WASHINGTON — First, some of the coronavirus tests didn't work. Then there weren't enough to go around. Now, just as the federal government tries to ramp up nationwide screening, laboratory workers are warning of a new roadblock: dire shortages of testing supplies.
The shortages are the latest stumble in a botched effort to track the spread of coronavirus that has left the U.S. weeks behind many other developed countries. Dwindling supplies include both chemical components and basic swabs needed to collect patient samples.
“What you have now is a global shortage of all these ancillary supplies needed to do these tests,” said Eric Blank, of the Association of Public Health Laboratories, which represents state and local health labs. “These are acute, serious shortages across the board."
Blank said government labs in the U.S. are competing for supplies with larger commercial labs and other governments around the world. In conference calls this week with the Centers for Disease Control and Prevention, some local lab workers warned that they may have to shut down testing within days due to lack of components, Blank said.
Wide scale testing is a critical part of tracking and containing infectious diseases like COVID-19. But the U.S. effort has been plagued by a series of missteps, including accuracy problems with the test kits the CDC sent to other labs and bureaucratic hurdles that slowed the entrance of large, private sector labs.
With the virus spreading in U.S. communities, many governments have shifted focus from tracking the virus to extraordinary measures to blunt its damage. On Thursday California's governor told its 40 million residents to stay home indefinitely and venture outside only for essential jobs.
But public health experts stress that policymakers are “flying blind” in deciding how to manage the pandemic.
“The only way to get through it without testing is to keep the entire country quarantined for the next 18 months” said Dr. Ashish Jha, a Harvard University global health professor. “That obviously is untenable.”
Jha and his colleagues say the U.S. should be screening 100,000 to 150,000 people per day. The current rate is roughly 20,000 per day, he estimates.
Local hospitals affiliated with Harvard are sending out “SOS emails” searching for swabs to test patients, Jha said.
South Dakota’s public health lab halted testing this week when it ran out of chemicals used for analyzing patient results. The lab resumed testing Thursday after getting new shipments, but officials said they can only run about 100 more tests. They are prioritizing tests for those who pose the greatest risk of spreading the coronavirus to vulnerable people.
The shortages have risen to the top of state and national agendas, including increasingly urgent communications between governors and federal officials.
“Most of my phone calls today have been about swabs,” Gov. Gina Raimondo said during a Tuesday news conference. “That’s our big issue at the moment.”
Other supplies are far more specialized. The test for coronavirus uses a chemical chain reaction to detect tiny traces of the virus' genetic material and reproduce it many times. State and local health labs follow the technique first developed by the CDC, which calls for a specific genetic kit made by German diagnostic firm Qiagen. Labs both in the U.S. and around the globe are reporting shortage of those kits.
Qiagen said this week it is trying to boost production from normal levels, which are capable of testing 1.5 million patients per month, to amounts that would allow for testing more than 10 million patients by the end of June.
The Food and Drug Administration has setup a toll-free number for labs having trouble with supplies. Commissioner Stephen Hahn told reporters this week the federal government has been trying to find new supply chains for critical supplies or alternative products, when feasible.
“We have been leaning in with manufacturers, both of the tests and these other supplies that are needed,” Hahn told reporters earlier this week.
The World Health Organization has instructed countries to “test, test, test” to track and isolate those carrying the virus. But the evolving message from U.S. decision-makers acknowledges that many suspected cases will likely go untested.
The White House's coronavirus task force has increasingly emphasized that testing should prioritize the elderly and health care workers who have symptoms of the virus.
"It’s important to remember that people without symptoms should not get tested,”
At the same time, the Trump administration is expected to soon announce the rollout of nearly 50 community-based testing
Some experts worry the introduction of convenient, mass screening will divert supplies from people with severe symptoms to those who face lower risks.
“It’s taking supplies that are already in very short supply away from the testing laboratories that are doing necessary testing,” said Blank, of the public health labs association.
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AP writers Michelle R. Smith in Providence, Rhode Island, and Stephen Groves in Sioux Falls, South Dakota, contributed to this report.
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Matthew Perrone, The Associated Press