New COVID-19 testing mandate presents challenges for local clinics

Health officials have mandated that healthcare providers test their own patients for COVID-19 starting today, July 31, but local clinics are already scrambling for testing supplies and struggling with long wait times to get test results back from labs.

“I do think it’s the right thing to do,” said Dr. Elisa Nicholas, CEO of TCC Family Health, a local clinic that serves low-income families. “They’re our patients, if they’re positive and/or if they have symptoms, we should be caring for them and following them and working with the public health department so we can really do the tracing and control the spread of the disease.”

Nicholas said her clinic sees about 75 patients per day with COVID-19 symptoms and of those, about 10-15% end up testing positive. Some of her patients end up going to the city sites or urgent care for faster results, she said.

The mandate requires providers to test their own patients for COVID-19 if they are symptomatic or have been exposed. It was implemented in part because doctors were often telling their patients to just go to the city drive-thru sites to get tested, city health director Kelly Colopy said. The mandate will help ensure that those who don’t already have doctors or insurance can get tested and helps ensure sick patients are in communication with their care providers.

Earlier this month, residents were reporting two week-long wait times to even get a COVID-19 test appointment at any of the city-run sites and then seeing sometimes longer wait times to get their results back. Now, city officials have largely worked out the kinks in their testing centers by limiting appointment time slot availability to three days and adding more appointments. Residents are also reporting getting their results back within one or two days.

But local clinics and doctors offices haven’t had the same experience: Many are waiting weeks to get results back for their patients. Nicholas said her clinic is seeing up to 14-day waits to get results back from the lab because of backlogs. She said her clinic has secured a contract with another lab, but won’t be able to use them until October because of supply shortages at that lab.

“The labs being back-logged is terribly challenging, even if we have enough equipment, enough tests, enough PPE, if we have no lab results for seven to 10 days, there’s not really good tracing happening,” said Andy Patterson, vice president of government affairs for California Primary Care Association.

There’s also a shortage of labs that can do the testing, Patterson said. Her organization as well as other medical associations are working with state health officials to amend the mandate to ensure there is enough access to testing.

One of the most used national private labs, Quest, is seeing long result lags of up to seven days for non-hospitalized patients, according to a statement by the company.

“The laboratory industry’s ability to add testing capacity is limited by a range of issues,” the company’s statement said. “The most significant hurdle we face now is limits to complex testing platforms and chemical reagents required to perform testing.”

These long turnaround times make containing and slowing the spread of the virus much harder for public health officials.

And if it’s not wait times, clinics are also having issues getting enough testing kits.

One Long Beach clinic, non-profit Community Medical Wellness Center, has temporarily put COVID-19 testing on hold until it can get more test kits from its lab, the clinic manager, Monica Sarim said. Her clinic, like TCC, also primarily serves low-income, Medi-Cal and uninsured patients.

The city is also having issues when it comes to helping procure tests for nursing homes, which are mandated by the state to surveillance test their staff and residents, Colopy has said.

“The city continues to work through challenges at our own public health lab to ensure that we have the necessary lab technology and supplies to expand testing capacity,” a city spokeswoman said.

Colopy said at a press conference this week that the city would work with clinics and medical providers to coordinate access to testing.

“We realize that right now, there still are some concerns about supplies that are difficult to get, but there are many more labs coming online through the FDA (Emergency Use Authorization) process and so more access to testing is becoming available each couple of weeks,” Colopy said. “So what we are doing is encouraging providers and medical facilities to look at some alternate labs.”

Nicholas said she thinks it will take local health officials and clinics coming together to solve the issue.

“It’s not an ‘or,’ its an ‘and,'” Nicholas said.

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Valerie Osier is a breaking news and crime reporter for the Long Beach Post. She’s a Riverside native who found her love for journalism while at community college. She graduated from the Cal State Long Beach journalism program in 2017 and covered the Palos Verdes Peninsula for the Daily Breeze prior to coming to the Post. She lives in Long Beach with her husband and two cats.