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Costly COVID-19 mistakes: Testing shortage was a key factor in virus spreading across Pa.

York Daily Record logo York Daily Record 8/10/2020 Candy Woodall, USA TODAY Network Pennsylvania Capitol Bureau
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Editor's Note: COVID-19 killed tens of thousands in the Northeast, caused massive unemployment and wrecked the economy. In an ongoing series of stories, the USA TODAY Network Atlantic Group, 37 news sites including those in south-central Pennsylvania, examines what the government got wrong in its response to the virus, what policies eventually worked — and why we remain vulnerable if the coronavirus strikes harder in the fall.

A healthcare worker stands by at a COVID-19 temporary testing site at Abington Hospital in Abington, Pa., Wednesday, March 18, 2020. For most people, the new coronavirus causes only mild or moderate symptoms. For some it can cause more severe illness. © Matt Rourke, AP A healthcare worker stands by at a COVID-19 temporary testing site at Abington Hospital in Abington, Pa., Wednesday, March 18, 2020. For most people, the new coronavirus causes only mild or moderate symptoms. For some it can cause more severe illness.

When Pennsylvania Gov. Tom Wolf evaluates the first five months of the pandemic in Pennsylvania, he looks to a flaw early on that he believes contributed to more than 110,000 positive cases of COVID-19 and 7,100 deaths. 

"I wish we had more testing early on," he said during an interview in mid-July with the USA Today Network Pennsylvania Capitol Bureau. 

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Wolf said Pennsylvania was in the same situation as several other states in the spring, grappling with a national testing shortage as the virus was spreading rapidly across the state. 

Pennsylvania was competing with hard-hit states like New York and New Jersey to get specialized testing swabs and test kits as the coronavirus was nearing its peak in the northeast. 

Without the testing, the state couldn't do contact tracing and isolate people who had the virus, Wolf said. That allowed the virus to spread in the first several weeks COVID-19 was detected in Pennsylvania.

But since then, hospitals developed their own tests and the state has worked to expand testing in Pennsylvania. 

Anyone who wants a test in Pennsylvania can now get one, according to Secretary of Health Dr. Rachel Levine.

What failed

The president's critics frequently say there's been no national strategy to control the coronavirus in the U.S.

But the nation's top infectious disease expert, Dr. Anthony Fauci, joined that chorus in March. Fauci, who has served as the director of the National Institute of Allergy and Infectious Diseases during multiple presidential administrations, on March 12 told Congress that testing was "failing" in the country.

"The system is not really geared to what we need right now. That is a failing. It is a failing. Let's admit it," he said. 

That was especially true in Pennsylvania nursing homes, which did not have enough tests for the tens of thousands of residents across the state, according to Secretary of Health Dr. Rachel Levine. 

A lack of testing and other factors allowed the virus to spread through nursing homes for months, resulting in more than 4,800 deaths in long-term care facilities across the state. 

Nursing home deaths account for nearly 70 percent of all covid-related deaths in Pennsylvania. 

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As cases grew in Pennsylvania and other states, President Donald Trump said the week of March 15 would be a "game-changer" in the U.S. 

An additional 2,000 labs and 1.9 million tests were expected to be available that week, his coronavirus task force said during a March 15 news conference. 

Testing is necessary to stop the spread of the virus, Fauci said. 

"The worst is yet ahead for us," Fauci said during that March 15 news conference. "It is how we respond to that challenge that is going to determine what the ultimate end point is going to be. We have a very, very critical point now."

Trump said he was going to invoke the powers of the Defense Production Act to order U.S. manufacturers to make testing swabs and test kits in those early weeks, but he didn't. The Federal Emergency Management Agency said it was able to get test kits from the private market without utilizing the act. 

The federal government sent Pennsylvania 4,000 of the 10,000 specialized testing swabs the state requested — and did not send any of the 18 reagent and chemical kits needed for COVID-19 testing.

Those 4,000 swabs were sent to the state as Pennsylvania was testing fewer than 10,000 people per day and had tested less than 1 percent of the Pennsylvania population overall. 

And those test results were taking two days to two weeks to come back because of the heavy demand on labs in the state and across the country. 

What worked

Hospital systems grew weary with long wait times for test results and didn't wait on federal help. 

UPMC, WellSpan and Penn State Health Milton S. Hershey Medical Center —  three of the biggest healthcare providers serving patients in the Pennsylvania's state capital city of Harrisburg — launched their own testing systems. 

UPMC and Penn State used their university research expertise to develop their own tests, and WellSpan partnered with public and private labs in the state. 

All three health systems, and several others throughout the state, also set up their own drive-through testing centers.

“Testing capabilities for COVID-19 in the U.S. have been delayed and limited, creating anxiety for the people we serve and impairing our ability to optimally guide the public health response,” said Dr. Donald Yealy, chair of emergency medicine for UPMC and Pitt. “By creating our own test and collection centers, we can both help our patients and the overall community. We seek getting a diagnosis in hours, not days.” 

The U.S. lagged behind other countries in testing capacity, and that's why UPMC created its own tests, according to Dr. Alan Wells, medical director of the UPMC Clinical Laboratories. 

"Testing capabilities are absolutely essential to managing a pandemic," Wells said. "If the communities we serve see a surge in severe illnesses, we must be able to diagnose people quickly to give them the appropriate care while protecting our staff and the broader community.”

As testing supplies became more available, Levine issued a universal testing order for long-term care facilities. All residents and staff are tested weekly.

Drawing on hospital expertise and some of Pennsylvania's largest universities proved to be a game-changer in Pennsylvania.

"At this time, we have the testing capacity we need to ensure those who need tested can get tested," state Department of Health spokesman Nate Wardle said in mid-July. "We have the testing supplies, including swabs and viral medium needed, but we constantly need that supply to be restored. There have been some specific locations, such as a few hospitals, that have seen some challenges in this area, and we are working to assist them once we are aware of a need."

What needs to be done

State health officials say testing needs to keep increasing to effectively stop the spread of COVID-19 in Pennsylvania. 

The Department of Health is focusing on continuously restoring testing supplies and helping facilities in need of those supplies, Wardle said. 

Testing is one of the core problems that must be addressed to prepare for another surge of COVID-19 in Pennsylvania, according to U.S. Rep. Conor Lamb, a Democrat from Allegheny County. There's been a "failure of the federal administration to really coordinate" testing, and the continued issues "demonstrate President Donald Trump’s failure to offer World War II-level leadership to a country fighting a pandemic," he said.

“The only recommendation that I can give is that he start taking the problem more seriously and embrace his own power as the president to try and solve it," Lamb said.

The Trump administration on July 14 announced faster and expanded testing for nursing homes. 

“Access to rapid point-of-care testing in nursing homes will further protect our nation’s most vulnerable patients,” Assistant Secretary for Health Adm. Brett P. Giroir said in a statement.

The U.S. Food and Drug Administration recently authorized faster testing systems that are now being distributed by the Centers for Medicare & Medicaid Services. Each nursing home is receiving one diagnostic test instrument and associated tests. 

Including the universal testing order in nursing homes, Pennsylvania has performed more than 1 million COVID-19 tests since March. That's about 10 percent of the state population. 

The state has partnered with CVS, Walmart, Rite Aid, Patient First and other sites to expand testing in Pennsylvania. 

“When we established our testing strategy, we wanted testing to be accessible, available and adaptable, and we are working to meet that challenge," Levine said. "Anyone who believes they have symptoms of COVID-19 can get tested today in Pennsylvania.”

Candy Woodall is a reporter for the USA Today Network. She can be reached at 717-480-1783 or on Twitter at @candynotcandace.

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This article originally appeared on York Daily Record: Costly COVID-19 mistakes: Testing shortage was a key factor in virus spreading across Pa.

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