Nearly three weeks into Michigan’s coronavirus crisis, access to lab tests for COVID-19 remains limited and problematic, health officials say.
There aren’t enough tests. There aren’t enough supplies for the tests. When specimens are submitted, it can take days to get results.
That’s not an issue for most individual patients. The treatment options are largely the same for coronavirus and influenza. From that perspective, the exact diagnosis is typically not critical information, health officials say.
But from a public health standpoint, it’s a big concern, officials say.
“It’s a huge problem, one that’s contributed to why we are where we are today,” U.S. Sen. Gary Peters, D-Michigan, told MLive.
Testing is an area where the United States “really dropped the ball” on its coronavirus response, says Dr. Teena Chopra, infectious disease specialist for Detroit Medical Center.
“You’re now seeing all the consequences from the lack of testing options,” Chopra said. “If we were to start (universal testing) now it may not help anymore because now it’s widespread community spread and a lot of damage has already been done.”
She compared the United States to South Korea, Hong Kong and Singapore, which have been better able to contain the spread of coronavirus. Those countries conducted widespread testing early on; determined who was infected, and traced their contacts to make sure those contacts were quarantined, Chopra said.
“They even tested milder and asymptomatic residents, and were able to get a contract trace and isolate them early on,” Chopra said.
By contrast, Michigan had 300 coronavirus test kits for 10 million people just before it confirmed its first case of coronavirus on March 10. Since then, a little over 15,000 tests for COVID-19 have been completed for Michigan residents, which is not enough, health officials say.
“Are we doing enough testing? Not even close," Oakland County Executive David Coulter said last week. "We know that one of the ways that we’re going to address this epidemic more effectively is to get more people tested.
“But we don’t have enough testing kits yet, "he said. “We don’t have enough laboratory capacity. Frankly, there’s not enough swabs and medium and other things to do all the testing. We’re still not anywhere near where what we need to be in terms of testing our population.”
Because of limited resources to do the testing, state and federal officials have prioritized who gets tests.
The top priority are hospitalized patients and health-care workers who have COVID-19 symptoms. That’s followed by people with symptoms who are first-responders, living in a long-term care facility and/or are at risk of complications because of their age or other health conditions.
Testing healthy, younger people with mild symptoms is a “non-priority” unless the person has had known exposure and/or a health-care worker or first-responder, the Centers for Disease Control says.
That means we really don’t have a good idea of how many Michigan residents actually have COVID-19. Although more than 5,600 cases have been reported in Michigan so far, “I think there’s dramatic under-detection, under-reporting” of coronavirus, said Dr. Paul Kilgore, a public-health doctor and epidemiologist at Wayne State University.
“It’s like completely walking in the dark from a public-health standpoint,” he said.
Chopra said that Gov. Gretchen Whitmer “has done a great job promoting social distancing and people staying at home and things like that,” but those measures only go so far in trying to rein in the pandemic.
“What’s important is testing, testing, testing, testing as much as possible, and isolating people" who are infected, she said. “The fact the state has limited its testing to some populations has not helped us. It’s made this situation worse, that we’ve had limited access to testing right from the beginning.”
She said it’s created nightmarish scenarios in hospitals and other health-care facilities. “You have patients suspected to have COVID, and physicians are waiting to see if they are positive or negative. And where do you move them while we get a surge of 40 more patients?” she said.
Linda Vail, public health officer for Ingham County, agreed that widespread testing is the only way to get a handle on the coronavirus epidemic.
“You’re never going to contain an epidemic if you just let the virus go rampantly wild out there and then only test people when they’re seriously ill,” she said. In that scenario, "you’re going to quickly run out of capacity to take care” of those who fall sick.
While right now, lack of testing is part of the problem, Vail said, in the long run it will be part of the solution, particularly until a vaccine is available.
Once the initial wave of coronavirus cases subside, she said, the hope is that testing capabilities will have expanded to the point where new outbreaks can be quickly identified and the patients isolated.
“Testing makes a difference in our ability to figure out what’s going one and try to contain it,” she said. “Although at this point in time, we’ve gone past a containment strategy to a mitigation strategy.”
In lieu of widespread testing right now, say Vail and other experts, the best way to break the back of this pandemic is for every Michigan resident to strictly adhere to social distancing and stay-at-home guidelines.
“Everybody thinks they need to be tested because they need to know” whether they have coronavirus, Vail said. But that “clamoring for tests” is putting more stress right now on a system that is already overwhelmed.
The lack of testing “affects our ability to control it on an public health level but it doesn’t impact your clinical care,” since most people can safety recover from COVID-19 at home, Vail said. “Just stay home. That’s the best thing to do.”
MLive reporter Lauren Gibbons contributed to this report.
Read all of MLive’s coverage on the coronavirus at mlive.com/coronavirus.
Additional information is available at Michigan.gov/Coronavirus and CDC.gov/Coronavirus.
CORONAVIRUS PREVENTION TIPS
In addition to washing hands regularly and not touching your face, officials recommend practicing social distancing, assuming anyone may be carrying the virus. Health officials say you should be staying at least 6 feet away from others and working from home, if possible. Carry hand sanitizer with you, and use disinfecting wipes or disinfecting spray cleaners on frequently-touched surfaces in your home ( door handles, faucets, countertops) and when you go into places like stores.
Related news:
Sunday, March 29: Latest developments on coronavirus in Michigan
Michigan has become an epicenter for coronavirus. Why?
Michigan COVID cases soar past 5,000
Western Michigan University student dies of coronavirus
Whitmer downplays tensions with Trump