Everyone that wants to get tested for COVID-19 will not be able to get a test.

That's because a continued shortage of COVID-19 testing supplies has prompted Michigan health officials to further prioritize and limit who will get tested for the virus. Last week, the Michigan Department of Health and Human Services (MDHHS) sent a memo to all labs expanding who gets priority for COVID-19 testing.

State health officials, and southeast Michigan's two largest health systems, are reporting adequate supplies to test these prioritized populations, such as health care workers, first responders, and symptomatic patients. But they also report competing with labs and hospitals across the country for a very scarce supply of reagents, the chemical that mixes with the person's nasal swab to yield a positive or negative result.

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Dr. Barbara Ducatman, chief of pathology and laboratory medicine for Beaumont Health, said the state's largest health system is testing 300 to 500 people per day, mostly symptomatic patients. The system uses Luminex and Cepheid brand rapid-testing kits.

She said capacity could be dramatically expanded if the health system can get more reagents. Because it has a limit on how many tests can be processed by in-house labs, Beaumont has started sending its curbside testing samples and referral patient work to Warde Reference Laboratory.

"We are trying to get kits in as often as our vendors can ship them to us," she said. "We are limited in our testing capacity because of shortages. ... Every day is a new challenge in getting sufficient reagents to meet the demand. Although new methods and instruments are being approved, the critical shortage is that of reagents."

She added that until more reagents are manufactured, shipped, and received, the eight-hospital system will not be able to offer COVID-19 testing services to people currently not being tested.

As of Friday, 22,783 residents had been confirmed positive for coronavirus while 1,279 have died from the illness. From March 16 through April 8, a total of 72,741 Michiganders were tested for coronavirus. Of that total, 47,898 tested negative while 24,843 tested positive.

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According to the state's memo, the following groups of people will receive testing priority and are eligible for testing by health care providers in Michigan:

Hospitalized patients

Healthcare facility workers with symptoms

Patients in long-term care facilities with symptoms

Patients over age 65 years with symptoms

Patients with underlying conditions with symptoms

First responders with symptoms

As resources allow, the following individuals have also been cleared for COVID-19 testing:

Critical infrastructure workers with symptoms

Individuals who do not meet any of the above categories with symptoms

Health care workers and first responders

Individuals with mild symptoms in communities experiencing high COVID-19 hospitalizations

The state Bureau of Laboratories is reporting enough in-house test kits to perform 300 to 400 tests per day or 2,800 tests per week. The state plans to increase its testing capacity to 4,000 tests per week when ThermoFisher kits are approved.

Lynn Sutfin, a health department spokesperson, said testing capacity is dependent on the number of reagents available, but also the amount of specimen collection supplies, which have also been in short supply and high demand at labs across the state.

"The availability of reagents is one of the biggest issues that limits testing across the country," she said.

Henry Ford Health System, southeast Michigan's second-largest health system, is reporting an adequate supply of reagents, but only to test priority groups.

Dr. Betty Chu, associate chief clinical officer and chief quality officer, said the reagent supply has limited testing that the health system.

"The supply of reagents and the swabs have been the things that we've been keeping a very close eye on, but fortunately we've been able to keep up," she said. "Right now, our testing strategy continues to focus on certain populations of people. Everyone needs to be screened for symptoms first before they can come through our drive-thru testing site."

The health system has processed 10,000 tests since March 16 with most results back in less than 12 hours, according to Dr. Richard Zarbo, chair of pathology and laboratory medicine. This includes testing of hospitalized patients, emergency room patients, outpatients, employees, Detroit's first responders and patients awaiting discharge to skilled nursing facilities.

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