In the rush to expand coronavirus testing across Georgia, a state-run partnership has lost more than two dozen patient samples and test results have been delayed for more than 4,000 people, an investigation by The Atlanta Journal-Constitution and Channel 2 Action News found.
The lapses in test kit handling and delays to process results raise questions about the state’s flagship program to ramp up surveillance for COVID-19. They also show the challenges of rapidly deploying an unprecedented statewide testing and processing network amid a pandemic that has reached every corner of the state.
Gov. Brian Kemp has touted the partnership between state universities, Augusta University Health System and the Georgia National Guard to quickly scale up detection of COVID-19 in a state that has trailed the nation in per capita testing. State officials say the partnership has done just that, completing more than 13,000 tests through Tuesday at dozens of drive-through sites.
Christen Engel, a spokeswoman for Augusta University, said the state is working to re-test about 30 people whose samples were lost, and the group has shifted processing to other labs to overcome a backlog at an Atlanta lab. The state has promised the partnership would produce results in one to three days.
One patient told the AJC and Channel 2 it was clear from conversations with testing officials that her personal information somehow became separated from her sample. Other patients said they are still awaiting results as much as a dozen days after their tests. Still others said they don’t trust the results they’ve gotten after waiting for more than a week and are seeking tests elsewhere.
Lester Gibb of Atlanta said he was tested April 24 at a center outside Greenbriar Mall and only received his test results on Tuesday, 11 days later. The results were negative, but Gibb said the long wait made him question whether the sample was still valid.
The test itself went smoothly, but he had trouble accessing a portal to get his results. Then he waited. And waited.
He said he wants another test, but by Tuesday, Gibb said he isn’t sure he’ll be able to get one.
“I’m assuming if you are rolling out a product you should have the infrastructure to support it,” he said. “I’m ready to move forward but I don’t know if I can because of my health status.”
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Kemp made it a top priority to increase testing capacity in Georgia after the state saw cases and deaths soar, and the ramp up is working. An AJC analysis of per capita testing data Tuesday found Georgia now ranks 30th nationally, up from 33rd on April 30 and 45th a few weeks ago.
But the university and National Guard partnership encountered some early stumbles. There was trouble setting up an interface at an Atlanta lab for patients to view their results and that lab also got overwhelmed with samples. AU Health moved samples to its Augusta lab to work through the backlog.
“We wish we would have caught it earlier and these people weren’t delayed at all, but we are getting those results taken care of as quick as possible,” AU Health Chief Medical Officer Dr. Phillip Coule told Channel 2 on Friday.
In total, approximately 4,200 tests results took longer than three days. Engel said crews were able to process about 2,000 tests in the backlog over the weekend and are working to clear approximately 2,200 others.
Engel said AU Health is still investigating how samples were lost and from which locations.
Kemp's spokeswoman, Candice Broce, said the administration expected to encounter challenges as testing ramped up, and asked Georgians to be patient.
"Those challenges have been instructive, and we have taken immediate action to improve operations by working to leverage additional resources," she said.
National Guard officials did not return a message seeking comment.
Results promised quickly
Dr. Harry J. Heiman, an associate clinical professor at the Georgia State University School of Public Health, said such operational problems are not unexpected.
“Standing up this kind of testing infrastructure is a monumental task and I think it is especially challenging for organizations to do it that haven’t done it before,” he said.
As it was conceived, Georgians wishing to be tested were to have a telemedicine consult with a medical provider through a new app developed by AU Health. The provider would schedule a test for patients deemed to be in need.
Test results were promised within 72 hours and patients were to receive a follow up call and find their results on a secure web portal. For positive patients, a provider would discuss treatment options or procedures for self-quarantine.
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Delays, lost results
But people interviewed by the AJC and Channel 2 described trouble accessing the portal, sometimes because they did not receive an invite email to establish an account.
Lindsey Eaton, a health care worker, said Wednesday she still doesn’t know the results of her test from April 24. Eaton, who was exposed to a person confirmed to have COVID-19, said she got an appointment for a test at the National Guard’s Decatur armory.
It was an uncomfortable experience. The nasopharyngeal swab required to obtain a sample is not a pleasant procedure to begin with, but Eaton suffered a severe nosebleed. She showed video of the aftermath to an AJC reporter.
Eaton said she was told she would get an email invite to create a portal profile, but one still hasn’t arrived despite repeated phone calls to a testing hotline.
Eaton said she doesn’t know if her test kit was lost or is simply delayed.
“How do you lose a sample?” she said. “Hopefully I’ll get an answer eventually.”
Eaton said she has since returned to her job after being symptom free for several days, but she has had to wear protective gear to shield her colleagues.
An investigator who spoke to the AJC and Channel 2 but declined to be named because of the sensitivity of her job, said she was tested April 24 at Greenbriar Mall and she also initially didn’t get an email invitation to the portal. Once she did, she said she became concerned when results didn’t appear in three days.
When she called AU Health for help, she said a representative told her there was a backlog in the test processing system delaying results up to a week. After seven days and still no results, the investigator said she called again and was told by a representative that some samples had “unreadable” personal information and they asked for her personal information again.
But the investigator said she wasn’t told how lab officials would be able to determine which sample was hers. On Tuesday, the investigator said she was notified her sample was invalid, but AU Health didn’t say whether her sample was lost.
She was re-tested Tuesday afternoon.
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