak, including 181 workers at Newport’s seafood processing plant, as well as Maluru.

Ogden said access to quick and reliable tests remained a challenge for her hospital and Lincoln County residents since the beginning of the pandemic. “This is this crazy scramble,” Ogden said, “trying to understand how we can do more and how we can help patients.”

Odgen said the Samaritan repeatedly encountered problems in the lab he initially contracted to handle the COVID-19 test. The hospital was sending samples to Quest Diagnostics, but switched because the turnaround time was too long. The hospital is now using its third lab, Willamette Toxicology, as equipment failures and supply shortages began to occur in its second lab, Legacy.

The Samaritan, like many hospital systems, has also developed an in-house ability to handle COVID-19 tests by diverting Abbott brand diagnostic machines that hospitals had to test for other pathogens. But, according to Ogden, hospitals face the same supply chain problems that are delaying commercial labs.

Nasal swabs, diagnostic equipment components, and chemical solutions used to store samples are all lacking.

“You are allocated how much test gear you can get after you set up your device,” she said.

The Oregon Institute of Public Health monitors the ability of laboratories in the state to test COVID-19.

A weekly report on the state’s latest test, issued on 20 July, warns that hospital labs may soon face even more serious shortfalls and distribution of test supplies.

According to the report, some manufacturers have informed the state that it may need to cut their supply quotas to Oregon laboratories, including the Oregon Institute of Public Health.

“These shortages can affect Oregon at a critical time when there is a significant increase in infections in urban and rural Oregon,” said Charles Boyle, Deputy Governor of Kate Brown.

Boyle said the state had asked the federal government for additional test supplies, but received a “slim” response.

“We continue to look for contingencies and other ways to expand our testing capabilities, including working with private test vendors, but additional testing supplies from the federal government are nationwide. It is essential in the face of a shortage of money,” he said.

On her part, Ogden says the only way she can get out of what the hospital has called a “test nightmare” is stronger leadership at the national level.

“Someone needs to have a vision to say, we’re going to get over this,” she said.

“It’s not there. It’s essentially a free market in every way. Free markets aren’t cooperative. Free markets don’t guide us where we need.”

Need state help

Sarah Poe of Malheur County says her community needs state support, either signing a new contract with another commercial laboratory or getting a quick test machine into the health care providers in the county. He said he needed help directly.

“We are aware that many other counties have multiple test sites and the counties in the countryside do not require additional support,” she said.

Meanwhile, according to Po, the most important thing that residents of Maul County can do is stay home if they are suspected of being ill.

“If you first needed a test, it’s really important that you just be patient and at home in case it’s positive,” she said.

The CDC recommends that people who suspect COVID-19 may be at home for at least 10 days after onset and at least 24 hours after their symptoms improve.

“This is what you can do to protect your community,” she said.