Michael spent four hours waiting to be tested for coronavirus at a private lab in Hershey after realizing that the pharmacy, which offers free tests, could not schedule it.
“I help take care of my grandparents, so [it was] it’s important to get tested, “said Michael, who asked to be identified by his father’s name. “[I had a] headache, shortness of breath and some pain. “
After all, Michael received a $ 1
This is the calculation that ordinary Pennsylvanians make, as the growing demand and growing infections of COVID-19 mean they have to wait longer to schedule front-end tests and even longer to get back-end results. .
And the patchwork testing system, which emerged from the first jump this spring, has led to significantly different results depending on where people live, how they are tested and what their economic conditions are.
A Buck County dentist was examined the same day she went down with a fever. A few sick days and a negative result later, she returned to her normal routine. A driver of a Fili truck, exposed to COVID-19 by a family member, waited for hours in a free clinic and is still waiting for the result. His employer will not allow him to return to work without him.
A grandmother from Lancaster shared her plan to ensure that Thanksgiving went smoothly. Her grown children would be welcome, as long as they had a negative result and they all ate in separate rooms. Masks had to be worn except during meals.
But she soon realized that her plan had a potentially fatal flaw: None of them could get quick tests, and by Thursday, most of her family were still waiting for test results taken three, four, five days earlier.
“I have some risk I’m willing to take – but not so much,” she said. “I just raised my hands: Thanksgiving is over. We will eat turkey sandwiches by Christmas. “
Pennsylvania sees no 7- to 10-day delays that hampered COVID-19’s response in the spring and summer as employees went up to provide basic supplies such as nasal swabs and chemical reagents. There are still some concerns in the supply chain, especially if the jump worsens at holiday gatherings, but most labs are better equipped than they were earlier this year.
Marianne Downs, president of the American Society for Clinical Laboratory in Pennsylvania, said many laboratories already have several diagnostic tests. If a hospital encounters a problem with one test – perhaps a delay in the shipment of the chemical reagent on that test – they can quickly return to another test.
Instead, much of the problem now focuses on the need for additional staff to meet demand.
“With the increased demand comes the delays,” she said. “Where you did a few thousand tests the day before, people now demand twice as much.”
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Downs said many facilities have already shifted more lab staff from routine tests to COVID-19 testing. Similarly, many retired technicians were forced into service. But because these technicians get sick, there are limited staff to replace them because of how specialized the skills are.
“You can’t make people appear out of nowhere,” she said. “We don’t have a large number of unemployed people doing laboratory diagnostics.”
There is some movement to train people without medical experience as temporary laboratory technicians working specifically for COVID-19, Downes said, but those efforts have their limits. First, these people need extra supervision if they encounter a floor problem that they are less equipped with. On the other hand, the training of newcomers requires the removal of an existing technician who could process samples outside the laboratory.
“When you train someone, you halve your own productivity,” she said. “You pay two people to do half the work.”
Despite all the challenges, Pennsylvania there is managed to increase its testing capacity.
The Ministry of Health laboratory in Exton, for example, can now process about 1,200 tests a day, up from 750 in the spring. Meanwhile, the total number of daily tests has increased from about 7,000 a day in April to about 58,000 a day now.
However, Pennsylvania currently ranks last (ahead of Puerto Rico) in the country in terms of tests performed on 100,000 residents, according to data from Johns Hopkins University.
Health Ministry spokesman Nate Wardle said the statistics gave a distorted view of the state’s efforts to expand the tests. For example, it excludes multiple coronavirus tests reported for the same person, as well as antigen tests that show whether a person has specific proteins found in the virus.
Similarly, John Hopkins’ ranking reflects testing levels throughout the pandemic, while the largest expansion of testing has occurred in recent months. In the last week alone, the state has seen a 14% increase in tests.
Based on PennLive’s calculations, if repeat and antigen tests are included, Pennsylvania will have a test rate of 41,653 tests per 100,000 inhabitants – which will still place it in the lower 15 states and territories observed by John Hopkins. And this ranking suggests that a change in methodology will only improve the situation in Pennsylvania, not simultaneously raise all states equally.
There is no clear reason why Pennsylvania lags so far behind the rest of the country in the tests, but it is probably a combination of funding constraints, its geography and policy.
Federal funding allocated through the U.S. Department of Health and Human Services to testing and other COVID-19 responses in April was not tied to the public. North Dakota receives the equivalent of $ 6 per capita, compared to a paltry $ 1.95 per capita in Pennsylvania. North Dakota, perhaps to no one’s surprise, currently ranks first in the Hopkins population testing rankings.
Downs also noted that the country’s remote geography is a unique challenge to test. People in more rural areas have limited testing opportunities and these tests may take longer to transport to a processing laboratory. The state has taken steps on this front by partnering with private entities such as Walmart to set up test sites in car parks and pharmacies.
The latter factor is much more difficult to quantify, but public health officials are increasingly talking about the dangers of “pandemic fatigue” and the growing distrust of some residents in mitigation efforts – even among those who are taking initial action. step to test.
This makes it difficult to fulfill mandates designed to limit the spread of the virus, such as Governor Tom Wolff’s order requiring those traveling outside the country to be screened before returning.
Michael Huff, state director of contact testing and tracking, noted that 96 patients with a COVID-positive response, achieved through follow-up contacts in the past week, have refused quarantine.
It is not clear what consequences these people may face for deliberately exposing an unknown number of people to the virus without being quarantined.
“If a person chooses[s] not to be quarantined, we can force them to do so by court order, “Wardle said in a written statement. “However, this is not a step taken by the department. When we work to inform people of the need to take these actions, they will usually do so as part of their collective responsibility to protect Pennsylvania. “
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So far, just over 3 million of the 12.8 million Pennsylvanians have been tested since the outbreak this spring.
Huff said the goal is to ensure that anyone who wants a test can get one, although he noted that the state already gives priority to tests in counties with significant outbreaks – although this is increasingly the case in every county. The department now identifies 63 of the 67 counties as having a significant distribution.
From next month, he said, the department plans to launch a mobile testing program in each county to expand its existing testing capacity.
It is instructive to think of mitigating the coronavirus as a three-legged chair with legs being tested, contact tracking, and public collaboration with camouflage, social distancing, and other guidance. As the first two components become increasingly tense by short staff, public health experts are increasingly urging residents to step up.
On Friday, Allegheni County Health Director Debra Bogen said this in an urgent request for people to take responsibility for limiting the outbreak in their community.
“If cases continue to rise at this rate, modeling predicts that our health care system could be crushed within a month,” Bogen said. “We know it may take two weeks for changes in behavior to affect the spread of the virus and the number of cases to decrease, so please start now.”
Wallace McKelvey can be reached at firstname.lastname@example.org. Follow him on Twitter @wjmckelvey. I find PennLive is on Facebook.
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