Two more Sonoma County residents die from coronavirus as testing delays hamper pandemic battle

The coronavirus has claimed two more lives, increasing the fatalities in Sonoma County during the pandemic to 22, county health officials reported late Tuesday.

This week alone so far there have been three deaths linked to the virus.

Seventeen of the county’s fatalities have occurred since June 28, as the highly contagious infectious disease spreads in the community afflicting more people and causing a sharp increase in hospitalizations.

County health officials couldn’t be reached Tuesday night to get any information about the latest virus-related deaths.

Dr. Sundari Mase, the Sonoma County health officer, said earlier Tuesday ballooning demand for coronavirus testing and the delays getting the results are partly to blame for hampering efforts to effectively fight the virus, particularly in area skilled nursing centers where the virus has gained a foothold.

Mase said long turnaround times at U.S. commercial laboratories like Quest Diagnostics and LabCorp are causing an increasing number of samples being sent to the county public health laboratory, leading to longer waits for test results here, too.

“Our lab is getting so many samples that even our turnaround time is now a little longer than it should be,” she said in an interview. “We’ve been trying to get the staffing to go 24-7 in the lab. I’ve been asking that we go 24-7 now for the past several weeks. But you have to understand we have to hire people to do the work. ... They're not quite like epidemiologists, but they are close to being worth their weight in gold.”

Shortages of COVID-19 test kits locally, statewide and in many parts of the country, and the chemicals necessary to process them, continue to put a strain on hospitals and health care systems. The shortages and delayed test results come at the most inopportune time when transmission of the infectious disease intensifying in the community.

On Tuesday, there were another 547 virus tests done locally, boosting the total to 66,896 out of a county population of about 500,000 residents. The county reported 29 new virus infections on the same day, bringing the total to 2,241 since the first case in early March. There are 990 active cases, and 1,229 people have recovered.

In the small lab at Healdsburg District Hospital, there’s a new $40,000 machine that can run two COVID-19 tests an hour. But it doesn’t because the hospital can’t get the necessary chemicals to process virus samples.

The company that sold the machine to the hospital, told the hospital leaders it doesn’t have enough chemical reagents, which come in the form of cartridges, to process COVID-19 tests. The hospital’s lab manager said the company is only supplying reagents to existing customers, due to shortages.

“The analyzer is just the machine, but you have to have the chemicals to use the machine,” said Nancy Thompson, the hospitial’s laboratory manager.

The Healdsburg hospital has been forced to use commercial labs like Quest and ARUP Laboratories in Utah, where demand continues to outpace test processing capacity, similar to the dilemma at the county public health lab.

“The labs are all overwhelmed,” Thompson said.

Thompson said Quest, which has been the most reliable national lab, is taking three to four days to return results on high-priority virus tests given to presurgery patients, and health care workers and other patients showing viral symptoms. The Healdsburg hospital’s policy is no one goes into surgery without a negative COVID-19 test.

Thompson said the county public health lab used to be the quickest test-processing option, but turnaround times there have been extended to up to 96 hours now for the hospital’s highest priority cases.

Sonoma County’s lab has a larger version of the same rapid-testing machine Healdsburg District Hospital bought, the GeneXpert, made by Sunnyvale-based Cepheid. It can process 16 virus test samples at once.

However, Mase said Tuesday that Cepheid is providing only 60 cartridges of testing chemicals a week for the machine, but she asked for a 1,000 of them.

Mase said the lab could process about 130 rapid tests a day if it could get enough cartridges. But it is only able to complete eight to 10 rapid tests in an hour. Those tests are in addition to turning around 150 regular COVID-19 test results a day.

On Monday, Quest reported that demand for COVID-19 diagnostic testing continues to outpace the company’s capacity, particularly in the South, Southwest and West regions of the country.

The company, after receiving emergency authorization from the U.S. Food and Drug Administration last week, has begun to combine multiple test specimens in small batches to optimize COVID-19 testing capacity. A positive test in a batch will trigger the retesting of each specimen in the batch.

Quest said it hopes this and other steps will improve turnaround times in the next few weeks, but it cautioned that testing speed is largely a function of demand, which is hampering the entire laboratory industry.

As a small medical center, Healdsburg hospital is particularly vulnerable to such widespread desire for testing. Larger hospitals are able to better contend with the testing frenzy.

For example, Kaiser Permanente, which operates a hospital in Santa Rosa, recently built a 7,700-square-foot lab in Berkeley to process thousands of COVID-19 tests each day. Kaiser said with existing supplies and test-processing equipment, it is able to test all patients with COVID-19 symptoms.

Matt Skryja, a Kaiser spokesman, said it usually only has to send about 10% of its COVID-19 test samples to commercial labs, which can take longer to return results. Kaiser’s own testing has a turnaround time of two to three business days. Patients who have to wait longer can call Kaiser’s 24/7 advice line or email their doctor for information.

Christian Hill, a spokesman for Providence St. Joseph Health, which runs Santa Rosa Memorial and Petaluma Valley hospitals, said the medical centers experience “daily changes on availability of supplies related to Covid-19.” Hill said the hospitals’ parent health care system has been able to shift supplies throughout its 51 hospitals to meet the overall need.

Ashley Boarman, a spokeswoman for Sutter Health, which operates a Santa Rosa medical center, said Sutter hospital labs are processing about 2,900 COVID-19 tests a day, meeting current demand. But Sutter continues to partner with local and county government agencies to obtain more virus testing instruments, swabs and chemcial reagents.

Almost half of the COVID-19 testing that’s been conducted by Healdsburg hospital involves staff and patients at its skilled nursing center. Getting timely test results is necessary when dealing with vulnerable seniors, said Thompson said, the hospital’s lab manager.

The county virus outbreak has infected staff or residents of 14 of the county’s 20 skilled nursing facilities. The pathogen is linked to at least 11 deaths of skilled nursing home residents and 118 confirmed infections of staff and residents.

Clearly, the coronavirus has battered these local skilled nursing and residential care sites, home to many elderly and vulnerable residents.

Crista Barnett Nelson, executive director of the nonprofit Senior Advocacy Services, said its outrageous skilled nursing centers must wait a week for results of COVID-19 tests.

“Why test at all if you don’t get results in seven days?” she said.

Editor’s note: An earlier version of this story misstated the batch coronavirus testing process. A positive test in a batch will trigger the retesting of each specimen in the batch.

You can reach Staff Writer Martin Espinoza at 707-521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @pressreno.