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US Labs Buckle Amid Testing Surge; World Virus Cases Top 15M

Associated Press

   Laboratories across the U.S. are buckling under a surge of coronavirus
   tests, creating long processing delays that experts say are actually
   undercutting the pandemic response.

   With the U.S. tally of infections at 3.9 million Wednesday and new
   cases surging, the bottlenecks are creating problems for workers kept
   off the job while awaiting results, nursing homes struggling to keep
   the virus out and for the labs themselves, dealing with a crushing
   workload.

   Some labs are taking weeks to return COVID-19 results, exacerbating
   fears that asymptomatic people could be spreading the virus if they
   don't isolate while they wait.

   "There's been this obsession with, 'How many tests are we doing per
   day?'" said Dr. Tom Frieden, former director of the Centers for Disease
   Control and Prevention. "The question is how many tests are being done
   with results coming back within a day, where the individual tested is
   promptly isolated and their contacts are promptly warned."

   Frieden and other public health experts have called on states to
   publicly report testing turnaround times, calling it an essential
   metric to measure progress against the virus.

   The testing lags in the U.S. come as the number of people confirmed to
   be infected globally passed a staggering 15 million on Wednesday,
   according to data compiled by Johns Hopkins University. The U.S. leads
   the world in cases as well as deaths, which stand at more than 142,000
   nationwide. New York, once by far the U.S. leader in infections, has
   been surpassed by California, though that is partly due to robust
   testing in a state with more than twice the population of New York.

   Guidelines issued by the CDC recommend that states lifting virus
   restrictions have testing turnaround time under four days. The agency
   recently issued new recommendations against retesting most COVID-19
   patients to confirm they've recovered.

   "It's clogging up the system," Adm. Brett Giroir, assistant health
   secretary, told reporters last week.

   Zachrey Warner knows it all too well.

   The 30-year-old waiter from Columbus, Ohio, was sent home from work on
   July 5 with a high fever a few days after he began feeling ill. He went
   for a test five days later at the request of his employer.

   Almost two weeks and one missed pay period later, he finally got his
   answer on Wednesday: negative.

   Though Warner said most symptoms -- including fever, diarrhea, chest
   tightness and body aches -- stopped a few days after he was tested, he
   wasn't allowed to return to work without the result. On Wednesday he
   got a call telling him he didn't have COVID-19.

   It was "frustrating that I've missed so much work due to testing taking
   forever," Warner said. "It is what it is ... (but) I'm glad I'm
   negative and happy to be able to get back to work this week."

   Beyond the economic hurt the testing lags can cause, they pose major
   health risks too.

   In Florida, as the state confirmed 9,785 new cases on Wednesday and the
   death toll rose to nearly 5,500, nursing homes have been under an order
   to test all employees every two weeks. But long delays for results have
   some questioning the point.

   Jay Solomon, CEO of Aviva in Sarasota, a senior community with a
   nursing home and assisted living facility, said results were taking up
   to 10 days to come back.

   "It's almost like, what are we accomplishing in that time?" Solomon
   said. "If that person is not quarantined in that 7-10 days, are they
   spreading without realizing it?"

   Test results that come back after two or three days are nearly
   worthless, many health experts say, because by then the window for
   tracing the persons' contacts to prevent additional infections has
   essentially closed.

   Dr. Leana Wen, a public health professor at George Washington
   University said it's reasonable to tell people awaiting test results to
   isolate for 24 hours, but the delays have been unacceptable.

   "Imagine, you tell a parent with young children to self-isolate for 10
   days or more without knowing they actually have COVID? I mean, that's
   ridiculous. That's actually absurd," Wen said.

   U.S. officials have recently called for ramping up screening to include
   seemingly healthy Americans who may be unknowingly spreading the
   disease in their communities. But Quest Diagnostics, one of the
   nation's largest testing chains, said it can't keep up with demand and
   most patients will face waits of a week or longer for results.

   Quest has urged health care providers to cut down on tests from
   low-priority individuals, such as those without symptoms or any contact
   with someone who has tested positive.

   As testing has expanded, so have mask orders and other measures aimed
   at keeping infections down. Ohio, Indiana, Minnesota and Oregon became
   the latest to announce statewide mandatory mask orders on Wednesday.

   The U.S. is testing over 700,000 people per day, up from less than
   100,000 in March. Trump administration officials point out that roughly
   half of U.S. tests are performed on rapid systems that give results in
   about 15 minutes or in hospitals, which typically process tests in
   about 24 hours. But last month, that still left some 9 million tests
   going through laboratories, which have been plagued by limited
   chemicals, machines and kits to develop COVID-19 tests.

   There is no scientific consensus on the rate of testing needed to
   control the virus in the U.S., but experts have recommended for months
   that the U.S. test at least 1 million to 3 million people daily.

   Health experts assembled by the Rockefeller Foundation said last week
   that the U.S. should scale up to testing 30 million Americans per week
   by the fall, when school reopenings and flu season are expected to
   further exacerbate the virus' spread. The group acknowledged that will
   not be possible with the current laboratory-based testing system.

   The National Institutes of Health has set up a "shark tank" competition
   to quickly identify promising rapid tests and has received more than
   600 applications. The goal is to have new testing options in mass
   production by the fall.

   Until then, the backbone of U.S. testing remains at several hundred
   labs with high-capacity machines capable of processing thousands of
   samples per day. Many say they could be processing far more tests if
   not for global shortages of testing chemicals, pipettes and other
   materials.

   Dr. Bobbi Pritt of the Mayo Clinic in Rochester, Minnesota, says the
   hospital's machines are running at just 20% of capacity. Lab
   technicians run seven different COVID-19 testing formats, switching
   back and forth depending on the availability of supplies.

   At Emory University Hospital in Atlanta, lab workers lobby testing
   manufacturers on a weekly basis to provide more kits, chemicals and
   other materials.

   "There's no planning ahead, we just do as many as we can and cross our
   fingers that we'll get more," said Dr. Colleen Kraft, who heads the
   hospital's testing lab.