After dealing with backlogs for weeks, diagnostic testing by private laboratories for COVID-19 has improved and commercial labs can process more than they are receiving, a state health official said Tuesday.
During a state Senate committee on COVID-19 meeting, DOH State Laboratories Administrator Dr. Edward Desmond said the five laboratories across the state that collect and process specimens from Hawaii patients can now turn out results within 24 hours.
In the past, test processing and results could take as long as 10 days or more, because many of the state laboratories depended on mainland partners to conduct the tests and surges in demand have led to national shortages in testing supplies.
Collectively, the Diagnostic Laboratory Services, Clinical Labs Hawaii, Kaiser Permanente, Adventist Health Castle and Tripler Army Medical Center have the ability to conduct 3,000 tests per day now. All five laboratories are federally certified to conduct the tests.
The number of specimens they receive these days has not reached that limit, Desmond said. Together, the laboratories have been producing anywhere from 400 to 1,000 test results per day.
As of Tuesday, 28,577 people have been tested. Of the 609 people in Hawaii verified to be infected with the virus, 505 of them have recovered and been released from isolation. The department is currently monitoring about 100 active cases.
Before the virus was documented to have taken hold in the islands, Desmond said the State Laboratories Division facility had the ability to conduct 250 tests and as many as 500 if needed in an emergency. That was before private laboratories were testing for the virus. It wasn’t until Feb. 29 that the FDA approved private laboratory testing.
Today, the state laboratory operates as a reference laboratory to check commercial laboratory results, maintain testing capacity reserves and conduct rapid testing for certain essential workers such as health professionals.
The improved diagnostics are because the laboratories have found stable supply chains for testing items such as chemical reagents and swabs, Desmond said. Local laboratories are not leaning on their mainland counterparts as much anymore, which caused delays in getting results in the past.
“This is much better than what the capacity locally once was,” Desmond told senators. “We’re trying to avoid anything from going to the mainland at all.”
The same Senate committee was told last month that the private commercial laboratories were experiencing shortages of certain supplies.
Mark Wasielewski, president of Diagnostic Laboratory Services, told Civil Beat by email that 100% of test orders are now completed locally. The laboratory, which is affiliated with The Queen’s Health Systems, has not sent tests to the mainland for processing since April 14, he said.
When it began testing in early March, DLS was able to perform only 40 tests per day. When supplies increased, it was able to conduct 188 per day.
Today, with stable resupply the capacity is 550 tests per day, with a turnaround time of 24 to 48 hours, according to Wasielewski.
“DLS has an inventory of 10,000 tests, so DLS can also meet short-term surges in demand,” he said. “DLS’ capacity increased as the testing manufacturers’ production increased.”
Only those who are showing symptoms meet the criteria to be tested, according to Desmond.
Laboratories are supposed to be testing only symptomatic people, according to DOH and federal guidelines from the CDC.
“It’s a limited resource — we have to keep the ability to test up to 3,000 per day, but that’s not for everyone,” he said.
Those criteria exist also because of the realities of what tests can tell us, he added.
“One of the things that I don’t think everyone realizes is if you become infected with SARS-CoV-2, the virus that causes COVID-19, you enter first a latency period, or incubation period, where no test will give you a positive result,” he said. “Someone who is asymptomatic may want to be tested and feel comforted that their test was negative, but that would be misleading.”
Whether or not those criteria are being followed is unclear, senators said Tuesday.
“The guidelines at this point don’t seem to be working for consistency,” said Sen. Donovan Dela Cruz.
Community leaders have increasingly called for ramping up testing as a key component of reopening the economy.
Last week, Mayor Kirk Caldwell announced plans to spend $2 million on 10,000 test kits from Texas-based Everlywell and to expand testing on Oahu in an effort to reopen businesses and resume social activities, but those plans are now on hold after DOH raised concerns about federal approval and test reliability.
Nationally, limited supplies and errors in the development of U.S. diagnostic tests have delayed and hampered the nation’s ability to track COVID-19 via testing.
Antibody tests, which hold some potential to distinguish one’s immunity to the virus, are still in development and many are not yet approved by the FDA.
The health department is currently developing a plan for surveillance testing that goes beyond its current practice of testing random specimens that tested negative for influenza.
Desmond said the state can expect to see a testing of samples that are “representative of the community,” or a “snapshot of the state.”
“As we gradually end shutdown requirements and open up the economy and the communities again, I think that we’re going to see new cases,” he said. “The sentinel surveillance will see what communities are infected so the contact tracing can be done and testing can be focused. There could be follow up testing depending on what we find.”
But DOH declined to say how many people would be tested or offer any details on the plan. DOH spokeswoman Janice Okubo said Tuesday it was premature to comment.
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