Banner Health Is 'Nowhere Near Ready' for Widespread COVID-19 Testing

The Arizona Department of Health Services says that testing for the new coronavirus at commercial labs has quickly become available, yet medical providers and laboratories warn that the supplies for widespread testing do not yet exist.

People have reported being denied testing, despite being ill with COVID-19-like symptoms, and the criteria for patients who qualify for testing remain vague. Doctors and hospitals have said that tests are reserved for the sickest patients, not mildly ill or potentially asymptomatic ones. The lack of testing has sparked fears that cases of COVID-19 are being undercounted.

At a press conference on Monday, Dr. Marjorie Bessel, chief clinical officer and COVID-19 lead for Banner Health, Arizona's largest hospital system, said that "later this week" people can expect more widespread testing, but declined to share more details.

In response to a question about whether it would ever be practical to conduct testing on everyone, Bessel said, "Certainly at this time we're nowhere near ready to do that." She added, "I don't foresee that anytime in the upcoming weeks."

The number of COVID-19 infections in Arizona is rising steadily and, as of Monday, stands at 18 people.

Bessel said the hospital is testing people at the hospital on an inpatient basis in conjunction with state and local health departments but will be offering commercial testing at ambulatory centers like urgent care centers, of which it has about a dozen in the Valley, and other outpatient clinics.

The criteria that Banner uses to test those in inpatient settings is different from those used at clinics like urgent care centers, Bessel confirmed, but "those algorithms are also fluid as the situation continues to change."

She declined to share the number of patients who had been tested for COVID-19 at Banner hospitals and ambulatory settings, citing patient privacy. She also declined to share the number of people who had asked for tests and been denied.
 
Dr. Susan LaSala-Wood, a doctor of nursing practice who owns a private clinic in Scottsdale, said that the limited supply of tests, as a matter of necessity, must be saved for the sickest people.

If nurses, doctors, and hospitals use up all their test kits on patients with low-grade symptoms, with perhaps a slight temperature and a slight cough, "How are we going to test the ones that are more severe?" LaSala-Wood asked. "That's why you have to gradate out who you test and who you don't."

Those with light symptoms should go home and use common sense: Stay home, practice good hygiene, and don't share food and drinks, LaSala-Wood said.

Sonora Quest, one of two commercial laboratories in Arizona that can test for COVID-19 and the novel coronavirus, which causes the disease, told medical providers that the swabs used to collect samples from a person's mouth or throat were "extremely limited," citing "significant demand."

In its COVID-19 specimen-collection instructions to health care providers, LabCorp ,which said on Monday that by the end of the week it expected to be able to perform 10,000 tests per day and 20,000 per day by the end of week, put the turnaround time for testing at three to four days. The company said, vaguely, that the test "is for use with patients who meet guidance for evaluation of COVID-19 infection." 

LaSala-Wood said that she has yet to test anybody for COVID-19 but said she had stocked up on supplies.

Doctors and nurses remain the gatekeepers for COVID-19. It is up to them to decide who merits testing and who doesn't. Laboratories have made clear that people cannot simply walk into a lab, demand a throat swab, and be tested for the virus.

But patients can be pushy, and LaSala-Wood said that although testing is currently available, she worried about panic setting in and those who aren't severely ill receiving testing.

“[Tests] are going to be limited here pretty soon, because you’ve got people in a panic who are using up supplies when they shouldn’t be tested,” she said.