These anxious Californians took a COVID-19 test. Then they waited for results ... and waited

On March 30, Berenice Dominguez’s sore throat and cough took a dramatic turn for the worst. Her fever spiked.

Because she showed some of the symptoms of COVID-19 and had developed pneumonia, doctors at a local walk-in clinic sent Dominguez, 28, to the emergency room in Colusa, her hometown.

That was on a Sunday. With her test results pending, she would lie in a bed inside the small Colusa Medical Center until Friday. Her husband, Vidal, and 4-year-old daughter, Emma, were at home, under self-quarantine, unable to visit her and not knowing if they, too, had been exposed.

“It’s the most frustrating part of this, honestly,” Dominguez said over the phone between coughing fits from her hospital bed. “It’s the not knowing.”

Dominguez’s story of waiting days for test results is one of the frustrating realities of the COVID-19 pandemic as government and private labs across the globe strain to test hundreds of thousands of samples as the disease spreads through communities.

Experts say the delays in testing make it difficult to track where the disease is hitting hardest, and in turn, allocate medical staff and resources where they are needed most. It’s a particular challenge for California.

During a Thursday news conference, Gov. Gavin Newsom acknowledged that nearly 60,000 test results are still pending in California. He noted that even the commercial labs, LabCorp and Quest, used to conducting many tests at once, aren’t able to keep up.

“This is a national problem,” he said. “Those commercial labs are overwhelmed by the demand… Every day we are increasing the number of tests that are being conducted but we do recognize the time delay.”

Although Newsom has noted the backlogs for weeks, they aren’t yet improving, he said. Other types of tests, including blood tests, are being developed and could start chipping away at the backlog once they are scaled up, Newsom said.

In the meantime, shortages of test swabs, testing chemicals and personal protective equipment for workers collecting samples and running the tests are contributing to the delays, he said.

New testing methods

There is some help coming as new labs come online.

For instance, on Friday in Sacramento, officials at the UC Davis Health Clinical Laboratory announced they had developed the capacity to run as many as 200 tests a day, using a robot the size of an SUV. It’s called the “Roche Diagnostics cobas 6800 System.”

The U.S. Food and Drug Administration granted “emergency-use authorization” to UC Davis to use the machine for COVID-19 testing in mid-March, officials said. The machine was purchased in December for between $400,000 and $450,000.

“We had chiefly purchased it for oncology testing,” Lydia Howell, chairwoman of the UC Davis Department of Pathology and Laboratory Medicine, said in an emailed statement. “We didn’t anticipate it was going to be used for this, yet there it was ready to go when this crisis came up.”

While new testing systems come online, the COVID-19 outbreak also is straining the workforce at laboratories in other ways, said Dr. David Louis, the chief pathologist at Massachusetts General Hospital. Many of the people who work in labs are highly trained and skilled, he said, and “there are not thousands of these people out there looking for additional employment.”

“It’s a tight workforce,” Louis said, “and as those people get sick or if those people are quarantined or if we split our shifts to protect our employees, we run the risks of not having enough people to run these machines.”

Labs closed on holidays?

Some local health care providers, meanwhile, are growing frustrated at the testing lag.

Amy Micheli, the chief operations and nursing officer at Colusa and Glenn medical centers, said some regional labs that receive samples have been hard to reach over the phone or unable to receive samples on weekends and holidays.

Micheli said she and her staff were particularly frustrated when they went to deliver Dominguez’s samples to the Sacramento County lab on Monday afternoon, and were met with signs saying the office would be closed for Cesar Chavez Day on Tuesday.

She said that on Tuesday her staff also called two local county public health departments and three public health labs, to see if they were open, and no one answered the phones.

“We thought this was a crisis,” Micheli said. “We thought this was a pandemic.”

Sacramento County officials said there was a misunderstanding: The lab employees weren’t off on Tuesday, but they had run out of reagent necessary to perform tests.

When the testing chemicals are available, the lab runs 8 a.m. to 5 p.m. Monday through Friday, and on Saturdays from 9 a.m. to 5 p.m.

The lab, which receives tests from five surrounding counties, prioritizes tests for hospitals, healthcare providers and first responders. Top priority is given to testing for individuals who are hospitalized, spokeswoman Kim Nava said.

“We have been able to maintain a turnaround time of 24-72 hours for results,” Nava said in an email.

Hospitals and healthcare facilities have the option of sending specimens to commercial labs for testing, however, turnaround time at the private labs is significantly higher: Up to 10 days for results, Nava said.

Delays burden families, hospitals

Dominguez’s nose was swabbed for a COVID-19 test on Monday. The sample was eventually sent to a state lab in Richmond, which on Friday — five days after she was admitted — notified her doctors that it came back positive.

Micheli said such delays are frustrating both for caregivers and for patients being held at the hospital awaiting test results.

With their lab results pending, the hospital has to assume that patients with COVID-19 symptoms are infected, even if they’re not. That means keeping them isolated in one of the limited beds available. Caregivers who enter their rooms have to don protective equipment like gowns, eye coverings and masks that have been in short supply.

Patients’ bills also keep climbing as the days drag on for their results, she said.

The average bill for one inpatient day at a California hospital was $3,532 in 2018, the second most expensive in the United States, according to the Kaiser Family Foundation, which tracks health expenses.

“I just feel like we should all have the answers quicker,” Micheli said.

Dominguez has private insurance through her employer, a local mushroom distribution company where she works in sales. Her plan has around a $6,500 deductible, and Dominguez said she will likely max out her share of the family plan’s out-of-pocket costs.

She said she was released Friday after receiving her test results. The good news is her doctors believe she’s going to fully recover. But her waiting continues. Only now, it’s not for tests. It’s for the day when her symptoms subside so she can again give her daughter a hug.

“We’re closer to being able to be together again,” she said.

This story was originally published April 4, 2020 at 5:00 AM with the headline "These anxious Californians took a COVID-19 test. Then they waited for results ... and waited."