Since starting in mid-March, health centers in Warren County have tested 1,294 unique individuals for COVID-19 using a PCR test.

“The number of tests would likely be higher, as some people may have been tested more than once,” said Nate Wardle, press secretary for the Pennsylvania Department of Health.

As of Friday, there were eight confirmed cases with a positive test and six probable cases. There have also been 1,286 tests that have come back negative.

Joseph Akif, the chief operating officer and chief nursing officer at Warren General Hospital, explained his facility’s process includes several pathways based on patient presentation in a recent email to The Times Observer.

“If a patient is symptomatic after visiting their medical provider, outpatient testing is scheduled for a specific time so that we can complete the task in a safe and distanced manner,” said Akif. “This time is in the evening at a separate defined location outside of the hospital so as to not potentially expose any providers or people unnecessarily.”

After acquiring the sample, the hospital sends it to referral laboratory patners in Erie and Pittsburgh with varied turnaround times.

“Results from these tests have ranged from a two day turnaround up to 10 days,” he said. “This is driven by the volume of testing that the laboratory is processing. If the test is ordered by a community medical provider, the results go directly to the provider. If the test is ordered by the hospital, the results will be delivered to the hospital.”

Rapid testing is also used on “inpatients only,” Akid said.

“This is a limited capacity that is reserved for symptomatic inpatients, symptomatic medical personnel and any patient being transferred by air medical services,” he said. “This is to reduce the exposure of medical personnel and other patients.These tests are performed in house and have a same day results reported.”

Asymptomatic patients are sent to Walmart.

“At this time, WGH does not have the ability from a supply perspective to complete community surveillance testing for COVID-19,” he said. “Challenges reside with the number of actual test kits and the supplies needed to complete the test. This would include swabs and travel mediums.”

All test results are reported to the Department of Health by the laboratory that completes the testing and results the findings, he noted.

The timeliness of testing has posed an issue across the state border in Chautauqua County.

“It is important for local health authorities to receive positive test results as quickly as possible,” Schuyler said. “The sooner we know of someone who has tested positive, the sooner they can be contacted, placed into mandatory isolation, and their contacts traced and put into mandatory or precautionary quarantine.”

During a May 21 Board of Health meeting, public health director Christine Schuyler indicated that the turnaround time at WellNow Urgent Care centers in Jamestown, Lakewood and Dunkirk, was taking a mimum of seven and a maximum of 10 to 12 days to receive a result back from their Massachusetts-based lab–in one case, a sample taken on May 2 did not have its result reported to the state and county until the day of that meeting. Progress has been made since then, she said.

“WellNow contracts with a bio reference lab to analyze the test results,” Schuyler said. “Statewide, there have been issues with elongated time periods between testing and results. The state is aware of this and WellNow’s medical director and staff have been receptive to our requests for improvements in reporting and patient messaging.”

“The quick need to onboard a partner lab, train our providers and establish a process did come with a few hiccups, but those were swiftly recognized and corrected,” Dr. Tanvir M. Dara, WellNow’s chief medical officer said, noting that the case referenced during the meeting included delays due to the partner lab needing to re-run the specimen three times to ensure state-mandated standards were met as well as travel restrictions. Results for both the molecular and antibody test usually are delivered to patients now through an online portal in four to five days.”

Molecular tests — known for the use of a nasopharyngeal swab — also have varied result times that are prioritized based on the situation at other facilities.

“UPMC Chautauqua has the capability to perform Cepheid testing analysis in the hospital lab with results available in about 45 minutes,” Schuyler said. “Because of ongoing issues with testing supplies, use of this analyzer is prioritized according to patient illness and risk factors and used sparingly which is very appropriate.”

According to Cecil Miller, vice president of operations for UPMC Chautauqua, tests taken at either the Jones Health or Riverwalk centers — in which a physician order is required — see resuts between 48 and 72 hours. Like most health centers in Chautauqua County, samples are sent to a Pittsburgh laboratory to be examined.

“We do inhouse rapid testing on health care employees, patients and nursing home patients, all others are sent out,” Miller said. We have tested over 2,600 people and less than 1% have been positive. We have not had a positive result from any asymptomatic, pre-procedure patients.”

Still, while Schuyler is encouraged with the progress made in Chautauqua County, she fears that nationwide surge will have a ripple effect on the region.

“It is encouraging to see what appears to be an ample supply of testing supplies and analyzing capabilities at this time,” she said. “There should be no reason for someone who needs to get tested to not be tested. If we see large clusters of contacts who become symptomatic, this makes it very difficult for the local testing sites and labs to keep up. Increasing infection rates nationwide also put a strain on large commercial labs, such as Quest and LabCorp, and will negatively impact the turn-around time for test analysis everywhere.”