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As Coronavirus Testing Increases, Some Labs Fear a Shortage of Other Supplies As Coronavirus Testing Increases, Some Labs Fear a Shortage of Other Supplies
(1 day later)
Laboratories around the country are now facing potential shortages of key materials and chemicals needed to run tests for the novel coronavirus, as cases spread to more than two-thirds of the states and the global pandemic strains testing resources even further.Laboratories around the country are now facing potential shortages of key materials and chemicals needed to run tests for the novel coronavirus, as cases spread to more than two-thirds of the states and the global pandemic strains testing resources even further.
Some lab directors say they are already beginning to run low of the supplies needed to extract RNA from nasal swabs, a crucial initial step that is separate from the millions of test kits that the federal government has promised to ship to every state. Others say they are weighing whether to borrow some materials from other research labs that aren’t involved in creating or running coronavirus tests.Some lab directors say they are already beginning to run low of the supplies needed to extract RNA from nasal swabs, a crucial initial step that is separate from the millions of test kits that the federal government has promised to ship to every state. Others say they are weighing whether to borrow some materials from other research labs that aren’t involved in creating or running coronavirus tests.
And some lab directors are worried about the future availability of the reagents, or chemical ingredients, used in the tests themselves. Several labs have also said that they have had trouble getting virus samples that are needed to validate the tests to make sure they are properly identifying positive samples.And some lab directors are worried about the future availability of the reagents, or chemical ingredients, used in the tests themselves. Several labs have also said that they have had trouble getting virus samples that are needed to validate the tests to make sure they are properly identifying positive samples.
Public health officials and health care providers have clamored to get enough tests following a botched rollout of testing kits by the Centers for Disease Control and Prevention — and a delay by the Food and Drug Administration in allowing independent labs to develop their own test — that led to weeks of delays in detecting the spread of the virus in the country.Public health officials and health care providers have clamored to get enough tests following a botched rollout of testing kits by the Centers for Disease Control and Prevention — and a delay by the Food and Drug Administration in allowing independent labs to develop their own test — that led to weeks of delays in detecting the spread of the virus in the country.
“The lack of testing in the United States is a debacle,” said Dr. Marc Lipsitch, a professor of epidemiology at the Harvard T.H. Chan School of Public Health. “We’re supposed to be the best biomedical powerhouse in the world and we’re unable to do something almost every other country is doing on an orders-of-magnitude bigger scale.”“The lack of testing in the United States is a debacle,” said Dr. Marc Lipsitch, a professor of epidemiology at the Harvard T.H. Chan School of Public Health. “We’re supposed to be the best biomedical powerhouse in the world and we’re unable to do something almost every other country is doing on an orders-of-magnitude bigger scale.”
Today, public health labs in every state say they are running the tests, and academic and commercial labs have been scrambling to increase their capacities to check for the virus.Today, public health labs in every state say they are running the tests, and academic and commercial labs have been scrambling to increase their capacities to check for the virus.
But Washington, New York and California are leading states with hundreds of cases, as officials warned again on Wednesday that the numbers will continue to rise.But Washington, New York and California are leading states with hundreds of cases, as officials warned again on Wednesday that the numbers will continue to rise.
People are also reporting that they still can’t get tested, in some cases because doctors and hospitals are evaluating patients based on their symptoms and whether those are indicative of the virus or regular flu.People are also reporting that they still can’t get tested, in some cases because doctors and hospitals are evaluating patients based on their symptoms and whether those are indicative of the virus or regular flu.
The RNA extraction kits “are usually things we wouldn’t ever even wonder if they were running out, because they’re always around,” said Michael Mina, an assistant professor of epidemiology at the Harvard T.H. Chan School of Public Health. “But in this case, because everyone in the world is trying to extract RNA right now, they seem to be low.”The RNA extraction kits “are usually things we wouldn’t ever even wonder if they were running out, because they’re always around,” said Michael Mina, an assistant professor of epidemiology at the Harvard T.H. Chan School of Public Health. “But in this case, because everyone in the world is trying to extract RNA right now, they seem to be low.”
At the University of California, Los Angeles, the chief of the microbiology section of the medical center’s clinical lab was so concerned about his supply of RNA extraction kits made by the company Qiagen that he recently sent an email to colleagues at the university’s research labs asking if they had any. “While our investigators were eager to help, none were using the kit in their labs,” said Elaine Schmidt, a spokeswoman for the medical center.At the University of California, Los Angeles, the chief of the microbiology section of the medical center’s clinical lab was so concerned about his supply of RNA extraction kits made by the company Qiagen that he recently sent an email to colleagues at the university’s research labs asking if they had any. “While our investigators were eager to help, none were using the kit in their labs,” said Elaine Schmidt, a spokeswoman for the medical center.
Eric Blank, the chief program officer at the Association of Public Health Laboratories, said his group has also been hearing about back orders of the extraction kits and other supplies. Now that independent labs are able to run their own tests, “it is increasing at a very rapid pace,” Mr. Blank said. “It just depends on how rapidly the manufacturers of some of these other ancillary materials needed to run the tests can ramp up their production.”Eric Blank, the chief program officer at the Association of Public Health Laboratories, said his group has also been hearing about back orders of the extraction kits and other supplies. Now that independent labs are able to run their own tests, “it is increasing at a very rapid pace,” Mr. Blank said. “It just depends on how rapidly the manufacturers of some of these other ancillary materials needed to run the tests can ramp up their production.”
Qiagen, a major manufacturer of the RNA extraction kits, said in a statement this week that because of the coronavirus outbreak, demand is “challenging our capacity to supply certain products” and that it was increasing production in sites in Germany, Spain and Maryland.Qiagen, a major manufacturer of the RNA extraction kits, said in a statement this week that because of the coronavirus outbreak, demand is “challenging our capacity to supply certain products” and that it was increasing production in sites in Germany, Spain and Maryland.
Roche, another supplier of lab materials and equipment, said in a statement: “Our manufacturing network has robust business continuity plans for dealing with the impact of a potential health crisis and is actively assessing and monitoring this evolving health situation.”Roche, another supplier of lab materials and equipment, said in a statement: “Our manufacturing network has robust business continuity plans for dealing with the impact of a potential health crisis and is actively assessing and monitoring this evolving health situation.”
The F.D.A. and C.D.C. have also said they are watching for potential shortages. The F.D.A. said this week it was “monitoring this issue and has heard from some manufacturers with questions about alternative reagents, extraction methods and platforms.” It said it was offering guidance to labs and updates on the issue on its website.The F.D.A. and C.D.C. have also said they are watching for potential shortages. The F.D.A. said this week it was “monitoring this issue and has heard from some manufacturers with questions about alternative reagents, extraction methods and platforms.” It said it was offering guidance to labs and updates on the issue on its website.
Updated June 30, 2020
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
But the extraction kits are not the only supply item with uncertain availability. The American Society for Microbiologists said Tuesday that it was “deeply concerned” about a potential shortage of the reagents needed to conduct the tests as well as other materials. “Increased demand for testing has the potential to exhaust supplies needed to perform the testing itself,” the society said.But the extraction kits are not the only supply item with uncertain availability. The American Society for Microbiologists said Tuesday that it was “deeply concerned” about a potential shortage of the reagents needed to conduct the tests as well as other materials. “Increased demand for testing has the potential to exhaust supplies needed to perform the testing itself,” the society said.
On Monday, the C.D.C. revised its guidelines to allow for the collection of one specimen swab instead of the previously required two, a move that the society said would cut the required amount of testing reagents in half.On Monday, the C.D.C. revised its guidelines to allow for the collection of one specimen swab instead of the previously required two, a move that the society said would cut the required amount of testing reagents in half.
Dr. Robert Redfield, the director of the C.D.C., told Politico on Tuesday that the agency was keeping an eye on the supply of materials needed to do the tests. But, when asked how the agency would deal with a shortage of RNA extraction kits, he said: “I don’t know the answer to that question.”Dr. Robert Redfield, the director of the C.D.C., told Politico on Tuesday that the agency was keeping an eye on the supply of materials needed to do the tests. But, when asked how the agency would deal with a shortage of RNA extraction kits, he said: “I don’t know the answer to that question.”
Integrated DNA Technologies, which is manufacturing coronavirus test kits for the C.D.C., said in a statement that beginning next week, it expects to be able to provide enough shipments of C.D.C. kits that would allow for five million tests a week. The company added that “is accustomed to scaling up to meet customer demand and does not anticipate needing to hire additional staff.”Integrated DNA Technologies, which is manufacturing coronavirus test kits for the C.D.C., said in a statement that beginning next week, it expects to be able to provide enough shipments of C.D.C. kits that would allow for five million tests a week. The company added that “is accustomed to scaling up to meet customer demand and does not anticipate needing to hire additional staff.”
Labs have also said they have had a difficult time getting so-called positive controls, or samples of the virus to ensure the tests are working properly.Labs have also said they have had a difficult time getting so-called positive controls, or samples of the virus to ensure the tests are working properly.
“We have requested these from a couple of vendors, but it has taken some time to get registered to have the controls shipped,” said Dr. Jim Dunn, the director of medical microbiology and virology at Texas Children’s Hospital in Houston, which is now running its own test for coronavirus for the hospital’s patients.“We have requested these from a couple of vendors, but it has taken some time to get registered to have the controls shipped,” said Dr. Jim Dunn, the director of medical microbiology and virology at Texas Children’s Hospital in Houston, which is now running its own test for coronavirus for the hospital’s patients.
Veronique Greenwood and Denise Grady contributed reporting.Veronique Greenwood and Denise Grady contributed reporting.