Since mid-March, local health centers across Chautauqua County have conducted nearly 22,000 PCR tests for COVID-19.

While testing supplies — once a huge issue — no longer pose an immediate issue for many local health centers, the timeliness of receiving results is what is of concern to public health director Christine Schuyler.

“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.”

The county reported three new cases on Friday — a female in her 30s, a male in his 60s as well as a male in his 20s that was sent back to his appropriate county — bringing the active caseload up to 16. There are 210 cases under quarantine/isolation orders that have either shown symptoms, are awaiting results or have risk factors — down from 738 a week ago, not including 778 people under domestic traveler quaranting for having arrived to the county from a state listed under New York state’s travel advisory.

Still, one of the largest challenges that exists with local health centers being responsible for testing, Schuyler said, has been the messaging to patients who are awaiting their tests.

“Great progress has been made here,” Schuyler added, noting that the county has begun distributing a document from the state Department of Health that outlines the next steps for someone who has been tested — that document notes that one should be quarantined if he or she has been in close contact with someone known to have COVID-19, even if he or she does not have symptoms and that essential workers can return to work if he or she has received an employer’s permission to do, does not have symptoms and have not had contact with a person known to have COVID-19.

While the timeliness of that system has taken approximately three to seven days, depending on the lab, the timeliness of reporting results has posed a problem to county officials. Schuyler, at a May 21 county Board of Health meeting, indicated that the turnaround time at WellNow Urgent Care centers in Jamestown, Lakewood and Dunkirk, was taking a minimum 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, Schuyler 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 day.

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

“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 results 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.”

Westfield Memorial Hospital operates very similarly, according to its president, Karen Surkala, who noted that a physician order is required to receive a test which, at her hospital, is a “drive-through process” that takes five minutes in a temporary structure behind the hospital. The sickest patients and symptomatic health care workers are also prioritized, she said.

“Some of the variables that contribute to testing include: access to collect specimens, test kits, lab possession of proper instrumentation, lab staffing and training, instrumentation capacity and processing time, and reagent/cartridge supply to conduct COVID testing,” she said. “If a patient requires hospitalization at (Allegheny Health Network) Saint Vincent, COVID testing can be done at the hospital in Erie, Pa., with results determined within two hours

The Chautauqua Center, with locations in Jamestown and Dunkirk, also has testing capabilities and saw a large volume of traffic after a slight surge after the Fourth of July.

“It kind of goes in waves,” Jen Wendel, office manager, said. “We saw a large volume in the beginning, it did calm down before the holiday, and then it kind of has spiked since.”

Their testing capabilities, too, are prioritized and have been stretched due to the recent surge nationwide, Wendel said.

“Our highest priority is going to be a symptomatic health care worker and then an asymptomatic health care worker,” she said, noting that their facility uses a Pittsburgh-based lab, as well. “The turnaround time for a high priority sample is one to two days, lower priority is within five days, but with the nationwide surge in testing and cases, that has been extended close to 10 days.”

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.”