Virginia Struggles With Testing: ‘There’s Not Nearly Enough Supply’

A Covid-19 testing site at a local community center in downtown Richmond. About 150 of the 200 available tests were used at this site Tuesday. (Courthouse News photo / Brad Kutner)

RICHMOND, Va. (CN) — When asked about the coronavirus in the health care facility where he works, Tim Wellington remembers one story in particular: When one family came in, member by member, and each passed away in the course of a few weeks.

“This disease is a family killer,” said Wellington, a pseudonym used because they feared reprisal. “One person will be symptomatic before the others.”

“If they had had access to testing, who knows what could have happened,” he added.

Testing in Virginia has long been the Achilles heel for the state. While the total number of deaths and infections is nowhere near as high as some others, outbreaks, especially in assisted living and low income communities, have become a staple.

And testing continues to leave a black mark on Democratic Governor Ralph Northam, the nation’s only medical doctor in an executive chair, as the state hovers in the bottom 10 nationwide for testing.

Northam live streams press conferences three times a week, and he’s used these opportunities to communicate with the public about his preference for a “data driven” approach to addressing the virus and slowly reopening the state. Among those early benchmarks for reopening was 10,000 tests a day.

But numbers from the Virginia Department of Health show the state is nowhere near that — Wednesday, the most recent day with numbers available, had only about 4,500 tests reported — despite many areas being allowed to reopen last Friday.

“The number of tests we’re performing depends on the day,” Northam said at Monday’s briefing. “We’re ramping testing up specifically in areas that have at-risk areas.”

The increased testing in higher risk areas did happen. Tuesday morning, according to Delegate Danica Roem (D-13), there was a seemingly endless line of cars queued up at a local high school turned testing facility near her District.

“The line was so long I didn’t even attempt to go onto the campus,” she said. Her district lies in the western parts of the D.C. suburbs. Often referred to as Northern Virginia, her region as well as the counties to the east often make up the lion’s share of positive cases as test results come in the highly populated and racially and economically diverse area.

While the state struggles to catch up to testing demand, she said she was glad to see the testing sites open that day, as well as the free price tag.

“[There’s a] huge amount of demand for free testing and there’s not nearly enough supply and frankly what we have now should have been in place two months ago,” said Roem.

Dr. Amy Mathers, an infectious disease physician at the University of Virginia Medical Center, is also championing testing in areas like Roem’s. As a member of Northam’s Testing Advisory Board, she’s had some insight into what’s gone wrong and right — though mostly wrong — with the state’s testing system.

She said her hospital took in the first Covid-19 tests on March 10, but they were working with commercial labs at the time. Her team developed their own test — a complex process involving FDA and CDC approval — and they began testing on their own by the end of the month.

But even that wasn’t enough. Mathers said their testing system relied on a machine purchased by Cepheid, a California-based testing company, which was able to test up to 1,000 kits a day. But the resources they were allocated by the company — swabs, chemical agents and the like — was enough for only 150 tests a day.

“A lot of labs and hospitals happen to rely on the Cepheid kits and those have been especially hard to obtain,” Mathers said. “Other states have more supplies cause they’re using a different commercial platform.”

In an emailed statement, a Cepheid spokesperson said they were unable to disclose customer locations but “Virginia has actually received a significant number of tests.” They also stressed the company was working to produce more testing resources to meet the rapidly growing need.

Mathers also said she was told the bottleneck in supplies was coming from above; it was the federal government who was giving guidance to Cepheid as to where they allocate resources.

“There is some kind of government allocation decisions that are made,” she said. “The federal government is giving guidance to the diagnostic companies on where to send tests.”

Both the CDC and FDA told Reuters there were no testing roadblocks coming from their agencies in a story published in early April. Attempts by Courthouse News to contact both agencies about this issue were not returned by press time.

In their emailed statement, Cepheid did not clarify if a federal agency had a role in their distribution of resources.

Killeen King, a spokesperson with the Virginia Department of General Services which helps acquire testing supplies for the state Department of Health, said Mathers was spot on about testing supplies being the root of the testing issue.

“If you can’t obtain testing supplies, you can’t perform testing,” she said. “This is an ever-changing situation. Some weeks we have no problem obtaining the necessary reagents and other weeks there are shortages.”

King said tests involve multiple different components, reagents, controls and plasticware to function and if any one part gets low, it bogs the entire system down.

She also said the federal government has played a role in supplying testing equipment, with Health and Human Services and FEMA buying items in bulk and “allocating these to each state at no cost to the state.”

“Depending on availability, we may get everything we order,” she said. “If supplies are limited, they may reduce our order and ship less.”

While the broader testing system is facing shortages across the state, there’s also problems with testing itself.

Jill Shell, a pseudonym used to protect their privacy, had spent the weekend with some friends just before Northam issued the lockdown in late March. And she soon found out those friends had recently spent time with people who had tested positive for the coronavirus back in New York. Already living with asthma, she started to experience breathing problems and went to the hospital to get tested.

She went to Richmond’s VCU Medical Center Critical Care Hospital and was asked about exposure in a series of questions before being separated into one of two groups – those with respiratory or without respiratory problems. She was tested for the flu, had to wait for those results to come back negative, and then was tested for Covid-19.

She was sent home with printed instructions on how to self-isolate and was told she’d hear her results in 7-10 days. While she spent the next 3 weeks quarantining herself just in case — including having her neighbors go grocery shopping for her — she eventually recovered, but never got her test results back — until early May.

“I was positive… I was flabbergasted,” Shell said about the month and a half it took for her to get results. “I figured I’d never hear back (because I was negative) but then I get a handwritten note in the mail. It was crazy.”

Mathers let out a gasp when she heard about Shell’s late notice.

“There’s a lot of concerns when trying to do things really fast and outside of normal processes,” she said. “I haven’t heard of that scenario, but I’ve heard of things that match it.”

“Testing is one thing,” she said, but all the steps involved — collecting, tracking, testing — can be a lot, and the state is dealing with a lot of tests at once.

“There’s a lot of work that needs to be done to test 10,000 people,” she said.

Still, Mathers is trying to stay optimistic. When Courthouse News first spoke to her Tuesday, she was emailing with the FDA to get approval of a new swab system her lab had produced. In a phone call on Friday, she said the swabs were on their way to being approved, produced in the US and could start being seen in testing sites around the state as early as June 1.

“We’ll be able to offer swabs to the state and additional testing capacity to the state,” she said. “And we’ll be that much closer to the 10,000 test benchmark.”

Meanwhile Wellington, still on the job, is optimistic as well. He said his coworkers, at first terrified of the virus, have since gotten more acclimated and are now able to support the infected more diligently.

“There’s a fear of the unknown,” he said. “Once they’ve taken care of a Covid patient, they’ll be like ‘I survived, I can do this.’”

As for Northam’s push to reopen the state, Wellington understands why, but he thinks testing will need to be more widely available before things will return to anything close to normal.

“My family will not go to the movie theater or the farmers market,” he said. “My mother won’t be going to the grocery store.”

“I just don’t think they have a grip on this yet,” he said.

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