Supply chain issues are still hampering the University of Virginia Health Systems’s COVID-19 test processing efforts.
UVa had a goal of running 3,000 tests a day by early June, but is currently only running about 750 tests a day due to material shortages, among other issues.
Melinda Poulter, director of clinical microbiology, said they’re not limited by the capacity of the instruments.
“If you add up the capacity of all of our instrumentation, theoretically, we should be able to do 3,000 tests today, and that was the goal,” she said. “But what we didn’t anticipate was all the supply chain problems, and the fact that although a company can give you an instrument that can do 1,000 or even 1,500 tests a day, they might not be able to provide you with enough reagents to do that every day.”
The Health System is using four platforms from three different commercial diagnostic companies to run the tests.
One, the Cepheid GeneXpert Infinity, could run nearly 1,500 tests a day, but the university was only initially allocated materials to run 100 tests a day. Poulter said they are reserving that test for patients where a fast answer is especially needed, and they had been saving about half of the materials, which the Health System is using now.
Last week, they were given enough materials to do 36 samples a day.
“It just keeps going down, and it’s so frustrating,” Poulter said. “These are just manufacturing problems with the company. They can only manufacture so many of these cartridges, they only have so many manufacturing facilities, and everybody in the world wants these cartridges and wants these kits. So you’re competing with every other hospital system in the country or in the world.”
The company has announced it has developed a four-in-one test that will test specimens for SARS-CoV-2, Flu A, Flu B and RSV from one sample. Poulter said she’s hopeful that Cepheid will be able to provide more cartridges when the new test is ready.
“We have three other platforms that we do testing on, as well, because the only way to overcome all the supply shortages is to diversify your instrumentation because all of the companies, every one of them, have supply shortages of something at some point in time,” she said.
The university has been waiting for months for another new instrument that Poulter hopes will allow them to increase capacity to about 1,500 tests per day. The instrument is now scheduled to arrive in September.
“We’ve got to have it by the end of September once the students are back,” she said. “We’re really going to need to be able to ramp up our testing.”
In a letter sent Friday afternoon regarding the decision for UVa to stick with plans to begin in-person classes on Sept. 8, university officials said “concerns about the supply chain for testing materials have been addressed.”
UVa contracted with an outside company for students to test themselves before they can return to Grounds, but once here, students who are symptomatic will be tested through the student health center or the Medical Center.
UVa has made some materials to overcome shortages, such as swabs, but Poulter said she doesn’t think they would make some of the other plastics, like a particular type of pipette tip, because they’re so specific to the instrument.
She said they are also limited by staffing and lab and storage space.
“We are in Central Virginia, we’re not in a big metro area where there’s a lot of really highly skilled certified medical technologists or clinical laboratory scientists that are trained to do this work …. I mean, there are really exceptional scientists, but it’s a challenge to find people with the qualifications we need.”