Covid testing (Kezia Setyawan/The Enterprise)
As Covid cases surge in Malheur County and across the country, the long turnaround time for test results is adding another difficult obstacle in stopping the pandemic.
Delays in receiving test results because labs are overwhelmed, short on supplies and an overall lack of testing are contributing to the “out of control” spread of Covid in Malheur County, said Sarah Poe, Malheur County Health Department director.
“Right now, we're not doing enough testing and know that there's a lot of cases out there we don't know about — meaning that people don't know that they're positive either,” said Poe.
At a July 16 press conference, State Medical Officer Dean Sidelinger said “it's important to be able to receive the results of [a Covid test] ideally in 24 to 48 hours.”
“But what we're seeing with many laboratories, particularly commercial laboratories, that process specimens from multiple states is that the delay in getting results can be a week or more,” said Sidelinger. “This is impacted by shortages in supply chains for chemicals that are used in the lab, as well as the increase in case counts that we're seeing, not just here in Oregon, but across the United States.”
While some long-term care facilities are doing rapid tests “in house,” Poe said, along with local health care providers “that have not previously been testing but are trying to have that capacity” have eased the burden of testing on the department, the need for testing is still great.
“We need more people testing,” said Poe.
Valley Family Health Care is doing testing, said Alicia Morcom, its director of nursing.
The journey of a Covid test begins with a nasal swab to collect potential virus pathogens, which is put into a freezer and later picked up by a lab courier, said Morcom. Three to four days later, test results from the lab are electronically sent to Valley Family. Before the recent surge in Covid cases, test results came back in a little as one day.
“Unfortunately test result turnaround time is out of our control, yet knowing results are delayed indicates there is more community spread, increased need for testing and a need to follow established recommendations to prevent further spread,” said Morcom.
According to Melissa Sutton, Oregon Health Authority senior health advisor, most of the testing doesn’t go through the Oregon State Public Health Laboratory, but is done by private and commercial labs, such as Quest Diagnostics, LabCorp and Interpath Laboratory.
Valley Family, for example, sends its tests to Interpath, according to Morcom.
Sutton said all labs processing Covid tests “for Oregon residents are required to report results to OHA’s database and to local public health.”
The health authority gathers Covid-specific testing data with a system called Opera and the information is then sent to local public health authorities so they can conduct case investigations and contact tracing. The state also shares the data with the federal Centers for Disease Control and Prevention.
While everyone tested at Valley Family is instructed to quarantine until they know their results, Morcom said one implication of the lag in receiving test results is that people may be positive, but without an immediate positive test result, might not follow quarantine instructions. Because of this, people who are tested need to “remain in isolation so the disease is not spread while waiting for results,” she said.
“Even if you feel well and your test results are negative, or if you're still waiting on your test results, it's really important to stay home,” said Rebecca Stricker, Malheur County Health Department nursing supervisor. “I know that it's really difficult sometimes, but it really does help to eliminate the spread of this disease.”
Another significant issue regarding testing, Poe said, is people testing positive for the virus and not staying home the entire two-week quarantine period because they don’t feel symptoms or their symptoms clear up before the quarantine ends.
Poe also said just because someone receives a negative test, the virus can still be in the body and contagious, but just not at the “viral load necessary to register as a positive.”
“A negative test does not get you out of quarantine,” said Poe. “We still have quite a number of false negatives, but it’s very, very rare to have a false positive — that you would actually show this virus but don't have it in your body.”
Because “the supply simply doesn't exist at this point,” Sidelinger said health providers need to prioritize which individuals are tested, focusing on people who are showing symptoms, have been exposed to a confirmed case or live and work in high-risk, congregate settings.
“It's these settings that we want to ensure that individuals who are tested can receive those results in a timely fashion,” said Sidelinger. “They're more likely to be positive.”
The county health department has done testing “multiple times” in long-term care facilities that have had staff members or residents test positive, said Poe.
Valley Family also prioritizes testing for “those with symptoms and valid exposures” due to limited testing capabilities, said Morcom.
The county health department held drive-up testing sites in June and July in Vale, Nyssa and Ontario, and will again hold test sites on Aug. 5 in Ontario, Aug. 12 in Nyssa and Aug. 19 in Vale. Analysis from the August drive-up testing will be done through the State Public Health Laboratory.
To increase testing capacities, Poe said the department is also working with the Public Health Laboratory about how many tests they can send each week that “they would be able to process in a timely manner,” and are asking if they can get a rapid test machine, which would help expedite the testing process by allowing processing in Malheur County.
Despite the issues with Covid testing, Poe said just “a week or two ago,” she was frustrated with the delay in results, but because more local health providers continue to start testing and the health department is reaching out for help from the state, testing woes may turn around.
“We were talking about potentially canceling our August [test] sites, and now we are not only doing them, but there's a chance that we will have really expanded testing,” said Poe.
News tip? Contact reporter Bailey Lewis at [email protected]
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