With Florida's public laboratories taking as long as five weeks to deliver Zika test results to doctors and patients, federal and state health officials said this week that they are buying more supplies and equipment and hiring more workers to speed up the often lengthy process for diagnosing the virus.
The Centers for Disease Control and Prevention announced on Tuesday that it had purchased about $2.5 million in laboratory resources to expand access to Zika testing and reduce wait times for results in several states, including Florida, where Gov. Rick Scott has repeatedly accused the federal government of failing to meet the state's needs.
With the number of Zika infections in Florida at 857, including four new local cases confirmed in Miami-Dade on Tuesday, the health department reported testing more than 7,815 people statewide. A total of 99 local infections have been reported in the state, including 10 out-of-state residents.
But with free Zika testing offered to all pregnant women in Florida, Scott said, state health officials need more help. During a visit to Miami's Wynwood neighborhood on Monday to declare the area free of the virus, the governor noted that he has allocated $36.2 million to help pay for the state's response and expedite Zika testing.
"We have ordered more equipment. We have put more people on," said Scott, who visited Washington, D.C., the week before to press Congress for emergency funding to combat Zika.
"We have asked for more support from the CDC," he said. "Finally, last week they gave us some additional lab support. We need more lab support. We have asked for an additional epidemiologist. We're going to continue to do our part, but we also need some support."
State Surgeon General Celeste Philip added that the health department is reviewing its Zika testing procedures to speed up results. She said a spike in demand — following Scott's Aug. 3 mandate that all pregnant women in Florida are eligible to receive free Zika testing — and the relatively new diagnostics also are causing delays.
Ten Zika tests have been approved for use this year under the Food and Drug Administration's Emergency Use Authorization, including the two diagnostics performed at Florida's public labs. And though Florida awarded a $5 million contract to LabCorp in August to conduct Zika testing, the arrangement has not reduced wait times significantly because some of those results require follow up, Philip said.
"Because these labs are still relatively new, when we have positive results from commercial labs, our public health labs have to confirm those (results)," she said, "and oftentimes that requires additional testing for antibodies. ... That can take longer. That can take four to six weeks."
That's about how long South Florida patients and physicians say they have been waiting for any Zika test results — positive or negative — processed through state labs, which advertise turnaround times of two to five days. Some situations require additional testing that can take several weeks.
South Florida physicians, however, say the state's delay in delivering Zika test results is due to more than a spike in demand or the need for additional testing. One doctor, the chief pathologist for Jackson Memorial Hospital, told the Miami Herald last week that the backlog appears to be on the paperwork and administrative side.
Years of job cuts at the state health department has reduced the agency's workforce from more than 17,000 positions in 2011, the year Scott took office, to fewer than 14,000 full-time employees this year, according to state records.
Asked whether staffing reductions have contributed to delays in delivering Zika test results to patients, Philip responded: "That's something that we are looking at. For the most part, those results are being delivered in a timely manner. There have been a few situations that we've been made aware of and we're working on making sure that does not happen."
According to the CDC, few labs in the country are certified to test for Zika. Philip said all three of Florida's public health labs — in Jacksonville, Miami and Tampa — conduct Zika testing, and that private labs and the CDC also have been helping.
Among the resources the CDC has reported sending to 43 states, the District of Columbia, Puerto Rico and nine Department of Defense laboratories are test kits for detecting antibodies that the body makes to fight a Zika infection.
Antibodies appear in the blood of a person infected with Zika beginning four to five days after the onset of symptoms and last for about 12 weeks, according to the CDC.
The federal agency has also sent materials to all states and 16 defense department labs that allows them to use a second Zika test, which allows doctors to tell if a patient has an active infection of chikungunya, dengue or Zika using just one test rather than separate tests for each virus.
Florida's labs perform about 150 tests for active Zika each day, and an additional 130 diagnostics for viral antibodies, according to the health department.
Philip, the state's surgeon general, noted that the volume of Zika testing in Florida — the only state in the nation where mosquitoes are spreading the virus — is "quite unusual," and she compared it to the 2009 swine flu outbreak.
"But for flu," she said, "they're rapid tests. This is a new test that has been developed within the past year, so there are still questions regarding how widely available these tests will be in commercial labs. Therefore, it's a very different scenario than we've ever seen in the past."