U.S. Covid test system gives way under the weight of Omicron’s push

Almost a year since President Joe Biden took office with a pledge to bring the pandemic under control, the Omicron variant threatens to overwhelm the country’s Covid-19 testing system, causing chaos for those seeking to travel, return to work or school, or visit elderly relatives.

The surge in infections has led to an explosion in demand for rapid antigen testing and more accurate PCR lab tests, with many retailers selling kits and labs struggling to deliver results on time.

In some parts of the country, people queue for hours in freezing conditions to be tested, increasing the risk of the virus spreading. Others have been forced to cancel family reunions, flights, or postpone children’s return to school due to testing issues, prompting growing frustration with the government’s response to the pandemic .

Dr Zeke Emanuel, professor of healthcare management at the University of Pennsylvania and former Covid advisor to Biden, said: “Everyone thought the vaccines were going to solve everything, which meant the administration lost the eyes when it came to testing. “

Calculations by Mara Aspinall, professor of biomedical diagnostics at Arizona State University, suggest that the United States currently has a capacity of 260 million home tests per month, although this is expected to double by March.

Many of these are used by large institutions such as schools and workplaces, making it difficult to find test kits at drugstores or other retailers.

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The White House is finalizing contracts for an additional 500 meters of home testing – enough for two for each adult – although it has not yet specified how long those contracts would take to be delivered.

The United States isn’t the only country with a shortage of home testing as cases skyrocket, fueled by the highly transmissible strain Omicron. The UK, Australia and several parts of Europe are also struggling to provide kits to anyone who wants them.

A White House official said: “The reality is that there is unprecedented demand across the world for Omicron, which is expanding testing capacity for many countries.”

But the situation in the United States is a source of particular frustration for many. Testing was so plentiful over the summer that Abbott, the largest supplier of rapid tests, laid off hundreds of workers and phased out millions of components by that time.

The move came amid the drop in cases and changed U.S. Centers for Disease Control and Prevention guidelines exempting people who had been vaccinated from testing when exposed to the disease.

Aspinall said: “There was optimism around the vaccine, which was well founded, but it led to a response from the administration that was not flexible enough to deal with a rapidly evolving virus.”

Now, US hospitals are asking the public with only minor symptoms to stop flooding emergency rooms looking for tests due to the nationwide shortfall. And some health experts are warning that testing delays spread the virus and could blunt new antiviral treatments for Covid that need to be given in the days following infection.

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“It kind of shook my faith in the testing process,” said Mary Ellen Carafice, who works at a school in Brooklyn and has canceled plans to visit her mother at Christmas due to delays in receiving the. test results.

The week before Christmas, she waited four days to receive the results of a PCR test performed by LabQ Diagnostics – a company warned by New York authorities it could violate “false advertising” laws for not having kept its promise to deliver results within 48 hours.

The delays forced Carafice, who was showing symptoms of Covid-19, and its partner to book another PCR test with an alternative supplier and join the race to locate and purchase rapid antigen tests. She then tested negative, but her partner received a false positive result and Carafice was forced to have Christmas dinner with her elderly mother during a zoom call.

LabQ did not respond to a request for comment, but a recorded phone message indicated that results this week could now take up to five days to be delivered. The wait time to speak to a LabQ operator was over an hour.

Safety concerns over inadequate testing led to the closure of Chicago public schools this week following a vote by teachers’ unions. Some American states have started restrict access to rapid antigenic tests provided by the public to vulnerable age groups due to limited supply. And the CDC has issued controversial guidelines that do not require a person infected with Covid to test negative in order to leave isolation after five days – a move that experts say is driven by a shortage of testing and risk. to confuse the public.

“I only wish the United States had followed the United Kingdom and Germany, where from the onset of the pandemic their governments supported the acceleration of the testing supply chain and indicated that rapid testing were a valuable part of the pandemic response, “said Carri Chan, director of the Columbia Business School health care program.

The U.S. administration’s inconsistent messages about the value of rapid tests made the private sector reluctant to increase production, leaving the country exposed when global demand soared because of Omicron, she added.

Dr Henry Walke, director of the CDC’s Preparedness and Emerging Infections Division, cautioned Friday against using self-administered antigen tests as a means of deciding whether or not to return to work.

“A negative antigen test does not necessarily mean that there is an absence of virus,” he said.

Abbott and other manufacturers of rapid antigen tests are once again increasing their manufacturing capacity, but are battling labor shortages, shipping delays and competition for components amid sharply rising demand. global demand for testing.

“It took a year and a half for the United States to assume the important role of rapid testing. Abroad it was not, ”said an Abbott spokesperson.

“We have always said that tests would be needed, along with vaccines, to keep people in the office, kids in school, events against cancellation, and care facilities safer.”

The largest lab test providers in the United States are also struggling to keep up with demand. Covid tests have increased 130% to a record 2.2 million tests every day since the Omicron variant was identified in late November, according to data from Johns Hopkins University. PCR and other molecular tests alone increased 40% to 1.7 million tests per day. Antigen testing is likely underestimated, with many states not reporting or collecting this data in the context of widespread use of home testing.

Quest Diagnostics said average times for results had dropped from 24 hours to two to three days due to the Omicron push. Other industry participants, who did not want to be named, said some labs were facing labor shortages due to staff absenteeism linked to infections.

Elliot Glotfelty, a student from Baltimore, who stood in line for four hours on Wednesday for a PCR test, told the FT he feared he could catch Covid while in line. Friday evening, he still had not received his result.

“Waiting for long periods of time somewhat defeats the purpose of the testing,” said Glotfelty, who was tested after experiencing symptoms. “My brother and sister teach in a school in the city and sometimes they don’t get results for more than a week, which defeats the purpose of tracing.”

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