Coronavirus testing in Kentucky is still reserved for those who need it the most.
Until the test becomes more widely available, doctors are following federal guidelines that prioritize people who have been hospitalized, those with the worst symptoms and those who are at highest risk of mortality.
“If you’ve got a very sick person in the [Intensive Care Unit], they are going to get their test, yes, within 24 hours,” said Dr. Forest Arnold, University of Louisville Hospital epidemiologist. “But if you’ve got somebody who’s not, or maybe they came and left and are at home they may not have their test for several days if at all.”
Testing also remains limited around the country, but it is scaling up.
As of Thursday, Kentucky has performed around 640 tests among a population of about 4.5 million people. At least a half-dozen labs are now doing testing for Kentuckians, but some of those have returned only a few tests thus far, said Gov. Andy Beshear at a Thursday evening press conference.
Kentucky’s state lab has a limited capacity and at most has only been able to perform 37 tests in a single day, Beshear said. U of L Vice Dean for Research Dr. Jon Klein says that the university’s labs have more, enough to test more than 200 people per day.
“We plan to scale that up but a lot of our ability to do that is dependent on the uncertainty in the supply chain,” Klein said, during an appearance on WFPL News' In Conversation program on Friday.
That bottleneck is in part because labs need certain ingredients to perform the tests, and they’ve only just begun to get them. But many labs, including the state’s, are not designed to handle the volume needed to test everyone in a community.
Commercial labs including LabCorp and Quest Diagnostics have larger capacities but are still scaling up production. So far, they haven’t been able to catch up with the demands. Arnold says those labs are working through a backlog to get to the point where they can turn around tests in 24 to 48 hours.
Indiana has begun to roll out drive-thru testing for patients who have already been cleared by a healthcare provider to receive a test. The Courier Journal is reporting at least one doctor in Lexington has begun drive-thru testing.
However, Beshear has said Kentucky testing remains more limited than in other states because Kentucky hasn’t seen a COVID-19 hotspot and because Kentucky doesn’t have a large commercial lab like New Mexico.
With a limited number of tests, doctors have prioritized those who are the most ill.
“If a city is going to do a drive-thru, well those aren’t the most critical because if you are able to drive your car into downtown, then you’re not a person on a ventilator in the [Intensive Care Unit],” said Dr. Arnold, with University of Louisville Hospital.
But, without widespread testing, it’s impossible to know the effectiveness of the severe measures the country has taken to avoid the spread of the virus. Beshear appeared frustrated at questions about increases in testing during Thursday’s press conference.
“All right, so we’ve taken four questions on this wait,” Beshear said. “Folks, again, this one of those things where we have people on the front lines every single day working as hard as they can, and I have limited numbers of people and I’m not going to take them off the front lines just so they can collate some numbers,” he said.
“We’re testing every single person we can.”
Kentucky isn't the only state dealing with a limited testing capacity. The CDC itself is not designed to do the level of testing that is required. That's what Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told Congress.
Additionally, the U.S. did not use the COVID-19 testing guidelines produced by the World Health Organization and instead, chose to make its own, according to Pro Publica. Then, the tests made by the CDC turned out to have faulty components, which states had to modify.
That's why the CDC has continued to advise healthcare practitioners to prioritize certain groups:
- Hospitalized patients who have symptoms that are “compatible with COVID-19,” i.e. coughing and fever.
- High-risk groups including older adults, people with chronic health conditions and those who are immunocompromised.
- Lastly, any persons including healthcare personnel who have come in close contact with a suspected or confirmed case, or who has a travel history.
Arnold says that sometimes there are exceptions, but for the most part it’s people who are in the hospital who are receiving the tests first.
“Some doctors in the hospital want a test on their patient and their patient doesn’t have a strong indication for the test and so, that’s not always carried out,” he said.
A spokesperson from LabCorp says it will begin performing more than 20,000 tests per day across the country on Friday, while Quest Diangostics says it will ramp up capacity to about 10,000 tests per day.
