Like thousands of people scared about getting COVID-19, a South Florida man, as a precaution, went to a walk-in-clinic in mid-July to get tested. He was told to expect his results in three to five days.
By day 5, he’d heard nothing.
By day 10, relatives who tested with him at the clinic had been notified that they were negative, yet he still had no news.
On day 11, he called the clinic to insist on learning his test result. He was put on hold while staff checked, and then he got the report: His test was positive.
“Why didn’t they call me?” said the man, who asked to be identified only as Adam.
Though he never felt symptoms, he presumes he was infectious and is grateful he routinely wears a face mask in public and practices social distancing at work. He alerted his contacts and, as far as he knows, none contracted the disease from him.
Adam is an acquaintance of State Sen. Lori Berman, a Palm Beach Democrat who referred the Florida Phoenix to Adam after learning how long it took to get his test results.
While health experts say widespread and frequent testing for COVID-19 is essential for controlling the spread of coronavirus, slow results for people across Florida, the nation and the world, can be frustrating, upsetting and often of little use if a COVID-19 infected person doesn’t know he or she has the disease and could potentially infect others.
Health experts say infected people need to know their health status as quickly as possible, not just to manage anxiety but to make decisions that dramatically affect public health overall.
Long, frightening days of waiting
Berman and her family went for testing after Adam contacted them about his condition and their possible exposure to it.
“Ten days is absurd,” Berman said about the slow test results for Adam and his family members. Berman’s family sought out a private lab that returned their test results, which were negative, in three days.
She said those were long, frightening days spent worrying that perhaps her entire family could become sick or worse. She said she thought about how it must feel to have to wait even more than a week.
“This virus is highly transmissible. Testing empowers that person to make the best decisions: for myself and my family,” Tanya Tatum, director of student health services at Florida A&M University in Tallahassee, told the Phoenix.
Tatum runs a state testing site that administers 500 COVID tests per day, six days weekly. Funded and equipped mostly by the state departments of health and emergency management, she said the site has tested more than 27,000 people since it opened on April 25 – free of charge, and all welcome.
(Note: The Bragg Stadium site and all state testing sites closed Thursday night because of the approach of Hurricane Isaias and will reopen when fair weather allows.)
Tatum’s site performs PCR (polymerase chain reaction) diagnostic tests on mucus collected with a nasal swab. Tatum, whose background is immunology and microbiology, said the results are highly reliable and, for now, are coming back within 48 hours.
“We’ve been very, very pleased,” Tatum said. Most of the recent test-takers are coming to get tests required in order to return to work or because they suspect they were exposed to the virus in their line of work, she said.
But many are there simply due to suspected exposure to infected contacts, she said, including families who find that their children are infected.
Over-the-counter, at-home COVID tests coming soon?
Rapid-result antigen tests, similar to rapid strep tests, available at this time are not as reliable as PCR tests, Tatum said, but they can be a useful tool to quickly identify people who may be infectious and should be tested further.
Rapid tests can produce results in a matter of minutes, but further testing is required to confirm a diagnosis, according to the U.S. Food and Drug Administration.
Last week, the FDA issued guidelines to help commercial developers produce at-home COVID-19 tests, and the race is on to create over-the-counter rapid tests the FDA would conditionally approve.
“The recommendations provided today are intended to help get tests to market that are simple enough to use at home, similar to a pregnancy test. We hope that with the innovation we’ve seen in test development, we could see tests that you could buy at a drug store, swab your nose or collect saliva, run the test, and receive results within minutes at home, once these tests become available,” Food and Drugs Commissioner Stephen M. Hahn said in announcing the guidelines.
The FDA notes that the guidelines do not require a level of accuracy equal to tests performed by clinical professionals. But they’re aimed at delivering to the general public a means of frequently testing themselves and their families before entering workplaces, schools, airports and other places where the virus can readily spread.
Along with PCR and antigen tests, labs perform finger-prick blood serology tests to identify the presence of antibodies that show a person was previously infected with coronavirus and recovered.
The FDA says most have not been evaluated for accuracy and their value is debatable because scientists do not yet know if antibodies protect a person from getting infected again. Antibody test results take only a few minutes and do at least add to a community’s body of information by learning who has recovered from the disease.
The Centers for Disease Control and Prevention emphasize that people sick with symptoms of COVID-19 are, for obvious reasons, prioritized for test results over people seeking testing for any other reason.
‘People are getting anxious’
At Florida A&M University, Tatum predicts the demand for testing and the necessity of turnaround time of no more than 48 hours will rise dramatically as workplaces, schools and universities reopen.
For example, she said, Tallahassee is home to three higher-education campuses — Florida A&M, Florida State University, and Tallahassee Community College — representing tens of thousands of young adults who could be carrying unknown infections.
“People are getting anxious as we get closer to more businesses and schools opening,” Tatum said. “In the midst of the pandemic, timely access to information is really important.”
As pressure mounts to reopen workplaces and schools, state Sen. Berman is pushing Gov. Ron DeSantis to adopt an interstate compact combining the purchasing power of Southern states that need lots of tests – not only more tests to cut down on the backlog but also faster tests that trigger contact tracing more quickly.
“In general, contact tracing involves identifying people who have an infectious disease (cases) and people who they came in contact with (contacts) and working with them to interrupt disease spread,” according to the CDC. “This includes asking people with COVID-19 to isolate and their contacts to quarantine at home voluntarily.”
In a letter last week, Berman urged the governor to review a Harvard Global Health Institute report calling for a drastic increase in testing and use of the interstate compacts.
The report, titled “The Path to Zero: Utilizing Interstate Compacts to Unleash Testing Capacity” starts with this introduction:
“Severe testing shortages and processing delays are hampering the COVID-19 response. Here is how to rapidly build the arsenal of timely tests we need to suppress and defeat the coronavirus.”