Rapid coronavirus tests that deliver results within minutes are in short supply in St. Louis, and health systems including Barnes-Jewish Hospital are having to ration them.
Health experts agree rapid testing and isolation is the most effective way to control the spread of the virus. But the national supply of rapid tests is decreasing, and results from the more widely used tests that utilize a long nasal swab are taking weeks to return for national testing labs.
“The rapid testing has always been a challenge throughout the pandemic,” said Dr. Alexander Garza, head of the St. Louis Metropolitan Pandemic Task Force. “There’s a limited quantity for rapid testing, a lot of it gets diverted to hot spots or workplaces where there’s a large outbreak.”
The supply of tests contracts as many parts of the country see large outbreaks of the virus at once, he said. Manufacturers are also making fewer of those tests as they start to create ones for the fall that look for the coronavirus and the flu simultaneously.
“There’s decreasing numbers, there’s changes in the way they’re doing testing, and then we have increasing cases,” Garza said. “Put that together and yes, we are challenged for testing right now.”
Barnes-Jewish Hospital in St. Louis has asked medical personnel to limit the number of the rapid coronavirus tests they use because of the shortage in supply.
“As cases of COVID-19 rise both nationally and in our community, there are worsening shortages of testing supplies. Currently, the demand for testing far exceeds the available supplies,” Dr. Katherine Henderson, Barnes-Jewish Hospital assistant chief medical officer, wrote in an email to hospital staff earlier this month.
“Our current daily system usage of 250 rapid tests per day far exceeds our supply,” Henderson wrote. “We must take significant action to preserve our clinical capabilities.”
The hospital will not receive more rapid tests because its manufacturer is switching production to the combination flu and coronavirus tests, she wrote.
Doctors at Barnes-Jewish must document the need for a rapid test in a patient's medical records, Henderson wrote.
Many hospitals are limiting rapid tests to first responders and people awaiting operations, Garza said.
The nation’s coronavirus response has been hampered by a shortage of testing supplies since early in the pandemic, said Sergio Chayet, a Washington University professor who specializes in global supply chain management. Most of those supplies come from overseas, where companies can make them quickly and cheaply.
“First you have the swab shortage, then we’re having some shortage in the reactive chemicals. This is part of the reliance of global supply chains,” he said. “It’s a good way to actually lower costs, but with all the benefits come risk.”
Lean global production means there’s less room for manufacturers to step up production, Chayet said.
St. Louis County Executive Sam Page announced Tuesday that the county health department aims to decrease wait times at its two government-run clinics by adding personnel and new saliva-based tests. While saliva-based tests aren’t as efficient as the rapid tests, they still offer results within days, not weeks.
The health department has hired three more workers to notify county patients of their results, Page said. He hopes patients at county-run clinics will soon receive test results in less than two days.
“We believe if we can get to a 24-, or in the worst case, a 48-hour notification period, we can have a pretty tight contact tracing system in our community and a pretty good isolation system,” he said.
Some patients have been waiting more than two weeks to receive test results from private clinics. That long a lag time renders the test pretty much useless, Page said.
St. Louis County also will offer pop-up testing sites in Jennings and Bellefontaine Neighbors, two communities in the north part of the county that have seen large numbers of coronavirus cases and deaths, Page announced.
But Page concedes most tests in the St. Louis region aren’t done by the health department. Private clinics and hospitals are feeling the same squeeze as county health departments, he said.
“The newest and most novel testing is going to be available for people with resources,” Page said. “To get that widely available in our community, it needs to be more widely available in our country.”
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