Prepared to isolate at his Oakville home for two weeks, Philip Hrdlicka took one of his 6-year-olds in search of coronavirus tests in late July, opting for an urgent care center over a recommended trip to a hospital in the city.
His son had been sent home from camp with two symptoms. Hrdlicka figured if one child had contracted COVID-19, the same would be true for his other two sons and his wife. The family prepared to isolate while awaiting results, meaning Maureen Hrdlicka would not be going to work.
However, a clinic near his home had rapid testing available. The tests took 15 minutes to process. Hrdlicka, his son and wife were negative, and a lengthy isolation period was avoided.
They were among the fortunate in getting an outcome that was derived by a fortuitous bit of timing.
“The nurse said we were lucky they had them because they would probably be out of tests in an hour,” he said. “And when we were checking out, they said they weren’t taking any more COVID patients. If I had gone an hour later, there’s a chance I would have been turned away. Had we not had rapid tests, we would have gone home and shut ourselves in for two weeks. So, it was a big relief.”
People throughout the country are making similar decisions about testing that, more often than not, result in a longer waiting period for results. According to a multi-institutional national study released this week, that wait averages 4.1 days. More extensive delays are common.
Professional athletes in Major League Baseball and the National Hockey League, as well as other sports, have access to nearly daily tests for COVID-19 with prompt results. College athletes returning to campus are being tested with faster-than-average turnarounds.
The contrast creates an interesting paradox for a society that places a high value on sports and for fans anxious to see their return. Massive testing involving the Cardinals and Blues allows people tethered to their homes to watch games played in stadiums void of fans.
The question becomes whether a population of younger, more affluent people should have access that isn’t widely available to the public as a whole.
“It sort of sets up this system where you’re using resources on things that are viewed as important to society,” said Dr. Alex Garza, chief medical officer for SSM Health and head of the St. Louis Metropolitan Pandemic Task Force. “I’m not making a declaration whether it’s right or wrong.
“If you think about testing from a risk perspective, we should be testing the highest-risk populations. But then you look at what we value as a society, and clearly we value sports, and to make that happen you have to have a regiment. It’s clear we have come to accept that as a community.”
Hrdlicka’s good fortune was a pro athlete’s everyday reality.
The NHL announced that it conducted 7,013 tests among players and team personnel from July 27 to Aug. 1. Teams in the playoffs are sequestered in “bubbles” in Toronto and Edmonton, and personnel are tested daily.
MLB conducted 32,640 tests among players on all teams from June 27 through July 23. In the week that followed the outbreak among the Miami Marlins, players on all other teams combined for 6,400 tests, and the Cardinals ultimately had seven players test positive. Players around the league are tested every other day, but the Cardinals will continue to test daily due to their outbreak.
“It shows you really how quickly something like this can spread, (and) we’re fortunate because we have the ability to test every day,” Cardinals president of baseball operations John Mozeliak said this week on a Zoom call. “Imagine if you didn’t. That’s what you see happen in schools or camps or office buildings. Even with the tools at our disposal it still can move.”
In the early days of testing, when there were shortages in availability, there were claims that athletes, celebrities and politicians were receiving preferential treatment. Now that tests are more widespread, that claim has been applied to wait times.
A study resulting from a survey of 19,058 people led by Northeastern University from July 10-26 showed that 63% of test results took longer than two days and 31% took more than four days.
Where a person tests can determine the waiting time for results. Choices include hospitals, urgent care centers, drive-thru facilities and private clinics. A recent surge in testing created a logjam at labs such as LabCorp and Quest Diagnostics.
Total Access Urgent Care operates 25 area locations and has been conducting approximately 1,500 tests per day, said CEO Dr. Matt Bruckel. He said early backups while working with Quest created waits of 10 to 14 days for results. TAUC moved to AIM Laboratories and is getting more tests done in two to four days.
Like many sites, TAUC offers rapid tests, but they are limited. Once they are gone, a person being tested can be looking at a prolonged wait instead of knowing before leaving the clinic.
“I don’t know how long it takes to run a test (at the lab) — maybe 30 minutes,” Bruckel said. “But it was taking as long as 10 to 14 days for results to come back. What is that? There’s no clinical utility in that. You’re either dead or completely cured, or you’ve passed it along to 30 other people.”
Although the estimated national wait time has not changed much over the last several months, some people have endured significant challenges.
Jacob Wertheimer of St. Charles said he was tested at a clinic in St. Charles on June 22 and never received results, even after numerous phone calls. Sean Conway, who lives in St. Louis, was tested July 1 and received results after 16 days. Robert McClimans of St. Louis was tested along with his girlfriend on June 29. His results took nine days, his girlfriend’s 11.
Some school districts, including St. Louis Public Schools, require all staff members to produce a negative test result before reporting to work, even if they are working remotely. Teachers say they are frustrated by the varying availability of tests and delays in results. Some report waits of more than 10 days.
“A lot of people may not have COVID symptoms,” said Mackenzie Amos, who teaches third grade at Humboldt Elementary, “and it takes away tests from other people who do need the tests.”
Superintendent Kelvin Adams said Thursday that 20 staff members have tested positive.
College students should be tested every two days on campuses this fall, according to a study published last month by the American Medical Association. Nancy Blattner, president of Fontbonne University, said delays in getting results make testing every student and staff member less useful. The university will recommend self-screening.
Professional sports leagues have been adamant that their testing does not interfere with labs producing results for the general public. MLB uses a lab in Utah that previously was used by the league to test for performance enhancing drugs. The league has added a lab at Rutgers University. The Cardinals also team with Mercy Hospital but only use its services when a rapid test is required on a limited basis, Mozeliak said. The NHL runs tests through Dynalife in Canada.
In the NFL, players will test daily during the first two weeks of training camp. Frequency after that will depend on the positivity rate. And in the NBA, players will be tested every other day until Oct. 13.
Meanwhile, systems such as SSM Health are being stressed despite processing tests 24 hours a day.
“We’ve reached our capacity and can’t take anymore testing,” Garza said. “Schools have asked if we can do their testing, but we’re tapped out with all of the patients. ... If you can’t turn it around in two days, it becomes more challenging because it pushes back contact tracing, and those people potentially infect someone and it snowballs.”
Athletes at St. Louis University and the University of Missouri have started to return to campus and must be tested before they can participate in workouts. SLU typically gets results in one or two days through St. Louis University Hospital. Mizzou does testing with medical staff from MU Health Care. Waiting times have varied with the total volume of testing within the community, but results generally have come between 36 and 72 hours.
Garza said the problem locally no longer is the availability of tests — although rapid tests remain restricted — but in how many patients can go through a testing site in one day.
After that, it’s about turnaround time at the labs, where tests are prioritized, according to Garza, based on people with symptoms or in high-danger demographics vs. those who are asymptomatic.
“It’s the best solution we currently have,” Bruckel said. “Things typically don’t develop easily. They develop in a clunky, cumbersome way and get better and better. Two to four days, by my standard, is too long, but it’s the best we have so it has to be good enough. I would like results today or the next day ideally to really address the illness.”
Blythe Bernhard, Derrick Goold and Dave Matter of the Post-Dispatch contributed to this report.