State rations tests for most vulnerable as labs race to boost capacity

The Miller Park entrance sign informs citizens that the COVID-19 testing drive-thru is open at Miller Park in Marietta, Wednesday, March, 18, 2020. Testing is by “appointment” only and isn’t opened to the public unless with a medical referral. ALYSSA POINTER/ALYSSA.POINTER@AJC.COM

The Miller Park entrance sign informs citizens that the COVID-19 testing drive-thru is open at Miller Park in Marietta, Wednesday, March, 18, 2020. Testing is by “appointment” only and isn’t opened to the public unless with a medical referral. ALYSSA POINTER/ALYSSA.POINTER@AJC.COM

Drive-through testing sites for coronavirus began opening in metro Atlanta in recent days, but testing availability remains extremely limited, frustrating worried residents, and a lack of capacity to process tests continues to hamstring hospitals swamped with suspected cases.

To ease the testing backlog, Gov. Brian Kemp endorsed a plan Wednesday to ration tests to those most at risk of coronavirus infection, such as older residents, and those on the front lines of the emergency, such medical workers and first reponders.

“Many Georgians are eager to be tested right now, but we need to be mindful of our resources,” Kemp said. “Georgia’s elderly, those with chronic, underlying health conditions, those who live in a long-term care facility like an assisted living facility or nursing home, and those serving on the front lines as a healthcare worker, first responder, long-term care facility staffer, or law enforcement need tests.”

» COMPLETE COVERAGE: Coronavirus in Georgia

The Cobb & Douglas Public Health Department on Wednesday opened a drive-through testing facility at Jim Miller Park south of Marietta that will strictly serve a select number of high-risk people with appointments. These include health care workers, first responders and people who live in congregate settings such as dorms, long-term care centers or homeless shelters.

The test site, heavily guarded by Cobb police, had an electronic sign alerting motorists, “Testing By Appt Only” and “No Public Testing.”

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“Today, is our first run at this and we have to start slowly,” Dr. Janet Memark, director of Cobb & Douglas Public Health told reporters Wednesday. “But we are making sure that logistically everything goes well and start with a few patients today.”

The Cobb and Douglas agency has fewer than 50 test kits currently, a spokeswoman said, though it expects to receive more. For now, patients through the Jim Miller Park facility must receive a physician referral that must be approved by the Georgia Department of Public Health before a patient is granted an appointment.

A similar restricted drive-through facility opened in Clayton County, while DeKalb County’s health agency is also working to establish its own drive-through test site on a referral-only basis.

In the southwest Georgia city of Albany, Phoebe Putney Health System set up a drive-through testing site of its own. There, patients with referrals are given an appointment time and a medical professional in protective gear performs two swabs of the throat and nasal passages. Specimens are kept in a special medium before being shipped to a lab.

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Though the federal government has approved billions in emergency funds to produce millions of test kits and to combat COVID-19, the disease caused by the coronavirus, testing is still strictly constrained nationally.

“There is not the capability to do large scale testing right now,” Memark said.

Still, the ramp-up of testing is putting pressure on the Department of Public Health (DPH) and private testing labs to process test results more quickly. Phoebe waited a week or more for some of its latest results, during which time at least one patient died before the results came in.

As of March 18, the state lab and two private labs have processed 1,508 tests, yielding 197 positive cases of the virus. Yet hundreds, perhaps thousands more are pending, based on test figures from Georgia hospitals and other providers.

DPH did not respond to a request seeking the number of backlogged test kits at the state’s lab, or the average time to process tests.

» RELATED: Two coronavirus deaths confirmed in southwest Georgia; total now 3

» MORE: First responders brace for strain from coronavirus

State officials and three of Georgia's largest hospital systems this week urged people not to come to hospitals to be tested if they are experiencing only mild or moderate symptoms to minimize the risk of exposing others.

Officials urge people not to show up unannounced at hospitals or doctors’ offices. Instead, people should contact their health provider or the state Department of Public Health coronavirus hotline at (844) 442-2681 for more information and instruction.

Children’s Healthcare of Atlanta, which operates three hospitals and numerous clinics in metro Atlanta, said it currently is not testing for COVID-19, though it said it is “collecting specimens at our hospitals if certain criteria are met.”

“Given nationally limited supplies of test kits at present and limited capacity to process specimens, this is reserved for higher-risk children or those deemed necessary to test by the Georgia Department of Public Health,” the health system said in a statement. “Parents can often manage symptoms at home, as testing is not required and does not usually affect how a child is treated for COVID-19.”

A medical professional in protective equipment swabs a potential COVID-19 patient at a Phoebe Putney Health System drive-through testing site in the Albany area. SPECIAL TO THE AJC

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Backlogs around the state

The Phoebe Putney Health System, which operates four hospitals near Albany, is awaiting results on more than 400 tests at national labs, with some pending for more than a week. Atlanta area hospitals, meanwhile, also have reported backlogs stretching several days.

Hospitals must treat presumptive COVID-19 cases as if they were confirmed. The testing backlog ties up precious resources on some patients who, while sick, might not require hospitalization or such strict isolation. Those resources instead could go to other patients known to have the disease.

“It’s very frustrating,” Phoebe President and CEO Scott Steiner said. “We have just got to get results.”

Frustrated by delays, Steiner said his hospitals recently switched from LabCorp to Quest Diagnostics. He said his hospitals are re-testing patients who already have been swabbed and sending those kits to Quest in hopes of a faster response.

Federal officials in a press conference with President Trump on Wednesday said national laboratories would soon bring online new processing capabilities to quickly work through the backlogs, which will likely create a spike in the figures of confirmed infection counts in Georgia and other states.

Emory Healthcare said this week Swiss pharma and diagnostic giant Roche would provide its lab supplies to process about 200 test kits per day. The state’s health lab, meanwhile, also is attempting to ramp up capacity to 200 tests per day. But it’s unclear when they will reach that capacity.

An electronic sign outside a COVID-19 testing center in Cobb County warns motorists “No Public Testing.” The Cobb & Douglas Health Department on Wednesday, March 18, 2020, opened the drive-through testing center at Jim Miller Park south of Marietta for high-risk people that is by referral-only. J. SCOTT TRUBEY/STRUBEY@AJC.COM

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‘Making a mask’

The lack of widespread testing has unnerved Georgians. Bill Taylor of Alpharetta said he experienced shortness of breath so bad a few weeks ago he dialed 911, afraid he’d contracted COVID-19.

At 56, and a scuba diver, Taylor said he had never experienced such respiratory distress. But he’d interacted with people who recently traveled to Italy and his immune system had been battered by a series of recent infections.

Taylor said he was told to go to an emergency room, but he said he feared if he had the virus he might spread it to others at the hospital. He said he got the runaround calling to his doctor, an urgent care clinic and public health agencies.

Ultimately, Taylor said he recovered at home. But the scarcity of testing scared him, and he said he still wants to be tested, fearing he might be contagious.

“Right now, I’m making a mask,” Taylor said. “I’m watching a video online on how to sew one.”

Staff writers Chelsea Prince and Ariel Hart contributed this this report.