Test capacity surges in San Diego, but still not enough to check everyone

The collective testing capacity of San Diego County’s COVID-19 is currently over 1,200 per day, significantly increasing the resources that will be online in the coming weeks.

However, while the population of people across the region who can take the test quickly is gradually increasing, the shortage of supplies continues to force distribution.

Just Wednesday, informing all local physicians, San Diego County’s public health department said that tests were conducted on people with symptoms severe enough to require hospitalization and those at higher risk of infection than average. Repeatedly stated that only should be provided. Candidates for testing include those 65 years old and older, chronic health conditions, living in a group home, or doing high-risk work.

For everyone else, especially healthy people with mild to moderate symptoms, they spent every day worried about whether they were coronaviruses or other microscopic abnormalities that were causing the disease. Even so, the advice stays at home.

Due to the lack of extensive testing, it is difficult to reliably read how many people sitting in the house are trying to keep their families out of this situation.

However, it will be able to quickly provide positive and negative COVID Much more than helping individuals for the majority with symptoms.

As epidemiologists explain, testing is the only way we really know how the new coronavirus has penetrated deeply into the local population. According to epidemiologists, however, extensive, relatively immediate testing increases confidence that pandemics can be managed in individual communities.
“It’s really and really what makes this very cumbersome from a social perspective is this uncertainty about who is infected and who isn’t,” said a medical director of epidemiology in San Diego County. One Dr. Eric McDonald said. “Is the symptom that people are experiencing really a coronavirus or something else?

“Being able to answer that basic question very quickly and very broadly for the entire community is important to getting us back to the normal state as possible.”

It frees us because it is only a widely-used test.

With the ability to quickly determine who needs to be segregated and who does not need to be sequestered, the public health sector has become more socially sensitive than previously as flat as a shovel. You can fine-tune your distance campaign.

Starting with only a handful of local hospitals and county public health laboratories offering COVID tests in early March, despite the continuing shortage of many chemical compounds called reagents needed to produce results There has been significant growth recently.

All labs in the region, and even labs testing local patients outside the state, need to notify the county public health department when results are available. On Saturday, the number of local results that passed 15,000 mark, more than twice the result of 6,078 Just returned a week ago.

Test surge

A survey of the local healthcare system showed that hospitals and healthcare systems were in the lead, doing whatever they could to add as much capacity as possible.

The University of California, San Diego currently has the greatest capabilities through an advanced clinical testing center in La Jolla, capable of performing approximately 600 tests per day. Sharp HealthCare is currently able to perform approximately 300 units per day at Copley Drive’s main lab in Kearney Mesa.

The Scripps Health Lab can handle 150 to 200 tests per day, and Raydi Children’s Hospital adds an additional 100. Palomar Health added 60 tests / day capacity on Friday and said VA San Diego and Kaiser Permanente could run 750 and 1,200, but resources were shared with a much larger area far beyond the San Diego County border It has been.

Finally, the county’s Institute of Public Health adds hundreds of tests per day, but its capacity is reserved for emergencies in nursing homes and emergency situations such as living support facilities. You.

Without including Kaiser and VA, the region will allow about 1,200 tests per day and return results within 24 hours. Commercial labs, which often send collected samples out of the state, also provide tests, but take 48 to 72 hours.

However, we plan to increase testing significantly in the coming weeks. For example, Sharp is on the verge of adding 200 tests per day by bringing a third test platform online.

UCSD hopes to reach 1,000 to 1,500 tests per day by mid-April, using five, and soon six, test systems from various companies. Rady expects to reach 800 tests per day in the next two weeks, and Scripps will be able to get the materials needed to start using a high-end panther automated test system that can exceed 1,000 tests per day. It is working.

The university was named with UC Riverside on Saturday to help lead a new statewide task force with a mission to increase statewide testing five-fold “over the next few weeks.” To get the job done, government and industry organizations work to set up 5-7 test “hubs” throughout the state that take a multi-platform approach similar to those already underway at UCSD.

The struggle to obtain the necessary reagents from the overwhelming global supply chain is widely cited as a reason why tests are delayed to a level where everyone with symptoms can access them.

Dr. David Pride, an infectious disease specialist at UC San Diego and head of the Microbiology Laboratory, says that while the deficiencies are improving, the situation is not yet free.

According to Pride, UCSD’s CALM lab will begin using the newly released “point-of-care” high-speed COVID test machine from medical diagnostics company Abbott Inc, the UCSD CALM lab announced Friday. It is much faster than the fastest test to date, which takes hours to perform the same task, because it can provide a positive COVID test in just 5 minutes and a negative test in 13 minutes. Pride hopes to get about 100 quick results per day, and said the system will be unused until the weekend because the required test cartridges have not yet arrived.

“We had a delay in shipping our materials,” Pride said. “That’s always happening. I’m expecting it one day, and I know that it will actually come a week later.”

Now, he said, the needed supplies are expected to arrive this week, hopefully allowing testing to begin immediately. All previous COVID tests use the polymerase chain reaction to extract genetic material from virus samples taken with swabs of the nose and throat.

Complex process

Scientists first find unique spots in the viral genetic code that are not shared with other members of the virus, and then design special molecules called primers that attach only to that particular sequence. Enzymes are used to rapidly replicate what the primer chooses. Finally, a special fluorescent probe designed to connect only the specific sequence selected by the primers is introduced into the mix, and when a certain number of connections are made, detectable fluorescence is emitted and the virus is present Notify that.

This method is very effective, but has problems. Most importantly, the virus must be active in the secretions of the patient’s nose and throat in sufficient quantity to amplify its genetic material to detectable levels. This means that after infection, tests performed before the body “clears” the virus from secretions will be negative. The same applies if the test is too slow after the amount of virus present in the body has been significantly reduced.

Each step along the way, from primers and probes to chemicals, requires unique, important substances to extract the genetic material from the virus and make sure it is pure enough to use. If one is missing, the system will be idle until inventory is restored.

This is a situation where literally all laboratories in the country are demanding the same supplies at exactly the same moment.

“Every single vendor we’ve worked with has had a problem with the supply chain someday,” said Pride. “If the supply chain was functioning properly, it probably already exceeded the estimate.”

No lab, regardless of size, was affected. Oceanside’s Tri-City Medical Center reports that in-house COVID testing is possible, but the supply of reagents has not progressed yet.

Nevertheless, despite the overall slow supply situation, there are signs of great progress.

Dr. Omid Bakhtar, a pathologist at Sharp Memorial Hospital, said that Sharp has recently been able to secure a commitment from Roche’s tests to receive enough material for 200 additional tests per day. This isn’t really about equipment, but Roche’s version of the COVID PCR, which runs on a huge automated Roche test system that the lab already owns and uses to detect a variety of different things. It promises to provide a stable supply of the materials needed to successfully run tests. Virus types in large integrated laboratories in Kearney Mesa.

However, at this point, Bakhtar should have said enough for Sharp to test for those whose public health leaders have recommended.

Existing equipment can be larger and significantly increase the number of tests per day, but doctors say it’s hard to know when or when it will occur . At this time, there are too many variables to reveal a clear picture.

“I don’t know what the quota will be three weeks from now, and what will be the demand three weeks from now,” Bakhtar said.

First-line profit

Meanwhile, however, there are benefits that appear at the forefront of the COVID battle.

Patricia Maycent, CEO of the University of California San Diego Health, said Friday University has added enough capacity to provide COVID tests to all patients undergoing surgery.

“This week is new,” said Maycent. “Everyone will be more comfortable if they can make sure that the people on the medical team are not harming themselves in every operation.”

She also recently said that enough tests were available to check healthcare professionals, which reduced the burden on staff.

“Providers are afraid,” Maycent said. “As you know, they come to work every day and act like they’re trained. They’re amazing, but it’s not true that they’re not uncomfortable.”

According to Maycent, UCSD tested 230 employees who were exposed to those who had undergone a COVID-19 test. So far, only five people have tested positive, she said. She said UCSD not only tests its employees and patients, but also plans to first branch to other at-risk people, such as local nursing homes.