Two weeks ago, Governor Gavin Newsom announced that help is on the way for those wishing to be tested for coronavirus.
A commercial laboratory called Quest Diagnostics, he said, would process 1,200 tests a day at its facilities in San Juan Capistrano and quickly increase production to 5,500 a day.
“We are increasing our capacity on an hourly basis,” said Newsom.
However, it was not only Newsom and the Californians who counted on Quest’s Capistrano laboratory.
Hospitals, doctors and governments across the country were encouraged by society and federal officials to send COVID-19 tests to this unique laboratory in southern California for treatment.
The deluge of samples caused a bottleneck that delayed the turnaround time for results at a critical time, when doctors struggled to identify those who had been infected, including among their own staff, to contain the spread of the virus.
Delays at the Capistrano laboratory highlight another early failure of the problem-ridden test process: the inability of commercial laboratories to quickly speed up test processing, despite the promises of Newsom and other politicians.
Waiting for test results has reached eight days among emergency medicine specialists in Orange County, where doctors fear the patients may have infected staff members. Without Quest’s timely test results, it is not certain that they should continue to care for patients, said Dr. David Merin, an emergency physician.
“Once they have been exposed, do you just make them overcome the disease?” Asked Merin. “Or withdraw them from work until they have answers?”
Commercial laboratories were seen as a crucial part of the complex and remote testing process. Quest chief executive Stephen Rusckowski was among the health care executives who stood alongside President Trump on March 13 as Trump announced “a new partnership with the private sector to significantly increase and accelerate our ability to test the coronavirus ”.
“We want to make sure that those who need a test can do it in a very safe, fast and convenient way,” said Trump.
But commercial labs struggled to meet expectations, as the already plagued testing process revealed their shortcomings. They and the public and hospital laboratories processing the COVID-19 tests lacked technicians and key chemicals.
And two weeks ago, they even pleaded for more funding after Vice President Mike Pence promised that the tests would be free for all Americans.
“Free tests for COVID-19 have now been promised to the American people,” wrote Julie Khani, president of the American Clinical Laboratory Assn., In a letter to leaders of Congress. “Laboratories should not bear the cost of” free “tests.”
There are signs that the tests are accelerating. Wendy Bost, a spokesperson for Quest, said that the Capistrano laboratory now processes “several thousand” tests a day. “Our employees work tirelessly,” she said.
She said the company also recently made changes that would allow COVID-19 tests to be processed at 11 other Quest labs across the country, reducing dependence on facilities in Southern California. By the end of last week, she said, the company expected its labs to be able to process 30,000 tests a day.
LabCorp, the other large laboratory company, currently processes the tests at only four of its facilities, none in California.
“We are exploring all possibilities of increasing our capacity both in our current testing labs and in our other labs,” a LabCorp spokesperson said on Thursday in an email. He said that the average wait time for the results was four or five days.
Newsom said at a press conference on Wednesday that it had a task force working on increasing testing. According to California data, as of Wednesday afternoon, 77,800 tests had been performed by Quest, LabCorp, Kaiser, Stanford, the University of California and other laboratories.
But the figures show persistent problems: no results were received for 57,400 of these tests.
“It’s one thing to do the diagnostics,” said Newsom. “This is another way to find the word.”
As tens of thousands of patients await their results, officials do not know how far the virus has spread and what efforts are needed to respond to it.
And patients often don’t realize that their samples can be sent hundreds or thousands of miles to be processed.
Douglas County public health officer, Dr. Bob Dannenhoffer, in Oregon, said Thursday that he had not yet received the results of samples taken nine days earlier from a test station behind the wheel of the park. county exhibitions and sent to the Capistrano laboratory in Quest.
“We are on the phone all day with them,” said Dannenhoffer, referring to Quest employees in Capistrano. “They’re trying but they don’t know either” when the results will be sent.
An intensive care nurse from Cedars-Sinai Medical Center in Los Angeles said the results were lagging behind for more than a dozen patients.
“For days and days, we still have no results,” she said. She added that she did not know where the samples had been sent for processing. She hands the test samples to the carriers, she says, where they go in the “black box”.
“The families are getting angry, but at this point there is nothing we can do,” she said.
Even a patient’s test sample that was first sent to a Utah laboratory ended up in the long queue at the Capistrano laboratory in Quest.
Nathaniel Rankin, a 34-year-old disabled man from Portland, Oregon, said his sample was originally sent to ARUP laboratories in Salt Lake City. But the lab, a non-profit organization affiliated with the University of Utah, stopped accepting samples on March 16, four days after it started accepting samples, according to its website. ARUP said it then sent some of the unprocessed samples received to other laboratories.
Rankin tried to isolate himself, but because of his disability, he had to allow home health workers to enter his apartment. Pending the results of his test, he said, his cough and fever got worse, eventually forcing him to go to the emergency room.
Rankin, whose trial was first reported by the Oregonian, finally got his test results on March 25 – 13 days after being tested. The results were negative. Test documentation indicates that the sample was processed at the Capistrano laboratory in Quest, he said.
Bost, spokesperson for Quest, said she did not know if the treatment was taking longer at the San Juan Capistrano laboratory than at its other facilities. She said it now takes an average of four or five days to get the results of a COVID-19 test from a Quest lab. “For some providers, it may take a week,” she said, “for others, it may take a day or two.”
She said that due to the delay, the company prioritizes samples for hospital patients and hospital workers with symptoms.
Times author Jaclyn Cosgrove contributed to this report.