AUGUSTA — Steve Gray hasn’t been able to hug his wife or 2-year-old daughter in 11 days.
After dismissing an irritated throat as early seasonal allergies, Gray became concerned as he developed a fever, a full-on sore throat and a persistent, dry cough over the course of a week. So when his fever spiked so high that he was bed-bound for a day, the Bangor resident’s primary care doctor advised him to self-quarantine and get tested.
Six days after finally getting tested and nearly two weeks after the initial scratchy throat, Gray is still waiting for his results. And that makes him question the number of coronavirus cases in Maine – up to 142 as of Wednesday – released during daily updates from the Maine Center for Disease Control and Prevention.
“We’ve dropped the ball on this at a fundamental level. We weren’t prepared,” Gray said. “And now we have no idea how bad it will get, or even how bad it is presently. … This entire experience has left me shaken to the core at just how much we don’t – and likely won’t – know about this situation until it’s much too late to act on that information.”
Maine CDC officials estimate there is a backlog of roughly 1,300 tests for the COVID-19 disease caused by coronavirus. In addition to the 142 confirmed cases, nearly 3,200 people have tested negative for the disease.
State health officials acknowledge that the 142 positives cases in Maine is “just the tip of the iceberg” due, in part, to the limited number of coronavirus tests they can process daily. Testing labs in Maine and nationwide are prioritizing rapid testing for hospitalized or critically ill individuals as well as health care workers on the frontlines of the pandemic.
But they also assure Maine residents that they are working diligently to address the root cause of those delays – namely, a shortage of key chemical components needed to run tests.
“This backlog is concerning to us and we don’t find it acceptable,” Dr. Nirav Shah, director of the Maine CDC, said during Wednesday’s daily news briefing on the coronavirus. “We are working to resolve that as quickly as we can. Sadly, the backlog is a result of a nationwide shortage of these vital chemicals that we need.”
Maine CDC labs currently use a type of test analysis equipment that requires a special chemical, or reagent, to extract RNA from the swabs taken from patients. But that reagent is in short supply nationwide as the pandemic spreads, thereby preventing labs from analyzing samples sent to them by doctors and hospitals.
Shah said the state received a new shipment of those reagents from the federal government on Wednesday, which should help address part of that backlog. But the state is also in the process of purchasing an alternative type of equipment from another manufacturer that uses different chemicals.
“We understand from the manufacturer of this piece of equipment they, too, are experiencing a backlog on their end with just shipping out the machine,” Shah said. But he believes the equipment should ship within a week or two, followed by a validation period of “a few days.”
“After that point, we will be able to go online with that” equipment, Shah said.
There are nationwide shortages of not only lab testing supplies, but also the gear that doctors, nurses, technicians, police and EMS crews need to protect themselves from the virus.
On the testing side, the U.S. fell behind other countries from the beginning by opting to develop its own coronavirus diagnostic tests rather than using one produced by the World Health Organization. Then, the U.S. CDC sent out early versions of its test kits with faulty reagents, causing delays just as the virus was beginning to spread.
In Maine, it is doctors and other health care providers who decide whether a patient should be tested. But how quickly those tests are analyzed depends on a host of circumstances, most notably how gravely ill the individual is and whether they have underlying health issues.
“These are folks that are in the hospital or the health care workers who may have been exposed and who are otherwise treating people who may be in the hospital,” Shah said in describing testing priorities during his Tuesday briefing.
Shah said this focus on the “highest-risk individuals” is necessary because doctors and clinicians need immediate guidance so that they can choose treatment options. While Maine has yet to report a death from COVID-19, the national death toll topped 700 Wednesday and is expected to climb significantly.
That emphasis is likely to continue if the number of cases around Maine continues to increase – as public health officials expect – and hospitals grapple with an influx of seriously ill patients.
The Maine CDC is receiving significant help on testing from five commercial labs as well as a laboratory affiliated with MaineHealth, all of which are helping to analyze tests. Some of those labs use different processes involving different chemicals than the reagent in short supply nationwide.
Regardless, the delays are frustrating for those enduring coronavirus symptoms and the nagging question of whether they have been stricken by a disease that has disrupted daily life around the globe.
Ron Petrone started feeling lethargic two Sundays ago. While he went to work the next day, he was so exhausted he struggled even going up stairs. The 48-year-old Cape Elizabeth resident’s temperature was 100.6 degrees that night and crept higher the next day, prompting him to call his doctor.
Those symptoms combined with Petrone’s asthma and a recent trip to New York – currently the coronavirus epicenter in the U.S. – convinced his doctor to order a test. He went in last Wednesday and was told the results would be available in 24-48 hours.
Two days later, however, the time frame had changed to three to five days. And when he called on the fifth day, he was told it might be closer to seven to 10 days.
“I did get the flu tests, which were negative,” Petrone said. “I don’t know if that’s good news or not.”
As he waits, his symptoms have improved. He had been quarantining away from his wife and 23-year-old daughter, both of whom don’t have any symptoms, he said. Petrone said if his results come next week, it’ll likely be after the 14-day quarantine period is over.
“I kind of hope I do have it at this point,” he said Wednesday. “I want to make T-shirts that say, ‘I survived the coronavirus.'”
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