Back on March 8, at a press conference to report Ulster County’s first case of COVID-19, the illness caused by the coronavirus, county Health Department Commissioner Dr. Carol Smith warned that a lack of testing capability was likely to complicate efforts to track and contain the contagion.
Ten days later, county officials say testing capacity is ramping up but remains vexingly short of the need. Instead, public health officials and private medical providers must make hard decisions about who gets tested and who does not.
“The biggest challenge we are still facing is ramping up our testing capacity,” said County Executive Pat Ryan at a livestreamed town hall event on Wednesday, March 18.
Lack of testing capability is a nationwide issue as health professionals confront the largest global pandemic since the Spanish Flu of 1918. Lack of preparedness at the federal level and bureaucratic delays in moving test kits to market have left the U.S. lagging far behind other nations dealing with the outbreak. Those issues have filtered down to local health departments where test kits remain in very short supply.
Smith said the county health department had received 250 test kits over the weekend and was anticipating another 200 in the coming days. In addition, hospitals and other private service providers have begun to acquire the kits, while major testing companies like LabCorp and Quest Diagnostics have begun their own testing programs. As of March 18, Smith said, 114 tests had been administered in Ulster County, resulting in nine positive results for coronavirus — a little less than 8 percent.
But because of the shortage of test kits, screening for the virus has been limited to family members and close associates of people who have already tested positive for the virus and people who may have been exposed who are at high risk of complications from the contagion based on age or underlying medical conditions.
Testing through private medical providers has also been complicated by a lack of personal protective equipment, like surgical masks and gloves, at many doctor’s offices. Suspected coronavirus patients must be assessed in an isolated environment by providers outfitted with specialized gear in order to prevent the infection of medical staff and other patients. Most private medical practices lack the facilities or equipment to carry out the procedure. On Wednesday, Ryan acknowledged reports of area residents concerned about exposure to the virus receiving conflicting instructions from private medical providers and the county’s COVID-19 hotline about testing protocols.
“In the midst of everyone trying to do their best, it results in confusion and concern for a lot of residents,” said Ryan. “We are aware of that challenge and are working aggressively to fix it.”
That fix could come as soon as the weekend of March 21 as the county doubles the number of public health nurses on the job and prepares to roll out a mobile testing site. Ryan said the mobile testing operation would travel around the county providing on-site testing for those approved for the test. Testing can be authorized by a private physician or by county health officials via the COVID-19 hotline at (845) 443-8888. Once approved, patients will be tested by public health nurses at the mobile site. Ryan said that the mobile test site would improve the county’s ability to track the virus and identify patients who must be quarantined. But, he cautioned, testing capacity was likely to remain far below the demand for the foreseeable future.
“I know everyone would love to be tested to assure themselves of their situation,” said Ryan. “We are not going to have the resources to test everyone, we’re going to have to triage based on need.”
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