Supplies to test South Carolinians for the coronavirus are running low, and state health officials said Thursday they may soon recommend that some not be tested to reserve supplies for the sickest patients.
Hospitals have been raising concerns for days about the dwindling supply of swabs and other equipment needed for testing as the rapid spread of the virus has placed a great strain upon national and global supply chains.
“The number of tests are dramatically increasing and it’s a challenge,” said Rick Toomey, director of the state Department of Health and Environmental Control. “We’re not limited by our volume, we’re limited by our supplies.”
This all comes amid general uncertainty in South Carolina about number of tests still waiting to be analyzed and the extent to which the virus had spread across the state.
In addition to swabs and other items used in the collection process, hospitals are worried about their shrinking stockpiles of protective face masks, gloves and sterile gowns to safeguard doctors, nurse and other emergency workers. It’s a problem playing out across the nation as the number of cases soars by the day.
In a sign of how dire the situation has become, the Centers for Disease Control and Prevention on Wednesday suggested nurses use bandanas and scarves as homemade masks as a last resort, though their ability to protect against infection isn’t clear.
State health officials said some hospitals around the state are down to a three- to four-day supply of protective gear. One cancer center in Columbia said it ran so short of masks this week it turned to painters and auto body shops for donations.
Gov. Henry McMaster's call for hospitals to stop elective surgeries should free up bed space and help preserve supplies of masks, gowns and other items, DHEC said.
The state also received its first requested shipment from the Strategic National Stockpile — 55 pallets of masks, face shields, gowns and gloves. DHEC said the distribution will be data-driven to “ensure needs are fairly met based on county populations and emergent needs.”
Testing lags
That will likely be challenging, as South Carolina’s testing effort continues to lag behind a number of other states, even much less populous places such as Rhode Island and Maine. That’s made it difficult for medical professionals to get a clear picture of the virus’s hold on the state so they can best target resources and care.
South Carolina isn’t even sure how many tests have been sent to private labs, how many samples remain to be analyzed or how long that will take. Anecdotally, people who have been tested say they have waited anywhere from 48 hours to six days to learn their results.
Still, hospitals have been working to ramp up new testing locations to speed of collections and analysis. One of the newest drive-thru testing sites opened Thursday in Kershaw County, the epicenter of the state’s coronavirus outbreak. Of the state’s 81 cases, 29 are from Kershaw.
While grateful for the new testing center, state Rep. Laurie Slade Funderburk, D-Camden, said this crisis has taught everyone a good deal about the need for better preparation to meet unforeseen emergencies.
"This has provided a time of reflection as to the readiness of our state and our nation to deal with public health crises,” she said. “We've been operating on an order-by-demand system here, but that is obviously going to fail us.”
Roper St. Francis Healthcare, which operates four hospitals in the Lowcountry, said it is working to set up additional testing sites for the virus, but is challenged in doing so with only about a week’s supply of swabs on hand. And that’s if demand for tests holds steady.
“The more we do, the more we are going to put pressure on getting those additional testing supplies,” said Scott Ferguson, who oversees Roper’s supply chain.
Roper also is keeping close track of its masks, gowns and gloves to ensure it has enough on hand to meet the need as it searches nationwide and explores overseas sources for replacements, Ferguson said. Down to about a two-week supply, Roper officials are urging staff members to think hard about whether protective gear is needed for each procedure they encounter, he said.
“We’re still doing OK, but it’s a really tight supply,” he said. “I think the important thing is we have to be preaching, ‘Let’s base the use of protective apparel on evidence, not fear.'”
Dr. Lee Biggs, chief medical officer at Trident Health, said the two hospitals in Summerville and North Charleston are checking their protective supplies twice a day. He said the system is judicious with the N95 protective masks, which can only be used once unless they are specially cleaned.
Prisma Health, which runs hospitals in Columbia and Greenville, did not respond to questions about its supplies of protective equipment and testing swabs. The Medical University of South Carolina did not immediately have figures available for its supply levels.
But while MUSC is "OK for now," spokeswoman Heather Woolwine said, the hospital is beginning to make plans for shortages and "how to continue to provide care in the face of those issues."
Scrambling for gear
As supplies run low, doctors statewide are sometimes scrambling to find basic equipment like the fine-knit masks that filter out tiny virus-carrying droplets.
When South Carolina Oncology Associates, a cancer treatment practice in Columbia, has tried to buy masks in recent weeks, its supplier has automatically canceled its orders because there are none available. It was finally able to track down one mask for each of its staff members this week — because a nurse called body shops and painters asking if they would share.
“If it wouldn’t have been for a nurse that was pretty resourceful, we wouldn’t have them,” said chief operating office Wade Bonner.
Even so, the office has only three extra masks, and it has struggled to find supplies as it tries to keep safe patients with weakened immune systems, Bonner said. It’s taking the temperature of everyone who comes inside, but came within an hour of running out of thermometer probes on Thursday, when a new shipment arrived.
Thornton Kirby, CEO of the South Carolina Hospital Association, asked the state’s medical manufacturers for help addressing the shortages. In a note sent to an industry trade group Wednesday, he asked if there are companies in South Carolina who make protective gear or could start to, “because we don’t think we will be able to get the supply we need from current manufacturers or the national stockpile.”
Schipp Ames, spokesman for the S.C. Hospital Association, said the supply of masks has been back-ordered since January. Ames said hospitals aren't able to purchase more from manufacturers at all.
Ames said they have turned to other states hit hard by the virus for guidance. There, hospitals have asked other industries to consider donating their supplies to help guard medical staff from infection.
"It's really difficult to expect the health care workers to come to work without the tools to protect themselves," he said.
Meanwhile, sick residents continue to wait anxiously to learn if they have been infected.
Caroline Mauldin, a 36-year-old from consultant from Charleston, fell ill last week shortly after returning from trips to Nigeria and Miami, where she came in contact with a politician who later tested positive for the virus. She’s been trying to get tested since the beginning of this week. On Thursday, she learned from MUSC that her test will have to wait until Monday and the results would be another five days coming, she said.
Mauldin said the hospital wasn’t sure how to accommodate her when they learned she didn’t have a car. She didn’t want to take Uber or Lyft and risk infecting a driver. Same with taking a bus. She thinks she can eventually borrow a friend’s vehicle, but worries about those in similar straights without transportation options.
Without ready access to care, she wondered, how will be the most vulnerable among us fare in a pandemic?
