Coronavirus: Hospitals in US don't have kits to test patients, New York doctor says it's a 'national scandal'

Dr. Matt McCarthy says he has to plead to the health department to test patients for coronavirus


                            Coronavirus: Hospitals in US don't have kits to test patients, New York doctor says it's a 'national scandal'
(AP Photo/Elaine Thompson)
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Speed is critical in the response to COVID-19. But according to a New York doctor, the US is grossly unprepared to identify and treat the new coronavirus, and that is largely due to a massive lack of diagnostic kits.

Stating that the US is not testing at full capacity, Dr. Matt McCarthy from NewYork-Presbyterian Hospital called it a “national scandal”.

“We now have this (confirmed case) in New York State. The person who tested positive is only the 32nd test we’ve done in this state. That is a national scandal,” said Dr. McCarthy during an interview on CNBC’s Squawk Box.

“They’re (referring to other countries) testing 10,000 a day in some countries, and we can’t get this off the ground. I’m a practitioner on the firing line, and I don’t have the tools to properly care for patients today,” he said.

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Dr. McCarthy is an assistant professor of medicine at Weill Cornell and a staff physician at New York-Presbyterian Hospital, where he serves on the Ethics Committee. 

CDC’s laboratory test kit for the new coronavirus (CDC via AP)

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The numbers have indeed gone up in the US. Tensions over how to contain the coronavirus further escalated Tuesday (March 3) in the US as the death toll climbed to nine and lawmakers expressed doubts about the government's ability to ramp up testing fast enough to deal with the crisis.

All of the deaths have occurred in Washington state, and most were residents of a nursing home in suburban Seattle. The number of infections in the US has crossed 100, scattered across at least 15 states, with 27 cases in Washington alone. Besides, since the interview, a second case was identified in New York on Tuesday — a man of about 50 who lives in Westchester County, just north of New York City. 

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Washington Governor Jay Inslee, right, bumps elbows with a worker at the seafood counter of the Uwajimaya Asian Food and Gift Market in Seattle's International District. Inslee said he's doing the elbow bump with people instead of shaking hands to prevent the spread of germs
(AP Photo/Ted S. Warren)

As on Sunday (March 1), the US Centers for Disease Control and Prevention had tested an estimated 472 suspected coronavirus patients. South Korea, by contrast, had tested tens of thousands.

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On Sunday, Dr. McCarthy tweeted, “People are going to die because we are the only industrialized country in the world that can’t perform this simple test. Where is the accountability?”

Swift diagnosis is particularly necessary in the wake of the fact that the CDC announced a series of interventions as steps that can be taken at individual and community levels during a pandemic when there is no vaccine or proven medical treatments for the disease. 

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And while the World Health Organization (WHO) has asked all countries to prepare for a pandemic, Dr. McCarthy said he has to plead to the health department to test patients for coronavirus. He said he still does not have a rapid diagnostic test available.

“It is easy to do (develop diagnostic tests) for some countries. What happened in the US is that the CDC created a test and sent it out to 50 states, and then said, 'don’t use it, let us fix it'. It’s now in March. We hear that it is coming very soon, but I am here to tell you right now at one of the busiest hospitals in the country, I don't have it at my fingertips. I still have to call the department of health. I still have to make my case plead to test people. This is not good. We know that there are 88 cases in the United States. There are going to be hundreds by the middle of the week. There’s going to be thousands by next week. And this is a testing issue,” Dr. McCarthy said during the program.

When questioned as to what happens to people who come to the emergency room and the hospital does not have the necessary diagnostic kits to test them, Dr. McCarthy said that the hospital tries to test them, but they are severely crippled.  

“Well, we call, we try to test. We isolate them. We have an outstanding team of infection control practitioners who know how to handle this. But they are hamstrung by the fact that they don't have a diagnostic test available,” he said.

The medical expert said that the hospital, however, does not send people home. “We are making sure they get what supportive care that we can give,” he added. 

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Dr. Matt McCarthy said he has to plead to the health department to test patients for coronavirus
(Getty Images)

According to the CDC, symptoms may appear 2-14 days after exposure. Testing delays will delay diagnosis and could lead to community spread. It could also hamstring hospitals’ ability to accept and treat patients with COVID-19, researchers warn.

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The CDC has come under the scanner for its faulty diagnostic kits. The CDC, which had earlier developed test kits to diagnose the infection, began dispatching about 200 testing kits to labs across the US and 200 more to over 30 other countries. Each kit, they said, could test about 700 to 800 samples. As part of the routine, labs that received these kits conducted quality control tests before using them on patients. And some of these checks failed. 

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“I think the diagnostic issue is the single most important thing that keeps me up at night right now,” Lauren Sauer, director of operations at the Johns Hopkins Office of Critical Event Preparedness and Response in Baltimore, told the New York Times in an article published on February 28. 

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She said, “the idea that we would have to really fight to get that test done, when CDC is saying they have capacity, is alarming. It is a challenge when the most important piece of information — does this person have this disease, yes or no — is not accessible, and there’s no timeline for improved accessibility.”

During a media briefing on February 26, Dr. Nancy Messonnier, director of the Center for the National Center for Immunization and Respiratory Diseases (NCIRD), CDC, said, “I am frustrated like I know many of you are that we have had issues with our test. I want to assure you that we are working to modify the kit and hope to send out a new version to state and local jurisdictions soon.”

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New rules will allow any American to be tested

Meanwhile, Vice President Mike Pence says the CDC will issue new guidance to healthcare providers making clear that any American can be tested for the virus subject to a doctor’s orders.

Pence said he wanted to end any confusion after some state leaders said they were being told from some laboratory workers that the only people who could be tested for the virus were those more than mildly symptomatic.

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The Trump administration also said on March 2 that nearly a million tests could be administered for the coronavirus in the US by the end of this week.

Vice President Mike Pence (center), along with experts from CDC, NIAID, and US FDA Commissioner Stephen Hahn (last on the right), speaks to reporters on March 2 in Washington
(AP Photo/Manuel Balce Ceneta)

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Food and Drug Administration Commissioner Steven Hahn said during the media briefing that till now, the US testing capacity was only between 75,000 and 100,000. 

“On Saturday (February 29), we issued a new policy allowing us some regulatory flexibility around the development of these tests. So, academic centers, private companies can develop these tests, tell us that they have validated those tests and then begin to use them. They alert us of that and then within 15 days, we can look at the validation data. With this new policy, we have heard from multiple companies and multiple academic centers. We expect to have a substantial increase in the number of tests this week, next week and throughout the month. The estimates we are getting from the industry right now is that by the end of this week, close to a million tests will be able to be performed,” said Dr. Hahn.

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However, some companies developing tests say their products are still weeks away from approval, reports the New York Times. The article states that even if a million test kits were available, public health laboratories say they would not be able to process nearly that many within a week.

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