Coronavirus test result lag complicates response

Medical personnel work inside a tent set up in the back lot of Legacy Community Health on N. Eleventh Street in Beaumont offering COVID-19 testing after screening and also doing flu testing. The clinic is the first private screening unit set up in Jefferson County. Photo taken Wednesday, March 18, 2020 Kim Brent/The Enterprise less Medical personnel work inside a tent set up in the back lot of Legacy Community Health on N. Eleventh Street in Beaumont offering COVID-19 testing after screening and also doing flu testing. The clinic is the ... more Photo: Kim Brent / Kim Brent/The Enterprise Photo: Kim Brent / Kim Brent/The Enterprise Image 1 of / 1 Caption Close Coronavirus test result lag complicates response 1 / 1 Back to Gallery

As positive cases of COVID-19 continue to rise in Southeast Texas, complications with supplies and an influx of demand have frustrated public health officials and clinics, some of which face a wait as long as 14 days for test results.

Legacy Community Health on March 18 was one of the first private clinics in Beaumont to create a mobile testing center in its parking lot and had been collecting test samples in the 11th Street clinic since at least two days prior.

Rachel Adams, a nurse practitioner and site lead at Legacy’s Beaumont clinic, said results, tested by an out-of-state lab, initially were coming in within at least four days, but now the company advised Legacy to expect up to a 14-day wait.

“Every testing site around the city is sending to the same private labs and some are taking longer than others,” she said. “They do have a backlog of tests and it has been growing as more people are getting tested everywhere.”

System-wide, Adams said Legacy has tested more than 1,000 patients in its clinics from Houston to Beaumont and around 150 in Southeast Texas. She said the demand has slightly decreased as the CDC amended its criteria for testing to include people in immunosuppressive categories such as the elderly or someone with a severe chronic condition.

The county’s own mobile sample collection point has also helped take some of the pressure off clinics such as Legacy.

Jefferson County already has gotten back results from test kits gathered Tuesday — the first day its drive-thru clinic at the Jack Brooks Regional Airport in Nederland was open.

Jefferson County Judge Jeff Branick said the test kits are taken to George Bush Intercontinental Airport, from which they are flown to a testing center in New Jersey that has capacity to test some 40,000 kits a day.

As manufacturers of tests ramped up their production at the beginning of March and more private and public health providers joined the push for distributing the sample collection kits, supplies at Legacy have stabilized, but just submitting a test doesn’t help a care provider aid a patient.

Jessica Michan, communication director for Legacy, said the long wait for results decreases the value of testing for a patient, at least from a clinical standpoint, and may mean the patient must rely on a physician’s advice to know how to react to symptoms.

“If we aren’t getting results back until well after the recommended quarantine period, it may not make sense for people looking for answers,” she said. “At that point, it’s just helping to keep track of numbers.”

Adams said testing can still be an important option for people among the high-risk categories of infection, but any patients feeling severe symptoms such as problems breathing should probably be seen by their doctor or even seek treatment at a hospital if their issues worsen.

Legacy isn’t the only area clinic balancing the demand for testing and the reality of long backlogs.

The Ibn Sina Foundation, a nonprofit that runs community clinics in Houston and Port Arthur geared toward the insured and uninsured alike, has been testing more than a dozen samples a day at their internal labs in Houston but haven’t been collecting samples in Port Arthur despite having around 15 testing kits at the site.

Liaquat Khowaja, general manager with Ibn Sina Foundation, said the Port Arthur clinic has adapted to telehealth appointments to keep serving patients during social distancing but is holding off on collecting samples because of a lack of resources and lab space.

“Right now, we are trying to secure rapid test kits and are waiting for them to be approved by the (U.S. Federal Drug Administration),” he said. “When that happens, we could have them here within a week and start getting results in 45 minutes instead of days.”

Port Arthur Mayor Thurman Bill Bartie said the city’s public health department is responsible for conducting the epidemiological investigation for all cases in the southern part of the county, including Groves, Nederland, Port Neches and Port Arthur. The county’s health department also is running the drive-thru testing area in Nederland.

The FDA gave emergency authorization to a rapid molecule blood test developed by California-based Cepheid last week, but its use so far has been approved only in hospitals and emergency rooms.

Other rapid tests used across the globe have received scrutiny after Spain announced Thursday that it would be returning a large stock of faulty tests to a Chinese manufacturer. Sources told Spanish newspaper El País that tests from a company called Bioeasy recorded accurate results only about 30% of the time.

Dr. Stephen Spann, founding dean of the University of Houston College of Medicine, said most doctors probably would like to hold out hope for a quicker way to test for positive COVID-19 cases, but a false negative — a person with the virus who has been told they are clear after a failed test — is a hefty risk to bear.

Until more resources or improved technology becomes available, Spann said the medical community will likely be split between those who think testing is useless without results a patient can quickly access and physicians who believe the process is too vital for public health to ignore.

“Some people are saying it’s out there in the community and we can diagnose it clinically with experience, so why wait for a test that may take forever,” he said. “The other line of thought is if we are going to get our hands around this as a public health crisis, we need to get the data from the test and quarantine the person.”

In an ideal world, he said, physicians would have enough resources to make calls for their patients while also helping further the public health response, but reality is still far from the ideal.

In Beaumont, the city’s public health department has been receiving results for both positive and negative tests conducted on residents and following up with investigations. Instead of conducting the tests themselves, the department is deferring to the county and private collection centers and focusing on making sure positive patients quarantine while it tracks their possible contacts with others.

When testing first started in earnest, Public Health Director Sherry Ulmer said results came back within 24 hours, but now demand has backed up some results to eight days out, further extending the department’s timeline to track possible contacts with the infected.

Ulmer said testing is vital to collecting data on the crisis and helping to prevent further spread of the virus. That’s why she said adhering to the CDC’s guidelines for testing and staunching the demand on labs across the country is the only way at the moment to protect those most vulnerable to infection.

“We want the public to understand that even with a mild case of COVID, they are infectious and need to stay home,” she said. “Sometimes they can recover without being tested or will be treated at the hospital if it becomes severe enough. We just really need the tests available for patients that are symptomatic in the 65 or older age category or with a compromised immune system.”

jacob.dick@beaumontenterprise.com

twitter.com/jdickjournalism