In crisis, COVID-19 testing woes leave Michigan waiting for answers

Craig Mauger
The Detroit News

Lansing — The seemingly simple task of determining who has COVID-19 in Michigan is plagued by dwindling testing supplies and delays that are hindering efforts to contain a virus overwhelming hospitals and devastating the economy.

Although test shortages exist nationally, Michigan appears to be facing the brunt of them, according to Detroit News analysis of data from other states. Michigan, which is among the 10 states with the most confirmed cases, has reported doing fewer tests than states with similar numbers of confirmed cases as well as a handful of similarly sized states with fewer cases, according to data available Thursday.

Beaumont Hospital staff in Royal Oak perform drive through screenings Wednesday afternoon.

When Michiganians are able to get tested, many face lengthy waits for their results. For example, Detroit pastor Horace Sheffield III said Thursday it took almost 10 days to get his results, which were positive. One East Grand Rapids resident, Ken Kolker, a longtime journalist, said he waited longer than a week in quarantine for his results.

Health experts say the speed of testing and returning results are critical in the race to limit the spread of the virus.

"If you start testing early on in a public health crisis, you can isolate people who are positive," said Dr. Teena Chopra, a Detroit-based infectious disease specialist who has called for more testing. The early testing makes it easier "to contain and flatten the curve" of new cases, she said.

Health experts couldn't say this week why Michigan’s testing efforts appeared to be trailing those in other states. The nation experienced an initial shortage of testing supplies, Michigan hasn’t been able to increase testing capacity quickly enough to match the immense need, and federal officials have focused resources on the states that were initially hit hardest.

Beaumont medical technologist Michael Diskin runs a COVID-19 test specimen.

National health experts have criticized the federal Centers for Disease Control and Prevention's handling of COVID-19 testing. On Feb. 8, Michigan received one testing kit containing enough supplies to test up to 140 individuals from the CDC, but it was flawed. Among other federal missteps were delays in "engaging the private sector to ramp up testing capacity," observers told the Associated Press.

Two weeks after the first COVID-19 case in Michigan was confirmed, the situation here differs from what happened in South Korea, Chopra noted. South Korean officials quickly expanded testing to restrict the spread of the coronavirus after confirming their country's first case in January.

South Korea, with a population of about 51 million, began doing 20,000 tests a day. Michigan, a state of about 10 million, is doing around 1,000 tests a day, according to health officials.

Gov. Gretchen Whitmer emphasized the need for more testing supplies during a Wednesday night appearance on MSNBC.

"If we can’t do the tests, we can’t isolate the right people," Whitmer said. "We have a hard time anticipating and modeling what it is we are in for."

Michigan laboratories have done at least 11,886 coronavirus tests, according to data the state released Thursday.

The News analyzed testing data available Thursday morning from the 10 states with the closest-sized populations to Michigan. Seven of the states released testing data that included negative tests and tests done by hospitals and private labs.

Of the seven states, five states — Illinois, Washington, Massachusetts, Pennsylvania and North Carolina — all had disclosed doing more tests than Michigan. Of those five, only Washington had more confirmed cases than Michigan at that point, according to tracking by the Johns Hopkins University & Medicine Coronavirus Response Center.

As of numbers released by Thursday afternoon, Illinois had 2,538 cases and had tested 16,631 people, according to the state. Michigan had 2,856 cases and had disclosed 11,886 specimens being tested.

CDC's laboratory test kit for the new coronavirus.

Michigan's numbers include totals from the state's Bureau of Laboratories, hospital labs and one private lab. Additional laboratories will be included over time, according to the state, so it's possible that more tests could be happening that aren't being reported.

Asked why other states seem to be doing more testing, Lynn Sutfin, spokeswoman for the Michigan Department of Health and Human Services, said testing supplies have been allocated to states with larger outbreaks, such as New York and Washington.

The Department of Health and Human Services is working daily to increase its own testing capacity and has assisted hospitals to bring on additional testing, Sutfin said.

Detroit Mayor Mike Duggan said Thursday the state’s testing capacity is increasing but is still not where it should be.

"We maybe are doing 1,500 tests a day now in this state, which is progress. We should be doing 5,000," he said during a press conference. "The only people who have really got testing right is the state of New York. Every place else, the data you’re seeing is based on the number of tests being done, and the testing shortage is everywhere."

In a Thursday letter to governors, President Donald Trump stressed national efforts to expand testing capacity. "Robust surveillance testing" will help the federal government monitor the spread of the virus and classify the risk in specific counties, Trump said.

The wait for a test

Ken Kolker, who lives in East Grand Rapids and works for WOOD-TV, was waiting earlier this week to find out if he would be among the growing list of confirmed COVID-19 cases in Michigan.

Kolker, who is over 60 years old, participated in a conference where two other attendees eventually tested positive. Afterward, Kolker's chest began feeling heavy and he had a dry cough, symptoms of COVID-19.

He went to get tested at Mercy Health on March 17. He was quarantined while he waited for his results. He had to wait eight days. His results came back negative on Wednesday.

"It’s just incredibly frustrating," Kolker said of the wait. How are health officials supposed to track what's happening with the virus if getting results is taking so long? he asked.

His test had been sent from Michigan to a lab in Utah, where an earthquake happened, so the test had to be sent somewhere else.

Kelly Weber of Haslett in Ingham County shared a similar story. She had a lingering cold and eventually wound up at her primary care doctor's office, where she was tested for COVID-19 on March 16.

Weber, who works for the American Red Cross, self-isolated inside her home for eight days where she continued to work remotely to try to protect the blood supply amid a health crisis. Her test results eventually came back negative.

She was told that her sample had been sent from Michigan to a lab in Chicago, where the testing was performed.

"I wish that the testing was more readily available," Weber said.

Kent County, where Kolker lives, is home to Michigan's second-largest city, Grand Rapids. There can be a seven- to nine-day waiting period for COVID-19 test results when the results are sent to commercial labs, said Brian Hartl, epidemiology supervisor at the county's health department.

Health care providers are also seeing "supply issues" on the swabs and what's known as the viral transport media, which is what the specimen is put in after it's collected, Hartl said.

"Those things are in shorter supply, so they need to prioritize," he explained.

Whitmer has said she asked the federal government for 200,000 additional swabs. But many other states are also hoping to boost their testing supplies at the same time.

At Beaumont Health, Michigan's largest health system, testing priority is being given to those with "severe symptoms" so staff can get a better sense of how to care for those individuals, said Susan Grant, the Royal Oak-based system's chief nursing officer.

During a Wednesday tele-town hall, Grant called testing "very limited" statewide. The state's laboratory in Lansing will only test patients who've been admitted to a hospital, said John Fox, Beaumont Health's president and CEO.

"You can't get an outpatient screening done through that lab," Fox said. "We're pretty rigorous in our screening. We won't give you the test unless you indicated symptoms and we already screened you for Influenza A and other viruses. It's only given as the last resort."

Cars line up at a drive-up COVID-19 specimen collection center Tuesday, March 17, 2020, at the Spectrum Health Lakeland Center for Outpatient Services in St. Joseph, Mich.

Fox said "we're way behind" other industrialized countries, such as South Korea, on testing.

"We have the ability to do more tests. We can't get the kits to go with it," Fox said.

Citing "wide-scale shortages of laboratory supplies" nationally, the Association of State and Territorial Health Officials, the Association of Public Health Laboratories and the Council of State and Territorial Epidemiologists issued guidance last Friday about how health care providers should prioritize COVID-19 testing.

Tests should first go to health care workers with symptoms, older people with symptoms and individuals "who may have other illnesses that would be treated differently if they were infected with COVID-19," according to their statement.

Testing for individuals outside the three groups "is not recommended" until sufficient testing supplies and capacity become more widely available, the groups' statement said.

The Michigan Health & Hospital Association highlighted this week the lack of supplies for the tests. John Karasinski, the association's spokesman, called on the federal government "to speed up the availability of tests to hard-hit states like Michigan."

State: More tests needed

Dr. Joneigh Khaldun, Michigan's chief medical executive, has been open about the need for more testing.

On Saturday — 11 days after the state's first COVID-19 case was confirmed — Khaldun said she couldn't say whether coronavirus was unusually concentrated in Metro Detroit. At that point, 86% of the state's confirmed cases were in Macomb, Oakland and Wayne counties.

Dr. Joneigh Khaldun, right, chief medical executive and chief deputy director for health for the Michigan Department of Health and Human Services, speaks during a press conference in Lansing as Gov. Gretchen Whitmer listens.

"I’ll be honest," Khaldun said Saturday. "We have not tested enough to get a good idea of what’s going on across the entire state."

Wayne County was home to 1,122 cases, 49% of the total cases in Michigan, as of Wednesday. Wayne County has the seventh most cases of counties nationally, according to Johns Hopkins University & Medicine's Coronavirus Resource Center.

As it stands, Michigan has six major hospital labs performing tests with others joining rapidly, Sutfin said. The state's Bureau of Laboratories is performing about 300 tests per day. Among all of the labs, about 1,000 tests are being performed each day overall.

"As a country, we did not make tests available quickly enough to be able to fully understand the scope of the problem," Khaldun has said.

On Monday, Khaldun said the state was working to improve the "reporting infrastructure" so people can see the number of negative tests happening. The following day, the Michigan Department of Health and Human Services issued an executive order requiring that all laboratory tests for COVID-19 be reported to the department within four hours whether negative or positive.

Eventually, Kolker's test will show up in the state's reporting.

Before he got his results, he spent his time keeping a journal of his experiences and moving from room to room inside his house, trying to keep himself busy.

"There are 30 tiles on my bathroom floor,” he said. “I counted them. And I counted them again.”

Staff Writers Leonard N. Fleming and Christine Ferretti contributed.