THURSDAy, MARCH 19 , 2020. THE WASHINGTON POST eZ sU A
the coronavirus outbreak
sisted living facilities would also
be given “high priority.”
Utah health officials are also
telling patients to refrain from
getting tested unless they are
displaying obvious signs of covid-
19.
“Unfortunately, we are faced
with infrastructure and logistical
challenges that prevent us from
being able to test everybody,”
Utah’s state epidemiologist, An-
gela Dunn, told reporters Tues-
day. S he said that officials instead
are trying to reserve tests for the
most at-risk populations.
“There’s not a win in that situa-
tion. It’s just what we have to do,”
she said.
from coast to coast, communi-
ties are wrestling with similar
problems.
“The testing situation is a frus-
tration for all of us.... That i s our
tool for understanding disease
location and transmission,” Jen-
nifer Vines, the lead health officer
for oregon’s multnomah County,
which is home to Portland, told
reporters Tuesday. “I just want to
be very clear that there is no
withholding of supplies or testing
capability. We are doing the best
we can.... I can assure you that a
lot of people are looking high and
low for a solution to the testing
supply question.”
Vines said the county esti-
mates it has a two-week supply of
protective gear for medical work-
ers. She also said officials might
be forced to do less testing in the
short term, prioritizing only the
highest-risk cases, to preserve
supplies and protect health work-
ers.
rhode Island’s Department of
Health said the governor had
been “on the phone with the
federal government — endlessly,
continually” trying to push for
more supplies to enable the state
to ramp up testing.
Abbott, a diagnostics and de-
vice company, received authori-
zation from the fDA for a corona-
virus test Wednesday and an-
nounced it would ship 150,
tests immediately, ultimately
ramping up to 1 million tests per
week. Those tests can run on
more than 175 instruments al-
ready deployed at U.S. laborato-
ries.
Thermo fisher Scientific has
said it has enough reagents for
the 1.5 million test kits that it is
currently distributing. It plans to
ramp up to 5 million per week in
April, but spokesman ron
o’Brien said that the scarcity of
raw materials — such as reagents
— and instruments could limit
the testing capacity.
[email protected]
[email protected]
[email protected]
[email protected]Michael Majchrowicz and Laurie
Mcginley contributed to this report.tific have been working to send
new testing platforms approved
by the fDA to major labs. once
those are up and running, testing
capacity should greatly increase.
But that change won’t happen
overnight.
“There’s a process of valida-
tion. It’s not like flipping a light
switch,” Julie Khani, ACLA’s pres-
ident, said in an email.
In addition, there are ongoing
worries about the supply chain
required for such large-scale test-
ing — a chain that includes chem-
icals needed to process tests,
personal protective gear, testing
swabs and shipment of speci-
mens.
“A ny one link in the chain of
supply and demand could sud-
denly cause a bottleneck,” Khani
said.
In many places around the
country, the potential shortages
have forced officials to limit who
gets access to the limited number
of tests for the virus.
on Tuesday, for instance, min-
nesota’s Department of Health
announced that “due to a nation-
al shortage of CoVID-19 laborato-
ry testing materials, the state is
forced to make adjustments to its
testing criteria to focus on the
highest priority specimens, in-
cluding hospitalized patients.” It
said that health-care workers and
those in long-term care and as-hospital said it was now perform-
ing covid-19 clinical testing. “We
have an adequate supply of all
other reagents needed to meet
our current testing needs,” i t said.
The Dutch diagnostics compa-
ny Qiagen said Tuesday it would
quadruple the supply of reagents
to support 6.5 million tests a
month by the end of April and
over 10 million tests a month by
the end of June. But Josh Sharf-
stein, a public health expert and
physician at Johns Hopkins Uni-
versity, said in an interview that
his best speculation was the
country might ultimately need to
carry out hundreds of thousands
of tests a day.
The American Clinical Labora-
tory Association, which repre-
sents commercial and hospital
laboratories, said its members
have performed roughly 27,
tests to date — i ncluding 8,200 on
monday alone. The group said
that the food and Drug Adminis-
tration’s recent approval of large,
automated platforms for testing
will help dramatically increase
testing capacity, assuming there
aren’t ongoing shortages of nec-
essary materials and supplies re-
quired.
The group said that commer-
cial capacity to test for covid-19 is
expected to exceed 280,000 tests
per week by April 1. firms such as
roche and Thermo fisher Scien-using a syringe to squirt some
saline into people’s noses and
draw it back.
He noted that each part of the
process depends on an essential
component remaining intact. for
example, after a patient is
swabbed, the swab needs to be
put into special vials that contain
a distinctive growth media,
which is also vulnerable and went
into shortage in a past outbreak.
many laboratories have com-
plained about shortages and back
orders of reagents, chemical solu-
tions that are key components of
testing kits. The reagents are
used to isolate the genetic materi-
al from the virus.
The International reagent re-
source (Irr), established by the
CDC, supplies the reagents used
in laboratory tests and assures
their quality. But “the Irr is not
keeping up with the demand,”
according to one public lab offi-
cial who spoke on the condition
of anonymity to avoid antagoniz-
ing the CDC. “They might ask for
100 of something and they are
getting 20. The supply chain is
backed up. We h aven’t f igured out
how that is getting resolved.”
Columbia University’s Irving
medical Center in New York said
that a week and a half ago it
received a six-month supply of
the necessary reagent from New
York state. In a statement, thespokeswoman for the South Car-
olina State Emergency response
Te am.
So the state requested materi-
als from the Strategic National
Stockpile, and the first shipment
arrived Tuesday — 5 5 pallets’
worth of N95 masks, face shields,
masks, gowns and gloves. Ship-
ments are expected to continue
over the next three weeks, ren-
wick said in an email.
South Carolina Gov. Henry mc-
master (r) has also ordered all
hospitals to cease elective proce-
dures, which has freed up 15,
beds across the state.
In florida, where covid-19 cas-
es surged 50 percent in one day,
state officials on Tuesday asked
the federal government for a
half-million each of additional
gowns, gloves and collection kits.
florida officials also requested
2 million N95 face masks,
100,000 16-ounce bottles of hand
sanitizer and 5,000 each of addi-
tional hospital beds and ventila-
tors.
matthew Binnicker, director of
clinical virology at t he mayo Clin-
ic, said he had been in meetings
where hospital leaders began to
discuss what would happen if
they ran out of swabs used to
scrape the back of people’s
throats and noses, a vital and
unpleasant part of testing. one
possibility they discussed wascare of patients with CoVID-19 as
a last resort,” the CDC said, refer-
ring to the disease caused by the
virus. “Caution should be exer-
cised when considering this op-
tion.”
At major hospitals in Seattle
and the District, mask shortages
had already become so acute that
doctors and patients were being
asked to reuse the masks, not
dispose of them as previous, tra-
ditional CDC protocol requires,
even after contact with infected
patients.
At rush University medical
Center in Chicago, hospital staff
have started using washable lab
goggles instead of throwing away
face shields for eye protection.
The federal government’s deci-
sion on monday to let state gov-
ernments regulate the produc-
tion and use of coronavirus test-
ing kits has jump-started efforts
at a wide variety of research
institutions and commercial lab-
oratories.
But even as commercial labo-
ratories pledged to boost produc-
tion of testing kits, hospital offi-
cials say that the length of time it
takes to get lab tests back from
private firms or state labs has
roughly doubled.
meanwhile, hospitals fear that
the surging number of cases will
overwhelm any increase in the
availability of tests and other vital
supplies.
Nicole Lurie, who served dur-
ing the obama administration as
assistant secretary for prepared-
ness and response at the Depart-
ment of Health and Human Ser-
vices, said the bandanna option
suggested by the CDC should be
“a wake-up call.”
“The bottom line is, if you
cannot protect health-care work-
ers and they get sick, the whole
system goes down,” s he said. “The
priority to maintain public health
is to protect health-care workers.”
Jennifer Avegno, director of
the New orleans Health Depart-
ment, said that there are not as
many test kits available as she
would like and that the turn-
around times with the commer-
cial labs are “significantly longer
than advertised or hoped.”
“This backlog really hinders
our ability” to ramp up drive-
through testing as the city
planned, she said.
Brian Stein, a spokesman at
rush University medical Center,
said delays in testing results
mean hospitals must use protec-
tive gear for longer times without
knowing whether the patients are
potentially infectious.
In South Carolina, some hospi-
tals reported they were down to
as many as four days’ worth of
personal protective equipment,
the highest level of medical pro-
tective gear, said Laura renwick,
testIng from A
Testing e≠orts hurt by shortage of masks, swabs, chemicals
NICK oTTo For THe WAsHINgToN PosT
An n95 label sits below an empty shelf where the masks should be a t Washington state’s Dayton general Hospital. Face masks are in such
low supply that the Centers for Disease Control and Prevention recommends health-care workers use bandannas or scarves as last resorts.BY MARIA SACCHETTI
AND ARELIS R. HERNÁNDEZU.S. immigration authorities
will temporarily halt enforce-
ment across the United States,
except for e fforts to deport for-
eign nationals who have commit-
ted crimes or who pose a threat
to public safety. The change in
enforcement status comes amid
the coronavirus outbreak and
aims to limit the spread of the
virus a nd to encourage t hose who
need treatment to seek medical
help.
Immigration and Customs En-
forcement said late Wednesday
that its Enforcement and remov-
al operations division will “delay
enforcement actions” and use
“alternatives to detention” amid
the outbreak, according to a
notification the agency sent to
Congress.
ICE told members of Congress
that its “highest priorities are to
promote lifesaving and public
safety activities.”
“During the CoVID-19 crisis,
ICE will not carry out enforce-
ment operations at or near
health care facilities, such as
hospitals, doctors’ offices, ac-
credited h ealth clinics, and emer-
gent or urgent care facilities,
except in the most extraordinary
of circumstances,” the notifica-
tion said. “Individuals should not
avoid seeking medical care be-
cause they fear civil immigration
enforcement.”The agency, which is a part of
the Department of Homeland
Security, did not immediately
respond to questions about how
many of the approximately
37,000 d etainees i t has in custody
will remain there. Nearly 20,
in ICE custody have some sort of
criminal history, but it remained
unclear how many of those peo-
ple have serious criminal viola-
tions in their past.
As of Tuesday, there were no
confirmed cases of covid-19 in
ICE detention facilities, but the
agency had suspended visits to
detainees and taken other steps
to prevent the spread of the
disease.
Advocates for immigrants had
filed at least one lawsuit and had
clamored for officials to release
the detainees, saying they were at
risk of infection because they
were being held in close quarters.Detainees in such facilities are
mostly adults, but the detainee
population also can include the
elderly and families with chil-
dren.
ICE Homeland Security Inves-
tigations agents will continue to
investigate criminal activity such
as child exploitation and gang
and drug activity, according to
the agency.
ICE officials said in a separate
statement that the agency made
the shift to “ensure the welfare
and safety of the general public
as well as officers and agents in
light of the ongoing CoVID-
pandemic response.”
The new priorities are similar
to the obama administration’s
“felons, not families” a pproach to
immigration enforcement, which
sought to spare immigrants from
deportation if they did not have
serious criminal offenses andhad deep r oots in their communi-
ties. President Trump has said
that all undocumented immi-
grants, an estimated 11 million
people in the United States, are
subject to deportation.
for now, ICE will focus on
people who are subject to man-
datory detention because of their
criminal convictions.
The move comes days after
immigration lawyers and labor
unions representing ICE prose-
cutors and immigration judges
joined in a rare united front to
call on the Justice Department to
temporarily close the immigra-
tion courts to avoid spreading
the coronavirus. Court officials
had canceled all hearings except
for those already detained as of
Tuesday night.
The American Civil Liberties
Union, the ACLU of Washington
and the Northwest Immigrantrights Project also sued ICE on
behalf of immigrants detained at
the Ta coma Northwest Detention
Center in Washington state who
the lawyers said were at high risk
of i nfection.
“Immigrant detention centers
are institutions that uniquely
heighten the danger of disease
transmission,” Eunice Cho,
s enior staff attorney with the
ACLU’s National Prison Project,
said in a statement when the
lawsuit was filed monday. “ Public
health experts have warned that
failing to reduce the number of
people detained — and in partic-
ular, failing to release those par-
ticularly vulnerable to the dis-
ease — endangers the lives of
everyone i n the detention facility,
including staff, and the broader
community.”
[email protected]
[email protected]ICE i s halting most immigrant enforcement in U.S., will focus on criminals
Aim is to limit virus’s
spread, encourage those
who are ill to seek helpS0136-6x3.“Away from thenoise and bustle”Discover great area neighborhoods
in “Where We Live,”
Saturdays in Real Estate.