COVID-19 testing is accelerating in Washington. So is the need

As gusts kept toppling their sidewalk sign and threatened to blow away the tent sheltering their coronavirus testing supplies, staff at the International Community Health Services clinic in Shoreline rushed to prepare for their first drive-through patient Monday morning.

The makeshift site along busy Aurora Avenue just north of Seattle is the latest in a string of testing locations that have popped up around western Washington as the tide of coronavirus keeps rising.

Statewide, the pace of virus testing has accelerated, but public health experts say it still has a long way to go.

“Day-by-day, testing availability increases,” nurse practitioner Erin Olanrewaju said before meeting her first drive-through patient. “Ramping up testing in our community is really important.”

The Aurora Avenue clinic, aimed at serving anyone in need in the Shoreline area, can do about 24 tests a day.

“This virus is really insidious,” Olanrewaju said. “It spreads easily between people, so increased testing allows us to identify and isolate people with coronavirus in the hopes that we're slowing the spread.”

Each drive-through session, culminating in Olanrewaju or a defensively garbed coworker inserting six-inch cotton swabs deep inside each driver’s nostrils, takes about 10 minutes.

“We just ask that you call first to be screened by our nurses,” she said.

Not everyone who call gets tested—even if they have COVID-19 symptoms.

Following Washington Department of Health guidelines, the Shoreline clinic focuses its testing on high-risk patients – the very ill and people like first responders, whose sickness could harm a whole community’s ability to fight the pandemic.

“Younger (less than 60 years old), healthy individuals with mild illness do not need to be tested and testing is not recommended in persons who are asymptomatic,” the health department has been advising since March 19.

Statewide, about 6,000 tests are performed each day, and more than 60,000 people have been tested as of March 30, according to the COVID Tracking Project.

“Testing capacity has been limited, and to see it almost doubling in the number of people who are being tested is great,” Washington state health officer Kathy Lofy said Tuesday.

“In Washington we’re doing better than some states at testing capacity and worse than others,” epidemiologist and University of Washington associate dean Janet Baseman said in an email.

Public health experts say rapid and widespread testing is a necessity to track and ultimately beat this virus.

“Everyone who has symptoms and wants a test should be able to get a test,” Baseman said. “I think a lot of us in public health will feel better when we get to that place.”

The surge ahead

A surge of coronavirus cases is expected to push demand for tests much higher in the next few weeks.

University of Washington researchers forecast that the pandemic’s toll in the state could peak at 27 deaths a day around April 19, or nearly twice the daily death rate over the past week, assuming Washingtonians continue to follow Gov. Jay Inslee’s lockdown orders.

Inslee said Sunday on CNN that a bottleneck of basic supplies is keeping more testing from being done.

“We have a desperate need for the testing kits,” Inslee said. “We have got to mobilize the entire manufacturing base of the United States like we did in World War II for things as simple as these testing kits.”

Given the limited supplies, Inslee’s health department is still recommending tests be administered only to the highest-risk patients.

More options in the works

Recent developments, both inside and outside the state, might make tests more widely available here.

The U.S. Food and Drug Administration on March 23 allowed different types of swabs and liquids to be used to gather and transport COVID-19 samples.

“That really does open the supply chain and allow people to purchase more testing kit material,” Lofy said.

“Swabs and viral transport media and personal protective gear have all been in extremely short supply,” said ZoomCare chief medical officer Erik Vanderlip.

Illinois-based medical device company Abbott is expected to begin shipping its newly approved “point of care” coronavirus tests nationwide on Wednesday.

The tests, according to Abbott, can be performed in a doctor’s office and can provide results in minutes, not days.

The Seattle Coronavirus Assessment Network has been mailing at-home testing kits to people who volunteer to participate in its study of the spread of COVID-19, while Portland-based ZoomCare is piloting a non-invasive test kit in the Bellevue area.

If it works and gains FDA approval, ZoomCare’s saliva-based kit could enable patients to spit in a tube, at home, and mail it off without having to go to a testing location or have a fully suited-up health care provider stick a swab inside their nose.

Not just equipment

A shortage of equipment isn’t the only big problem for organizations that perform coronavirus tests, according to Ron Chew of International Community Health Services. The Seattle nonprofit serves immigrant communities and provides medical care in 50 languages.

A week before launching drive-through coronavirus testing in Shoreline, ICHS did so at its clinic in Seattle’s International District.

The economic and social fallout from the pandemic has hit Chew’s organization and the people it serves.

Chew and other non-medical workers at ICHS have been furloughed two days a week.

“We’ve been trying to maintain frontline medical staff as much as possible,” Chew said.

Chew said many of the clinic’s patients, who are predominantly Chinese and Vietnamese, are scared of both viral and human threats. It’s not unusual for them to cancel their appointments.

“The people we serve have been very fearful in this time period because of the anti-immigrant, anti-refugee sentiment that’s expressed on many levels of society,” he said.

“Obviously, the president calling this a Chinese virus certainly doesn’t help.”

Chew said the nonprofit hopes to set up more testing sites in Bellevue and Seattle’s Rainier Valley.

“We’re trying to set up one at a time as quickly as we can,” he said.