A day after Dr. Anthony Fauci, the nation's top infectious diseases expert, warned that the United States could soar to 100,000 daily new cases, a top federal health official admitted that labs across the country were scrambling to meet the demand.
It is "absolutely correct that some labs across the country are reaching or are near capacity," Adm. Brett Giroir, who is overseeing the nation's COVID-19 testing, said Wednesday during a briefing with reporters.
Some of that surge, Giroir said, can be attributed to increases in testing at nursing homes and in prisons. An estimated 500,000 to 600,000 tests are performed each day, according to Johns Hopkins University.
But it's clear that will not be enough. In hard-hit states such as Arizona, California and Texas, demand for COVID-19 testing has grown rapidly. People are reporting waiting in line to get tested for two, three or more hours — often in the hot summer sun.
In nine states, people must wait up to four days to get results on their COVID-19 tests. In 41 states, it can be a three-day wait for test results. Patients who are sick enough to be hospitalized are given priority for a quicker turnaround.
It's the latest hurdle in the U.S. efforts to test for the coronavirus. In February, the Centers for Disease Control and Prevention sent out flawed test kits, which caused critical delays in catching new infections. For several months, some states struggled to increase their capacity to test.
On Wednesday, Giroir said federal health officials are planning "surge testing" among people living in states with rising cases, even if they have not had symptoms. Plans for the increased testing are in development.
"The strategy is to conduct the number of tests you do in a month in just a few days," he said, to identify asymptomatic spread of the virus. The approach is meant to help bolster efforts to find cases through contact tracing.
Giroir also anticipated providing as many as 5 million additional "point-of-care" tests during the month of July, with a goal of 20 million or more by September. Like rapid flu tests, COVID-19 point-of-care tests return results much more quickly, within minutes, while the patient is still in the doctor's office. But the rapid COVID-19 tests have not proven to be as accurate as those sent off to labs.
Abbott Labs’ ID NOW test, for example, can deliver results in less than 15 minutes. But a small study from NYU Langone Health found that the test returned false negatives for nearly 50 percent of certain samples that a different test had found to be positive.
That study has not been peer-reviewed, but the Food and Drug Administration has issued an alert about the potential for false negatives.
"In an ideal world, you would have a point-of-care test that you get the results back in five minutes, that would be highly sensitive and highly specific. We don't have them right now," Giroir said.
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This week, health officials touted the potential for pooling of test samples, a strategy that could be particularly beneficial as colleges and universities resume in-person classes in the coming months.
Rather than test one sample at a time, which can be time-consuming, scientists would "pool" as many as 10 samples in one test. If the test is negative, it can be assumed all 10 are negative.
It's only if the test is positive that scientists would have to test each sample to find which one is positive.
On Tuesday, the CDC released recommendations that universities not offer routine testing. But some colleges, such as Duke University in Durham, North Carolina, said it plans to test all incoming students and faculty members.
Giroir said that while increased COVID-19 testing is critical, "we cannot test our way out of the current outbreaks," adding that "we must be disciplined about our own personal behavior, especially around the July 4th holiday."
That includes wearing masks or other face coverings, maintaining a physical distance of at least six feet, and remaining vigilant about hand-washing.