Las Vegas Sun

October 21, 2020

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Recent drop in COVID-19 testing in Nevada raises red flag for UNLV epidemiologist

Cashman Center COVID-19 Testing Facility Preview

Christopher DeVargas

Diane Vega, a respiratory therapist at UMC, processes sealed COVID-19 tests at the new Cashman Center testing facility, Mon. Aug 3, 2020.

On Wednesday, more than 17,000 coronavirus tests were completed in Nevada — the most ever in a single day in the state since testing began in March.

But that high-water mark six days ago belied what has occurred most of the month: Testing in the first 23 days of August is down nearly 7% from the same period a month ago, from an average of 8,862 tests a day in July to 8,259 tests a day this month, according to figures compiled from the Nevada Health Response website.

The decrease is worrisome for Brian Labus, a UNLV epidemiologist and a member of Gov. Steve Sisolak’s COVID-19 medical advisory panel, if people are avoiding testing.

“Testing is one of several important parts of containing the virus,” Labus said. “If we cannot identify infected people, we are unable to conduct contact tracing and stop disease transmission.”

Since the pandemic’s onset, the Southern Nevada Public Health Laboratory had seen testing increase month over month. In June, testing was up 15% from May; in July, it was up 25% from June. Unless testing picks up the remainder of August, though, that string will come to an end.

The reasons for this month’s decline aren’t fully known, but Labus speculated the drop could be attributed to a couple of reasons.

“We have seen a plateau in positivity rate and hospitalizations, which may mean that we are starting to see decreased disease transmission,” he said “It may also be frustration with the process, as there have been long delays in getting appointments for testing and getting results.”

The Associated Press reported earlier this month that testing was down across the United States, possibly due to long wait times for results. On seven of eight days from July 22 to July 28, more than 10,000 COVID-19 tests were administered daily statewide. Nevada health officials said the sheer quantity of tests overwhelmed the state’s public labs, causing delays in reporting results, sometimes of a week or more. The Nevada State Public Health Laboratory at UNR and the Southern Nevada Public Health Laboratory process the majority of tests conducted in Nevada and report the results.

The reporting delay has not been apparent in tests conducted by private laboratories.

Two of them, Quest Diagnostics and LabCorp, have reported an average turnaround time for reporting coronavirus test results of two to three days, according to Adm. Brett Giroir, assistant secretary for health at the U.S. Department of Health and Human Services.

“In the face of unprecedented demand on our commercial lab system, we have worked together to innovate and expand capacity; and we have seen steady progress,” Giroir said.

Quest Diagnostics, which operates labs nationwide and throughout Las Vegas, is able to provide up to 150,000 COVID-19 molecular diagnostic tests a day in its network. Quest’s communications manager, Kimberly B. Gorode, said the demand at Quest for coronavirus tests has plateaued “albeit at a high level.”

“We attribute much of the plateau in demand to our efforts to ask providers to prioritize patients so we may direct testing to those most in need,” Gorode said in an email to the Sun.

Quest has completed more than million COVID-19 molecular diagnostic tests to date nationwide. It has gradually increased its capacity for tests to around 120,000 per day and expects to scale up that number to 185,000 tests a day by Labor Day.

A COVID-19 diagnostic test must be ordered by a healthcare provider to be tested at a commercial lab. This can be done at a physician’s office, hospital, urgent care center or community drive through.

The federal government is covering the cost of testing to patients under the Families First Coronavirus Response Act, so there is no charge for the test itself. A patient may have to pay for a doctor’s appointment and for specimen collection, depending on what his or her insurance covers.

The Southern Nevada Health District recommends testing for anyone regardless of whether they have symptoms.

Testing is especially recommended for anyone who:

• Has symptoms

• Has been in close contact with a person who is a confirmed or possible case of COVID-19

• Was exposed to a large crowd of people with little or no social distancing or people were not wearing face coverings

• Will be visiting a person who is at high risk for COVID-19, such as older adults or someone with a chronic medical condition.

But Labus said people should not get tested unless they are symptomatic or have been exposed to someone who is infected because of the testing capacity issue.

“The numbers might be down, but that does not mean we have excess capacity to encourage everyone to get tested just because they want to. The best way to ensure that we have adequate testing capacity is to get the outbreak under control through staying home, social distancing, and wearing masks. If fewer people are infected, there is less demand for testing and we can offer it more broadly to the community.”