One of the biggest challenges facing medical providers is the continuing shortage of testing capacity, noted Robert Salata, MD, chairman of the department of medicine at University Hospitals Cleveland Medical Center. Salata spoke as part of an expert panel assembled to answer reporters’ questions about the pandemic response on April 9.

“We are still triaging in our institution, and many others, the types of individuals that we do [COVID-19] testing on,” explained Salata, a professor of medicine, epidemiology, and international health at Case Western Reserve University in Cleveland. “We’re focused here on our own standup platform, testing-wise, on those [patients] who are hospitalized coming from the EDs [emergency departments], and also our healthcare workers. We haven’t been able to test everyone, and that has been one of the major issues here.”

Expanded testing capacity is crucial to fully understanding how broad the COVID-19 problem is in the United States, according to Salata. “We could talk about the confirmed cases and the death rates related to that, which in the U.S. is about 2.5%. But we don’t really know the denominator here because there are many people who are either asymptomatic ... or have what is called pre-symptomatic [indications], which are very mild in nature,” he shared. “Still, 80% of people who develop this infection can stay out of the hospitals for the most part and recover from this without specific treatment.”

Another problem with testing in the ED has been the time it takes to receive results, observed Eric Morley, MD, clinical director of the department of emergency medicine at Stony Brook University in Stony Brook, NY. Morley shared his thoughts during an April 7 media briefing hosted by the Patient-Centered Outcomes Research Institute. “That has been a major complication to getting patients upstairs,” Morley acknowledged. “We are lucky in that we are now running COVID-19 testing in house.” However, the Stony Brook lab does not have the capacity to run all the tests ordered from the ED, so testing for patients scheduled for admission is being prioritized, Morley reported.

Further, regarding the tests that are sent to private labs for processing, the Stony Brook ED staff are working closely with these facilities on processes that might be able to trim the turnaround time for the results. Morley suggested that colleagues similarly open the lines of communication with their testing partners.