July 10, 2020 -- Carole Jean Smith, a retired pharmacist in Davie, FL, didn’t think she had been exposed to COVID-19. But she decided to get tested because "I just wanted to know." Her husband, George, goes to a workplace every day, and ''that was a concern," she says. Both were following all the recommended measures -- wearing masks, washing hands, and social distancing.
So she got tested June 29, expecting the results in a few days. But it took until July 9 to find out she is negative. She tried to stay upbeat, but it was hard to wait. She told herself: "Maybe since they aren't getting back to me, they are getting to the positives first."
Delays in getting test results are becoming a problem nationwide. As the number of COVID-19 diagnostic tests have increased, backups at the labs that read those results have also grown. In addition to causing anxiety in people waiting for their results, the delay can slow down attempts by public health officials to reach others who may have been exposed.
For most people, the turnaround time for a COVID-19 test from Quest Diagnostics has gone from 3 to 5 days the end of June to 4 to 6 days, says Kimberly Gorode, a company spokesperson. It's a 1-day turnaround for priority 1 patients, including hospital patients, people who are getting needed surgery, and health care workers with symptoms. Quest, one of the largest labs in the country, says it has reported results of about 6.6 million diagnostic tests since the pandemic began.
At LabCorp, another large lab, the time to report results has also grown, says spokesperson Kelly Smith Aceituno. Until recently, the company was able to provide results to patients on average between 1 and 2 days, she says. But due to an increase in demand and the availability of supplies and equipment, the average may now be 4 to 6 days. That turnaround time is faster for patients in the hospital.
On its website, Healthvana says to expect results in 3-5 days, but it could be longer.
Even Atlanta's Mayor, Keisha Lance Bottoms, had to wait. She tweeted that it took 8 days to get back her results and learn she and two other family members are positive.
Effect of Delays on the Pandemic
The long wait time doesn't just increase stress on people, who often end up isolating themselves for many days before finding out if it’s needed.
"The lag in COVID testing results is a major problem," says Amesh A. Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security. "If a test result takes more than 5 days to return, it likely defeats the purpose of the test, he says. Once someone tests positive, public health officials try to trace and contact people that person may have been close to -- called contact tracing. Those people also need to put themselves in quarantine and get tested.
"We need to be able to test in order to identify cases, isolate them, and trace their contacts. And any delay impedes that process," he says. "It must become a priority to decrease this lag so that testing can be as close to real time as possible."
Audrey Arona, MD, who leads three county health departments in suburban Atlanta, says their results are taking 6 to 7 days to come back. The department sent almost 5,000 tests to LabCorp last week, she said on WABE’s podcast, “Did You Wash Your Hands.”
“Because of the delay in testing results, oftentimes the quarantine period for contacts is almost over by the time we get to them,” Arona said.
Cara Christ, MD, director of the Arizona Department of Health Services, says a delayed test result still has value. She agrees that ''when there is a lag in testing [results], that does mean there is a lag in reporting to public health, and that makes contact tracing difficult." But the tracing is still done, and "I think it gives the patients some comfort" to know the results, even after a delay, she says.
Arona says because of the delays, people need to “act as if you’re positive” while waiting for results.
In hard-hit Arizona, Gov. Doug Ducey announced a collaboration with Sonora Quest Laboratories on July 9. The goal is to provide up to 60,000 tests a day by the end of August. According to Sonora Quest Labs, it hopes to give results in 24 hours.
Earlier this week, Adm. Brett Giroir, U.S. assistant secretary for health, acknowledged the increase in wait times and said that more rapid, ''point of care" tests should be available soon. That should decrease the burden on some labs.
The FDA cautions that the antigen tests may not detect all active infections and may need to be confirmed with the test commonly used, called a PCR test.