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Dr. Gupta: Lack of testing is country's 'original sin'
02:03 - Source: CNN

Editor’s Note: Dr. Emily E. Volk is president of the College of American Pathologists, a board-certified anatomic and clinical pathologist, associate professor of pathology at the University of Louisville, and the chief medical officer at Baptist Health Floyd in New Albany, Indiana. The views expressed in this commentary are her own. View more opinions on CNN.

CNN  — 

The US has been on a troubling course in its fight to end the pandemic: Since the first cases of Covid-19 caused by the Omicron variant were identified in the US, case numbers have been on the rise, with hundreds of thousands of new patients diagnosed per day. Given the latest Covid spike, demand for testing is surging along with misperceptions of what it takes to perform a test, from collecting the sample to delivering a diagnosis.

Emily E. Volk

It is important for the public to know Covid tests, like many other products facing delays and shortages, have been limited by supply chain shortages. Understanding this helps put in perspective the lack of availability that can arise when demand for tests peaks. It is understandable people are frustrated by resource shortages, but there is something the public can do to help right the ship: be responsible about testing correctly (which includes reporting positive at-home test results to your physician), vaccinating and taking additional safety measure like quarantining when infected with or exposed to Covid-19.

Developing Covid-19 tests

Pathologists are the physicians medically responsible for laboratory testing and diagnosis. We ensure clinical laboratory quality so diagnostic testing is safe and accurate when performed.

Alongside medical technologists and clinical laboratory scientists, we sprang into action in March 2020. We worked tirelessly to get Covid -19 testing up and running in laboratories across the nation. It was no easy task; it included working to develop the Covid-19 PCR test and safely implementing high volume testing technology in hospital and clinical reference laboratories across the country. It was all done while continuing the other largely unseen work that is critical to the nation’s health – work like diagnosing cancer from patient biopsies, identifying other infectious diseases by running blood cultures, making safe blood transfusions available to trauma patients or examining patient blood smears for signs of sickle cell anemia.

Quite frankly, it felt like trying to fly a fleet of planes while building them. It’s what we do 365 days a year. Our laboratories have always run around the clock, out of public view, processing millions of patient tests, because treatment cannot happen without a diagnosis.

Resource limitations

Most of us are aware the pandemic brought with it supply chain shortages. Clinical laboratories are not immune. We are asked to run thousands of tests daily for emergency room and clinical patients, hospital ICU patients, and community drive-through testing sites, all while managing day-to-day unexpected shortages of testing supplies such as the swabs used to retrieve samples from patients’ nostrils.

In addition, especially early in the pandemic, transport delays prevented many tests from rural hospitals and ambulatory clinics from reaching the clinical laboratories in a timely fashion, prolonging wait times for Covid test results.

And, just like at the bedside, the pandemic triggered clinical laboratory staffing shortages and burnout. We must keep laboratories running 24/7, even while dealing with a critical shortage of medical technologists and phlebotomists, an issue only heightened by Covid-19 testing demands.

It’s not just about testing

We cannot test ourselves out of this pandemic; we never could. Testing is critical for managing patients, tracking overall progress and identifying new variants, but testing alone will not end the pandemic.

We must also find a way to reach those who are still hesitant about receiving the vaccine and try to change hearts and minds so we can begin to release the pressure on our health care system.

We need to interrupt the stream of deadly misinformation and share the good news about safe and effective FDA-approved vaccines that can prevent death and long-term health problems from the virus. The public, the private sector and the medical community need to be in lockstep on this messaging. This I know for sure.

I also know, to some of you, this may sound like a broken record, old news, something I’m sure you are tired of hearing, but if you are looking for different answers there are none.

Testing the right way

For those using at-home tests, I can’t stress enough the need to read the test directions carefully and follow them to the letter. The College of American Pathologists understands the need for at-home tests, but I urge caution: it is imperative to make sure the tests are of high-quality and performed correctly.

If you are symptomatic and cannot get a PCR laboratory test, but test positive using an at-home test, chances are the test correctly identified the virus. If you are symptomatic and have had an exposure to the coronavirus virus, and then you test negative with an at-home test, you must follow up with a PCR test.

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    Quarantine until you receive your PCR results. If you do not, you put others in jeopardy. Also, contact your primary care doctor if you test positive at home. It’s critical your diagnosis be reported to county and state health departments. It can help with allocating health care resources should you be hospitalized and determining what areas of the country are seeing a spike in Covid-19 cases.

    We often hear about the inadequacies when it comes to Covid-19 testing; not enough tests, long turnaround times and even longer lines to get tested. Take it from the physicians who test for a living, we don’t regard failure as an option. We are very much with you in the struggle to adapt, carry on, and do what needs to be done.