Free CORONAVIRUS OUTBREAK

State officials are expecting more materials for testing to arrive in Oregon by mid-week, after the supply of kits dwindled to 130 Monday.

Dr. Dean Sidelinger, state public health officer, addresses the media last week during a tour of the Oregon Health Authority’s operation center . (Jonathan House/Pamplin Media Group)

The Oregon Health Authority will run out of coronavirus tests by Wednesday without an infusion of kits from the federal government, officials acknowledged in response to questions from The Oregonian/OregonLive.

The state lab had just 130 tests remaining as of Monday night, according to an agency spokesman. That translates to about 65 people, given that it takes about two tests per person to diagnose the disease.

State officials say they are confident more enzymes – a critical component of the tests – will arrive from the Centers for Disease Control and Prevention on Tuesday and Wednesday.

If and when that happens, state officials say they will have the capacity to test about 4,800 people.

“I have a high level of confidence these tests will arrive,” said Dr. Dean Sidelinger, state health officer and epidemiologist.

State officials say they can pursue contingency plans, such as commercial or out-of-state labs, if needed.

The glaring reality of Oregon’s dwindling testing capacity only became clear Monday night after state officials for days had declined to answer how many tests remained. The state originally received 1,500 tests from the federal government but those supplies have not gone far.

It remains unclear exactly how the state used up so many tests, or the underlying testing components, so quickly.

The state has tested only 179 people for COVID-19, with 14 of those confirmed or presumed to have the disease. An additional 52 people have submitted specimens to the state lab and are awaiting results.

But what is clear is that Oregon’s strained testing capacity has kept the number of cases artificially low. Health officials have readily conceded that there are an unknown number of people in Oregon who have the disease but their mild symptoms don’t warrant testing from the stockpile of limited supplies.

“In addition to these 14 cases,” Sidelinger said, “there are likely many other cases in the state of Oregon that we haven’t identified.”

State officials across America have been eagerly awaiting more testing supplies from the CDC as the coronavirus spreads. There are now more than 660 confirmed or presumptive cases nationwide, with Oregon recording the seventh-highest total, according to a database compiled by The New York Times.

Oregon officials identified their first case Feb. 28 and later insisted “supplies are on hand to perform approximately 1,500 tests.” But when the CDC loosened guidance March 4 about who could be tested, a top Oregon public health administrator told lawmakers that the state “did not have that capacity.”

The Oregonian/OregonLive has been asking for days how many tests remain. Pressed for an answer during a news conference with reporters Monday, Sidelinger said: “I don’t have the answer for how many tests we have on hand. But we anticipate receiving additional supplies in the next couple of days.”

Three hours later, an Oregon Health Authority spokesman said the agency had only 130 tests remaining.

“We’re covered for today and tomorrow,” Jonathan Modie said in an emailed response to written questions.

Details of the state’s testing supply were not immediately available. Each person who is checked for the coronavirus uses at least two tests, officials said, but some tests – or components from the tests – may have been given to hospitals and others to develop their own capacity.

The state could not say how many tests had been used to date.

“I don’t have the specific number of how many specimens were tested; multiple samples can be collected from one person,” Modie wrote.

State officials also could not say how many tests they requested from the CDC. But the enzymes that are supposed to come this week should dramatically increase the testing capacity at the state lab.

“With what we’ve been told we’ll receive this week, we’ll be able to test about 4,800 people,” Modie wrote.

If a contingency plan is needed because testing supplies don’t arrive, the Oregon Health Authority said it could seek help from commercial labs or neighboring states.

The state said it could refer clinicians to LabCorp or Quest Diagnostics, two commercial enterprises now offering tests. Testing by the University of Washington could also be another option, although officials conceded that other states may already have a place in line.

The state is also working with local hospitals that hope to soon begin testing in Oregon. Officials are aware of four hospital systems that are looking to develop their own tests or lab capacity.

That could happen this week or next.

“We don’t formally approve them but support them with supplies that help validate tests,” Modie wrote. “We’ll be confirming their first 10 tests.”

It remains unclear how many people in Oregon might have coronavirus but don’t meet the state’s strict testing criteria – so far limited to people who have COVID-19 symptoms and have traveled to known hot spots or had contact with a known case, as well as people who have such a severe respiratory illness that they need to be hospitalized but they test negative for influenza.

That uncertainty is growing in part because of a lack of transparency by the state.

Oregon health officials use a database to track people in various categories of risk, including people who don’t qualify for testing but have some symptoms and have spent time in the same environment as a known case yet not in close contact.

The Oregonian/OregonLive requested that information but officials have declined to provide it. A formal public records request is now pending.

“We are not releasing those data because they are not considered cases,” the state said.

Health officials acknowledged the true number of coronavirus cases will only become clearer in the weeks ahead.

“We expect more testing to come on line in the days and weeks ahead, so we expect for more cases to be confirmed,” said Dr. Jennifer Vines, the health officer for the Portland metro area.

“This information will start to tell us truly how widespread the virus is,” she added, “and what the picture is.”

(Fedor Zarkhin of The Oregonian/OregonLive contributed to this report.)

(Republished with permission)