By Elizabeth Rosenthal
Desperate to continue the tradition of a family beach week, I hatched a plan that would allow some mask- and sanitizer-enhanced semblance of normality.
We hadn’t seen my two 20-something children in months. They’d spent the lockdown in Brooklyn; one of them most likely had the disease in late March, before testing was widely available. My mother had died of COVID-19 in May.
So a few weeks ago, I rented a cute house on the Delaware shore. It had a screened-in front porch and a little cottage out back, in case someone needed to quarantine.
I asked my son, who had participated in several protests and had been at a small outdoor July Fourth gathering, to get tested before he came. Testing had been recommended by the governor and the mayor, and many centers were offering an anticipated 48-hour turnaround.
He got one and downloaded the app for results. And waited. And waited. And waited. For 12 days.
Coronavirus testing in the United States has been bungled in every way imaginable. The latest fiasco is perhaps the most Kafkaesque: Tests are now widely available in many places, but results are often taking so long to come back that it is more or less pointless to get tested.
If it takes up to two weeks to get results, we can’t detect brewing outbreaks and respond with targeted shutdowns. We can’t do meaningful contact tracing. We can’t expect people to stay home from work or school for two weeks while they wait for the result of a screen. We have no way to render early treatment and attention to those who test positive, to try to prevent serious illness. It’s a disaster.
Many doctors can do a rapid strep test in half an hour, and the “slow” test takes a day. Imagine if it took 12 days before doctors knew whether to prescribe an antibiotic. You’d end up with more cases of meningitis, pneumonia and rheumatic fever. Strep could spread through families and schools like wildfire.
One canon of medical practice is that you order a test only if you can act on the result. And with a turnaround time of a week or two, you cannot. What we have now is often not testing — it’s testing theater.
For months the hue and cry was about testing not being more widely available. Even many sick people couldn’t get one. The first tests proved faulty. Then good ones were not distributed to the hot spots. Then there were not enough swabs, personal protective equipment or ingredients like reagents needed to administer the tests.
After all these missteps, the political pressure to provide widespread free testing was enormous. And with little help from the White House, many states turned somersaults and delivered. Voilà!
But there was far less pressure to make sure that labs receiving the swabs had the capacity to process all those collected specimens.
Now, in cities like New York and Washington and Los Angeles, there are dozens if not hundreds of clinics where anyone who wants a test can walk in and get the famous stick up your nose or some variant. Though the simple tests are by law “free” to patients, the clinics bill insurers (or the government) hefty fees — sometimes hundreds of dollars — for administering them. This gives clinics the incentive to throw open the doors and do as many tests as possible.
Some hospitals, clinics and cities that run the specimens themselves or outsource to an array of different labs can deliver results in a timely fashion. State labs in Texas, which is experiencing a major outbreak, say their turnaround time is two to three days. But many results take far longer.
LabCorp and Quest, the two biggest commercial labs, have both acknowledged sometimes long delays in processing the vastly increased volume of tests. Governors are furious. Gov. Jared Polis of Colorado said that the nine days it sometimes took to get a result from these companies rendered them “almost useless.”
A coronavirus test is not really a test if the result is too late to act on. So labs need to ramp up capacity, as they’ve vowed to do. More important, all those centers offering free testing need to take responsibility for delivering results within 48 or, maybe, 72 hours. That means contracting with labs that can guarantee turnaround.
“Anyone who wants a test can get one” is a nice-sounding political promise, but it’s not helping anyone. Sick people need to know if they’re sick with the coronavirus. Those who have been seriously exposed need to know if they got it. And others will need tests to be cleared for work, school or a family visit with vulnerable relatives.
This is how the coronavirus played out in my family’s vacation: While my son arrived on schedule, his test results did not. So he was consigned to the quarantine cottage. He wore a mask in the house and the car. We ate outdoors and he sat at the far end of a picnic table. We even squirted the ketchup on his burger for him, so that he wouldn’t have to touch the bottle. Each morning we checked the app, hoping for deliverance. It never came.
Finally, 12 days after my son’s last potential exposure at the Independence Day picnic, I agreed he could take off the mask. He had no symptoms and at that point he was most likely no longer contagious, either way. We hugged and enjoyed our last two days of vacation. Then he returned to New York.
The next morning, I got his text: “Test came back negative!”
Elisabeth Rosenthal, editor in chief of Kaiser Health News, was an emergency room physician before becoming a New York Times correspondent. She is the author of “An American Sickness: How Healthcare Became Big Business and How You Can Take It Back.”
I took a test on Thursday July 23rd at the Flagler Pharmacy in Flagler Beach. I was told test results would take 7-10 days. I was impressed with how professional the whole process was administered. I received my results on Saturday July 25th. Two short days from when I took the test. My test results were negative.
Reinhold Schlieper says
Germany is testing people for COVID19 at airports as those folks try to enter the country. Results are back soon enough to make solid decisions; I understand that the wait is a matter of hours, not days. Such tests are available. Why not here? Is that too hefty a bill to pay for our Trumpublican administration because they had to pay off all the obscenely rich people with a tax cut?
Willy Boy says
Interesting interview with Bill Gates yesterday on CNBC where he said pretty much the same thing. If the results aren’t back in 48 hrs, it was virtually useless. Maybe all this false negative, false positive test will help the scientists in the future, but right now it appears to be huge waste of money.
Tom Brown, Port Orange, FL. says
Thanks for exposing this farce that’s making billions for the labs but not protecting public health.
Stale test results are like that. If you can’t get an immediate result the very next place you go is an exposure risk that is every bit as high as where you were tested. Add that “asymptomatic” results even the 5 out of 6 that are positives, really false positives and you have to really have to be skeptical of any test kit developed to date. It becomes a healthcare scam to be tested. The Orlando lab that had a 98% positivity rate that they walk back to 9-10% positivity indicates that almost a perfect 10 of 10 positivity rate that 1 out of 10 is an actual new Coronavirus case. Is it an asymptomatic new case or is it a blatantly obvious positive ? A blatant & obvious Coronavirus case, so obvious that no test was really required to determine that ? One that would really have to be showing the symptoms and a confirmation to proceed with a treatment plan to cover their arses ? Coronavirus is the ultimate scam in that regard. They know next to nothing about it, it’s virtually unauditable and is there even such a thing/concept as malpractice for a pandemic for the Mutawba(Wuhan) virus ?
I heard the same thing from a dear friend in Canada. They get their test results back in 4 hours or less. The US “was” the greatest country on the planet. Why can’t we get anything right to save the pain and suffering and death from this virus? This administration from the white house on down to the state house and the county commission has been a complete failure!
Carol L Pagliuca says
And this is why I don’t follow the numbers that the media, government and Fauci are throwing at us. The numbers are not accurate at all!
Concerned friend says
A person that I know was tested 2 weeks and 1 day ago. NO RESULTS. Her employer requested she have it redone and possibly ask for a faster test. She has had to quarantine, 10 of those days being sick, before she is eligible for disability pay from work. 2 weeks of useless, agonizing, frustrating waiting. It’s shameful.
Taking a sample is NOT A TEST.
A TEST include several steps.
TEST result=Taking sample + laboratory evaluation + delivery of the lab result.
Why are in the media are not smart enough to see this equation?
Am I stupid?