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COVID labs face high numbers of tests, calls, with few technicians

southern immediate care testing

April Klein and Lindsey Cain work on COVID-19 test results in the Southern Immediate Care lab in Anniston.

Updated 6:10 p.m. July 28.

The phones at Southern Immediate Care’s three locations never stop ringing.

People have been calling about COVID-19 tests for weeks; setting up screenings, checking for results and asking about the coronavirus. Some workplaces require proof of a negative test for employees to return to their jobs after they’ve been in contact with COVID carriers, which can lead to a tense wait that might last days. Southern Immediate Care does its own lab work on COVID tests, and the company — a trio of clinics in northeastern Alabama, one in Anniston — also makes outbound calls to provide test results. 

Inbound call volume got so high recently that the company had its phone lines analyzed, according to Dr. Jason Junkins, owner of Southern Immediate Care.  

“We got over 3,000 phone calls per day,” Junkins said. “We were still trying to create a call center at the time, but when we saw that volume of calls ... you just can’t hire that many people.” 

Confirmed cases of COVID-19 have been climbing in the county and state for weeks, and the demand for testing has ramped up in turn. Recent test sites administered by the Calhoun County Department of Public Health and partner organizations have seen record numbers; last week a testing event at Harvest Church of God broke the county record for tests at a single event, the third time the record has been broken this month. According to Michael Barton, Calhoun County Emergency Management Agency director, 390 people were tested Thursday, 80 more than the previous record. 

Early in the pandemic, testing procedures were defined by a strict rules imposed by a small stock of supplies. Most testing was reserved for people showing symptoms of the virus. But now that test kits are relatively plentiful, there’s another bottleneck: Getting results back from the labs. 

Keeping up with the COVID

“Our goal at this point is to test at least 2 percent of the population each month,” said Dr. Karen Landers, assistant health officer with the Alabama Department of Public Health. “The challenge is that while more people need to be tested and want to be tested as we see more community transmission, manpower is an issue, not only for the state health department but commercial and clinical facilities.” 

Testing has evolved over the months since March, when the pandemic began in the United States; some methods have been debunked and tossed aside. A finger-prick to check blood for antibodies has its uses, but Landers said it’s not useful at all for COVID-19 screenings. 

Southern Immediate Care manages its own lab work for COVID tests, Junkins said, rather than send it off to LabCorp or Quest, two of the leading laboratory chains in the nation, or to labs manned by the Alabama Department of Public Health. 

The clinic uses PCR tests — polymerase chain reactions — to scan for viral genetic material, the same kind of tests employed by ADPH. While PCR tests take a little longer to process, about three hours, they’re also more accurate than “rapid” tests that check antigens in around 20 minutes, Junkins and Landers both said. Those tests are less specific, and might offer up more false positives, or worse, false negatives, Junkins said, which can help the virus spread. 

Three hours to process a test doesn’t sound like much; some labs take days to turn out results. But three hours is just for processing a single test, and doesn’t account for the volume of incoming tests, which reach as many as 1,000 in a week for the immediate care clinic. 

“You hear three hours and you think that’s not that long,” Junkins said. “But we’re doing 175 to 200 tests per day.”

Each lab tech can manage about 25 tests per day, Junkins said, but there are only three working for Southern Immediate Care. The pandemic has made the health care job market an inverse of the non-pandemic world; now there are too many open positions and not enough workers to fill them, and employers are competing for bright, energized people. Junkins has been hunting for new lab technicians, but they’re rare quarry in 2020; he’d like another two or three, at least. 

Once tests are complete, there’s also the work of sharing the results. Each test, positive or negative, requires a call to the patient, and if every call were completed in even an average five-minute span, 200 five-minute calls per day total more than 16 hours of work. People who test positive will have questions, though, and people who test negative might still have more to say, and might need documentation to prove they’ve been cleared; longer calls are likely, Junkins said. 

“Usually when we call them it’s a complex phone call; ‘when can we go back to work, what if my family members were exposed,’ there are a lot of questions to answer,” Junkins said. 

Like most systems, health care communications weren’t designed for the weight of the pandemic. Though Southern Immediate Care usually manages to turn results around in about a day, Junkins said, he hoped patients would understand they aren’t being ignored if they’re having a hard time connecting with staff. 

“We just want people to understand that if their phone call goes to voicemail, it’s not because anybody is ignoring their call,” Junkins said. “It’s just literally an overwhelming task.” 

Preparing for processing times

Barton, the county EMA director, said test result turnarounds vary from private and public labs. The state Health Department often has results ready in about five days; some of that time is spent transporting specimens and ensuring the test samples are correctly labeled and tracked. Testing machines, meanwhile, will only go as fast as they must to reach a true result.

In the meantime, and especially before showing symptoms of the virus, people should prepare a COVID-19 plan for themselves and family members, Barton said. That includes preparing self-isolation supplies for up to 14 days to use while awaiting test results, or during self-quarantine if a test comes back positive; securing a support system, like family members or friends who can deliver essentials to the home; and thinking ahead about where to be tested if symptoms arise. 

Planning ahead is similar to preparing for a tornado and deciding on a safe place for family members to take shelter, or where they should meet after a house fire, he explained. 

“Now that we have such great community spread, the likelihood has increased significantly now that you may need to be tested or could contract the virus,” Barton said. “What’s your COVID plan?”

Assistant Metro Editor Ben Nunnally: 256-235-3560.