Slow Turnaround Times for COVID-19 Tests Compound Fears With Stress for Local Family

Alii Health Center nurse delivers COVID-19 test samples to Clinical Labs on Oahu after testing drive on Saturday. (Submitted by Anne Broderson)

The COVID-19 pandemic has Hawai‘i residents suspicious of every sniffle and clamoring for more comprehensive testing statewide. Patients waiting for several days or weeks for results, however, say the stress of anticipation can equal or surpass the worries that sent them seeking testing in the first place.

Steve and Sarah Balzer, of Waimea, are an example. Their two-year-old daughter came down with coronavirus-like symptoms 15 days ago. She was tested the following day. This morning, they finally received word her results were negative. But so far out from the initial concern, the news had minimized value — both emotionally and practically.

“It puts you in the limbo, this terrifying state,” Sarah said. “If the test had come back in a reasonable amount of time, we could have alerted family and her school and (started to) quarantine.”

Another frustrating element of the testing experience, Sarah said, was that healthcare professionals weren’t always proactive about communication during the process.

“You have to be your own self-advocate,” she said. “The fact that I had to call every day sucks.”

The Balzer’s daughter was tested Tuesday, March 17, 2020, at the drive-through testing site at North Hawai‘i Community Hospital (NHCH). They were told her results would be available within two to three days.

“The first couple of days after she was tested … she was also most sick then,” Steve said. “That was when it was worst for me.”

On Friday, when they hadn’t heard anything, Sarah called NHCH, which forwarded her to a call center on O‘ahu. Representatives at the call center told Sarah that swabs were no longer being sent to O‘ahu, as its testing capacity was overrun with demand.

“That was the biggest thing,” Steve said. “They were just overwhelmed.”

Instead, their daughter’s swab was on its way to a Centers for Disease Control and Prevention lab on the mainland. The turnaround time now seemed more likely to be five to seven days, a call center representative said.

Sarah reached out to the call center again Monday, per instructions — six days after her daughter’s test was administered in Waimea. There were still no results to be shared, a representative explained.

“They were kind and gracious, but they didn’t have a lot of information,” Sarah said.

Worried and frustrated, she called NHCH, which connected Sarah to a diagnostics lab. The lab said her daughter’s swab was sent to a mainland lab the previous Thursday. Results were pending, and Sarah was advised to call every couple of days to inquire.

“Every time I called, it just kept getting pushed back and pushed back,” she said.

By this point, Steve had already taken several days off work to impose a mandatory, 14-day self-quarantine in case he’d been exposed to COVID-19 by way of his daughter.

The results finally came in Monday, Sarah said. However, when she called her doctor Tuesday, he didn’t have them in his possession.

“I had to call the lab and ask them to re-fax the results over to the doctor,” Sarah said.

Tackling turnaround times

Hawai‘i Department of Health Director Bruce Anderson acknowledged that the Balzer’s experience was not unique across the state, nor were turnaround times a problem for only drive-through testing operations.

However, Anderson described recent issues as a “temporary situation.”

“Testing done up until recently was mostly being done on the mainland,” Anderson said in a press conference Monday afternoon. “Often, they were backlogged for a week or more. In some cases, it was taking 10 days to get results back.”

Or in the case of the Balzer family, 14 days.

“Local labs are now up to speed on doing tests here,” Anderson continued. “Very likely, we’ll be seeing turnaround times of a day or so for future testing.”

Anderson added that turnaround times on COVID-19 tests for symptomatic healthcare workers and first responders should be even faster than a day, as those are being prioritized above all others.

DOH believes results can be obtained within three hours, which could prove crucial to curbing the outbreak, as first responders with unknown infections could prove the most effective vectors of the virus.

Testing, in general, has ramped up across Hawai‘i in recent days. Anderson said Monday that the state had tested more than 8,700 patients for COVID-19. Lieutenant Governor Josh Green added that the state is now capable of testing more than 1,500 people daily, the third-highest testing rate in the nation.

Steve noted that the number of tests Hawai‘i has managed to administer shows a significant increase in testing capability. However, that figure doesn’t mean as much without the context of how many of those tests have actually returned results and how quickly those returns are happening.

Sarah was also skeptical of claims that the state, as overwhelmed as it was only a week before when she was scrambling to find answers for her daughter, would be in a place where one-day testing turnaround times were possible on a consistent basis.

“That would be brilliant. That’s the end goal, that we can actually see a return on results within the day because then you just have a better chance of protecting the community,” Sarah said. ” But I don’t have a lot of hope for that.”