Coronavirus testing: Shortages, delays, and drive-through improvising in Philly area and beyond

The coronavirus is taking ever deeper roots in the Philadelphia region and across the country, and much of that spread, experts say, is due to shortages that have forced health officials to ration testing.

But the problems go deeper than a lack of test kits. Potentially infected patients are supposed to start the process of getting tested with their health-care provider, but many family physicians and urgent care clinics report not having the protective gear or the protocols needed to safely and correctly swab patients’ noses and throats, then ship the specimens to labs.

After weeks of panicking consumers’ snapping up face masks, some providers say they don’t have the N95 masks they should wear to collect potentially virus-laden secretions.

» READ MORE: At the Pennsylvania Department of Health, 138 tests for a state of 13-million people.

President Donald Trump on Friday declared a national emergency and pledged $50 billion to deal with the epidemic, which first surfaced in the United States in January. Once focused more on assuring the public that things weren’t so bad, White House staffers met Friday with representatives from Target, Walmart, CVS, and Walgreens, plus commercial labs and public health agencies, to talk about expanding testing, the Washington Post reported.

But health systems don’t have time to wait for the funds and supplies to flow. Many have started to fill the voids created by a slow federal response.

For example, ChristianaCare, Delaware’s largest health-care system, on Friday became the first “drive-through” coronavirus swab collection site in the region. More than 50 cars lined up along the riverfront in Wilmington for the 10 a.m. start. After a few hours, samples for 536 coronavirus tests had been collected at no charge. Results will be available in two to five days.

Patients sitting in cars had to have symptoms such as fever and cough, but they did not have to meet any other criteria to give samples to nurses in protective gear. In contrast, until this week, the U.S. Centers for Disease Control and Prevention, along with state public health labs, restricted tests to people with coronavirus exposure through travel or contact with a confirmed case. Patients and physicians in Pennsylvania and across the country reported being denied tests even after the CDC loosened up guidelines.

Abington Hospital-Jefferson Health on Thursday opened a temporary, largely isolated facility designed to collect samples from patients with symptoms consistent with coronavirus, without accidentally exposing workers or hospital patients. The facility has separate parking and next-door access to the lab that will package and ship the specimens to LabCorp, one of three companies that this week began commercial testing.

On the first two days, more than 30 patients from the health system’s 450 affiliated practices were swabbed, said Gerard Cleary, Abington’s chief medical officer.

Besides LabCorp, Quest and Roche this week began offering coronavirus testing services that doctors and hospitals can use without permission from the CDC or public health labs.

But the U.S. is a long way from the kind of testing on demand that places like South Korea have been offering to stop the spread of the virus. The problem with waiting for symptoms to test is that people can harbor and shed the virus, yet have no symptoms.

For now, companies like Roche are focusing on hot spots. “In thoughtful collaboration with the CDC, we have aligned our current U.S. approach of targeting our limited supply to large, national reference labs, as well as limited deployment to regional hospitals in the most highly impacted areas," a company spokesperson said in an email Friday.

Jefferson Health, with an academic medical center in Philadelphia, expects to begin using the Roche service — but not for several weeks, Cleary said.