Coronavirus: Why doesn’t Florida have enough kits to test for it?

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TALLAHASSEE — Florida state officials say they don’t have enough testing kits to meet federal guidelines for who should be tested for novel coronavirus, even as anxiety has mounted over the potential for community spread of the highly contagious respiratory illness.

During a Thursday news conference, Gov. Ron DeSantis said Florida is awaiting “tens of thousands” of testing kits from federal authorities that would allow state officials to test in more locales. The tests are now only being done in public health labs in Tampa, Miami and Jacksonville.

“We’d like to get them as soon as possible,” DeSantis said. “To be able to do that local testing would make a big, big difference.”

Helen Aguirre Ferré, Gov. Ron DeSantis’ spokeswoman, told the Times/Herald on Thursday the state was working closely with federal health officials but simply didn’t have the resources to meet its latest guidance from Wednesday, which was to test anyone who physicians suspect might have the novel coronavirus that causes the disease known as COVID-19.

And even under the more limited, previous criteria for testing that the state has used since the weekend — testing only those people who traveled to certain places with the disease, had close contact with someone infected or have severe lower respiratory illness of unknown origin requiring hospitalization — Florida’s labs in Miami, Tampa and Jacksonville have struggled to manage a rush of specimens, given the highly complicated nature of the test for the virus, which can take hours and needs to be re-run if there are complications.

In a Thursday morning update, the Florida Department of Health said it had tested about 100 people so far, though it is still waiting for the results in 69 of those tests. The agency listed 31 negative results, on top of three positives confirmed earlier this week and one announced Thursday, following five days of testing. The state said it is still monitoring more than 250 people.

“If the federal government is going to say everyone should be tested, fantastic. Florida [Department of Health] would be happy to comply,” Ferré said. “But please know, we don’t have enough testing kits to test absolutely everyone.”

Ferré maintained that the state was still in the 24-48 hour window to produce testing results, but could not explain why pending tests were far outpacing announced results.

“We’re trying to turn it around as quickly as possible,” she said.

Unless the state is able to expand its testing capability, the current standards for testing in Florida are that a patient meet two of the following three criteria:

• Travel to or from an area with widespread community transmission — Italy China, South Korea and Japan — and showing symptoms of COVID-19: cough, shortness of breath and fever.

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• Close contact with a confirmed COVID-19 case, with the same symptoms.

• Severe, acute lower respiratory illness and fever requiring hospitalization, and without an alternate diagnosis, like the flu.

Ferré said those restrictions are crucial public health measures to make sure state labs aren’t overwhelmed, but a lack of proactive testing has been a major concern for public health experts since before novel coronavirus even arrived in Florida. Without wide testing, it’s impossible to detect the spread of the contagion in the community.

Ideally, public health experts have said local officials should be performing surveillance, or testing individuals proactively, which has uncovered cases of suspected community transmission in Washington state. Experts have also said federal health officials need to deliver “point of care” testing, which gives local physicians and hospitals the ability to test on-site. The governor on Tuesday said that development was “potentially months away.”

In Washington state, the country’s biggest known COVID-19 hotspot, health officials have recently resorted to “social distancing” measures such as eliminating large gatherings and working from home to try and contain community transmission.

Faulty testing and bureaucratic red tape has been blamed for allowing the virus to circulate there undetected there for weeks, the Seattle Times reported.

Ferré, the Florida governor’s spokeswoman, has maintained that the state has “not reached its ceiling” for coronavirus testing but conceded that the testing process has been cumbersome.

The state labs might be ill-equipped to handle such molecular-level testing, according to David Krause, who has a Ph.D. in toxicology and was a former state toxicologist at Florida Department of Health from 2008-2011. He said state health labs were never built or intended to manage a high number of samples per day and are better equipped for handling simple tests like water quality samples.

“I have limited expectations that they’re capable of doing this in a broad fashion,” he said.

Mary Jo Trepka, a Florida International University professor who worked as an epidemiologist at the Department of Health from 1998-2003 and visits state labs every year for teaching purposes, said the testing situation indicates a “big problem,” but said it was more a question of staffing than expertise.

“They don’t have a large staff,” Trepka said. “When we had the Zika outbreak, they had to have commercial labs help with all the testing, and that’s going to have to happen here, too, most likely.”

On Saturday, state officials heralded the development that Department of Health labs — in Miami, Tampa and Jacksonville — would start testing for novel coronavirus, ending weeks of reliance on the CDC lab in Atlanta.

At that time, state officials claimed in-state testing would drastically cut the wait times for results, from several days to 24-48 hours, but the numbers have yet to reflect any spike in testing.

When the state first received its testing kits for the virus from the federal government last month, the kits were faulty, and so all testing samples — such as oral or nasal swabs, or saliva — collected at local hospitals or county health departments had to be sent to the U.S. Centers for Disease Control and Prevention in Atlanta. The results came back three to five days later.

After the initial fumble by federal health authorities, the Centers for Disease Control announced that it was vastly expanding its testing across the country.

Since then, reports have sprung up across the country of states having surprisingly limited testing capability. For example, the nonprofit investigative reporting outlet Spotlight PA reported that Pennsylvania labs could only test six samples per day, though state officials have since said they can now test up to 25 samples per day.

If capacity catches up, will cost be a barrier?

State and federal lawmakers have floated suggestions for how to cover the cost of testing.

U.S. Sen. Rick Scott tweeted Tuesday that he was “calling on Congress” to include money in an emergency appropriations bill to pay for coronavirus tests for “anyone experiencing symptoms.”

At a news conference in Miami, DeSantis said Vice President Mike Pence, who has been assigned oversight of the national response to the outbreak, said President Donald Trump’s administration would find funds to help states get reimbursed for testing.

“What the vice president is envisioning as a former governor is ‘Look, you guys need to be able to combat this thing. So you guys do what you’ve got to do. We will appropriate money and then simply reimburse you on the back end,’” DeSantis said.

DeSantis said he would be also be asking lawmakers to find room in the state budget that will be passed during the 2020 legislative session, which ends March 13.

Senate Health and Human Services Appropriations Chair Aaron Bean, R-Fernandina Beach, said that he met Monday with his House counterpart, Rep. MaryLynn Magar, R-Tequesta, to discuss the idea of creating a “super line” in the Department of Health’s budget for the upcoming 2020-2021 fiscal year.

The “super line” would give department Secretary Scott Rivkees spending money to use on public-health emergencies like the spread of coronavirus and hepatitis A.

Times/Herald staff writer Lawrence Mower and the News Service of Florida contributed to this report.

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Tampa Bay Times coronavirus guide

Q&A: What you need to know after Florida’s first positive coronavirus cases.

PROTECT YOURSELF: Household cleaners can kill the virus on most surfaces, including your phone screen.

BE PREPARED: Guidelines for essentials to keep in your home should you have to stay inside.

FACE MASKS: They offer some protection, but studies debate their effectiveness.

WORKPLACE RISK: A list of five things employers could be doing to help curb the spread of the disease.

READER BEWARE: Look out for bad information as false claims are spreading online.

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