The city of Seattle’s coronavirus testing sites are being stretched beyond capacity, according to the city’s testing leader, who is asking those seeking testing ahead of the holidays to hold off so sites can serve people who have symptoms or exposures.
“People who don’t have symptoms and haven’t been exposed shouldn’t be socializing at Thanksgiving and they shouldn’t need to get tested,” said Brian Wallace, an acting captain with the Seattle Fire Department, which is leading the city’s testing efforts. “The bottom line is: We don’t have the testing capacity to test everyone in the Puget Sound Region for holiday travel. We just don’t.”
Between its four testing sites on Tuesday, Seattle’s emergency medical technicians swabbed 5,465 people and sent samples to the University of Washington Medicine’s Virology Lab, Wallace said.
“As recently as two weeks ago, we were testing between three and four thousand a day,” Wallace said. “Demand has gone up dramatically.”
The rise in testing demand comes as state health officials said the coronavirus was spreading faster than it had in months.
“We are experiencing the fastest growth of COVID-19 since March,” said Dr. Kathy Lofy, the state’s health officer, during a Wednesday news conference, as a chorus of health officials and medical experts implored people to stay home during the upcoming Thanksgiving holiday.
“Do not have people over for Thanksgiving,” said Dr. Elizabeth Wako, chief medical officer at Swedish First Hill, who said cases at the hospital had tripled since Halloween.
If trends hold, at a gathering of 15 people on Thanksgiving Day, the risk of one person having COVID-19 will be 18%, Lofy said, citing modeling that projects the prevalence of COVID-19 within the community.
The number of tests administered statewide has rapidly increased this fall. The state now averages between 22,000 and 24,000 molecular tests for the coronavirus each day, said Dr. Charissa Fotinos, deputy chief medical officer for Washington’s Health Care Authority and leader of state testing efforts. Two months ago, that figure hovered around 12,000, according to data from the Department of Health’s dashboard.
The proportion of positive tests has soared also as Washington sets records for newly-reported COVID-19 cases. Preliminary testing data from this week showed more than 8% of tests returned as positive for the virus.
The city of Seattle has drive-through facilities in Seattle’s Sodo neighborhood and on Aurora Avenue North. Walk-up testing is offered at sites in Rainier Beach and West Seattle. People can book in advance, online, or show up without a pre-scheduled appointment.
At the Sodo site Tuesday afternoon, a line of vehicles wound through about six blocks of traffic, punctuated by the occasional honk of a horn. The line moved briskly.
Jill Freidberg, a documentary filmmaker, visited the city’s Rainier Beach site Monday to receive testing after a possible exposure to the virus from household members. Freidberg said a zigzagging line of people, 6 feet apart and masked, wiggled throughout the parking lot while rain poured.
A city worker brought umbrellas to those who remained beyond a tent awning. Her family waited for about 50 minutes.
“It was kind of daunting to see how overwhelmed the testing site was,” Freidberg said, adding that it reminded her of a “bad apocalypse movie” with everyone lined up in puddles of rainwater.
Freidberg said it was reassuring to see so many people get tested and described the scene as a “visual representation” of how individual behaviors have “a ripple impact.”
“Somewhere, two weeks ago, or three weeks ago, perhaps somebody thought their individual choices affected nobody but them. And you fast forward two, three weeks, and testing sites are so overwhelmed and you have somebody’s grandmother standing in the rain in her slippers,” Freidberg said.
More community transmission of the virus is compounded by an increase of asymptomatic people seeking testing before Thanksgiving, a trend Wallace said left some people who had symptoms or who reported a recent exposure to COVID-19 without sufficient testing access.
“All this testing in advance of the holiday is resulting in delays for people of up to 60 or 90 minutes,” Wallace said. “When we’re this busy, we do have to intermittently close the site to people without appointments.”
Wallace said rejecting people without appointments presents an equity issue: Some people might not have access to technology or read English well enough to book online.
“People doing holiday planning, holiday travel, is coming at expense of those with symptoms,” Wallace said.
The increased testing is straining staffers. Wallace said that among the four sites, the city has between 30 and 32 emergency medical technicians working each day: 45 registration technicians, 10 to 12 parking-enforcement officers doing traffic control. That’s in addition to several administrators, staffers who deliver supplies and a notification team of six who call people who test positive.
“We’re really at the limit,” he said.
A UW Medicine laboratory processes all of Seattle’s samples, typically within 48 hours.
Dr. Alex Greninger, assistant director of the UW Medicine Clinical Virology Laboratory, says the lab is “short on everything” as are most other labs around the country.
“It’s not a situation where you place an order and an item will definitely come in or is immediately available,” he said. “Even gloves are not always easy to get right now.”
The UW lab is expecting delivery soon on an instrument ordered seven months ago in late March – a process that would ordinarily take two to four weeks.
Staff shortages are also a chronic problem, and the lab is “always hiring,” Greninger said.
But the lab is still able to process about 10,000 tests a day, more than ever before in the pandemic. “So the sky is not falling, and we can keep testing,” Greninger said.
The shortages are also affecting other types of medical tests, said Dr. Andrew Bryan, medical director of the clinical laboratory at UW Medical Center – Northwest. Manufacturers have shifted production to products related to coronavirus, creating shortages in other areas, like the agar plates used to culture bacteria when testing for sexually transmitted and other infections. Testing for tuberculosis and C. difficile, an intestinal bug that causes diarrhea, is also impacted, because it relies on some of the same instruments used for coronavirus tests, Bryan said.
Testing capacity concerns are not limited to King County or Seattle. Skagit County officials this week asked asymptomatic people to stop seeking testing. The county’s testing site, which had been located at Skagit Valley College, was closed Monday and Tuesday as county officials physically moved testing infrastructure to an indoor space on the county fairgrounds so testing could be performed more easily in inclement weather.
Local respiratory clinics saw a crush of people seeking testing before the Thanksgiving holiday.
“They were being overrun by people who were asymptomatic,” said Laura Han, a county spokesperson.
“We just can’t deal with the demand. We need to make sure our testing site is available to those who need it the most.”
On its own, a negative coronavirus test does not guarantee a safe visit to family. It’s rare, but tests can produce falsely negative results. Tests might not catch an infection in its earliest days before viral loads begin to spike within the body. And, exposures are still possible after a negative test.
In advance of the Thanksgiving holiday, Gov. Jay Inslee banned indoor gatherings, outside one’s household, unless participants quarantine for 14 days before the gathering or quarantine for seven days before and receive a negative coronavirus test within two days of the planned gathering.
But some local public-health officials are discouraging people from relying on testing to meet those requirements.
“We don’t want people to use testing to justify their risky decision,” Han said. “It is inherently risky to gather.”
GETTING TESTED: Only those who have symptoms of COVID-19 or have been exposed to someone with the disease should be tested at the City of Seattle test sites. If you fall into those categories, there are walk-up sites at 8702 Seward Park Avenue S. or 2801 S.W. Thistle Street where you can be tested. For more information call 206-684-2489 or online at seattle.gov/covid-19-testing.