GOSHEN — A lack of available testing kits at the state and federal levels has severely limited the ability of health workers to adequately test for cases of the COVID-19 virus in Elkhart County. But, even without the test results, the county’s health officer believes the virus is present in local patients.
That’s according to Elkhart County Health Officer Dr. Lydia Mertz, who provided an update on the county’s current preparedness efforts related to the virus during a special meeting of the Elkhart County Health Board Friday afternoon.
According to Mertz, while there were still no confirmed cases of the COVID-19 virus in Elkhart County as of Friday afternoon, she noted that in all likelihood, the virus is already present in the county, though the absence of available testing kits and the backlog of tests already in play is hampering efforts to adequately diagnose potential cases.
“The lack of testing kits, and the lack of the ability to do testing, is just a huge boulder in the way of our progress,” Mertz told the board Friday. “And right now, there’s no way around it, because the supplies that make the test kits are indeed in short supply.
“So, they’re working on those things. They’re working on a fast test kit that could be done in an hour. They’re working on all that. But this is a brand-new virus, and they just haven’t had time to get everything geared up yet,” she added.
As of Friday, Mertz indicated that Goshen Hospital had conducted about 50 tests for the virus, while Elkhart Hospital had conducted just over 100.
That said, she noted that results from the tests have been very slow in arriving, due in large part to the backlog of tests currently awaiting processing at the few labs currently able to analyze such tests.
“They are getting swamped with test results that they have to run through the lab,” she said, noting that a large number of tests statewide are still pending results. “They can only run through so many at a time, so everybody is waiting on that.”
Adding to the issue, Mertz said, is the fact that the complexity of the test for COVID-19 currently precludes most smaller health departments, hospitals and doctors offices from conducting their own tests, and instead requires the tests to be mailed to a few large labs, like those at the Indiana State Department of Health, or a few select commercial labs.
“The state is not going to send out test kits to people at this time. They don’t have that ability yet. They are still wanting us, if we have appropriate patients, to send the test kits down to Indianapolis,” she said. “They have the lab there that can run them. It’s a complicated test, so it’s not a test that you can do in a doctor’s office. It requires a big lab.”
According to Mertz, a typical COVID-19 test, as with most viral tests, involves the use of what she called a nasopharyngeal, which involves taking a small cotton swab attached to a long, flexible metal wire, and threading it through the nose and down into the throat, where a sample of the back of the throat is taken.
“Then they put it in a viral culture medium to keep the virus alive, and then we send it off to the state lab, or to whatever commercial lab is doing it if it’s not the state,” she said. “And then the other way would be to do a throat swab, like with strep throat. And then again, it would go into a viral culture and then off it would go to the lab.
“So, you have to have the swabs, and the tubes that contain the culture medium, the stuff to mail it off, and all those things together make up a kit,” she added.
Mertz noted that she had hoped many more testing kits would be forthcoming once commercial labs began producing the kits in addition to the federal and state labs, though the results have not been what she expected to date.
“We were hoping for a lot more tests when the commercial labs were able to get test kits done, but it’s not been as much as we would like. It’s better than just ISDH, but it’s not as much as we would like,” she said. “And I believe that the commercial companies are working as hard as they can to get more test kits. They are not working against us. It’s just a time factor. This is a new virus. A pandemic is a marathon, and that’s what we’re in.”
That said, she indicated that the county health department does currently have a plan in place for when the first official case of the virus is confirmed, which could be any day now.
“When you look at the map of counties that have had cases, they’re kind of scattered all over. It’s not just a glob around Indianapolis,” she said of the likelihood of a case being confirmed in the county sooner rather than later. “It’s here.”
In addition to the shortage of available virus testing kits, Mertz noted that the county is also currently experiencing a shortage of available personal protective equipment, or PPE, such as gowns, gloves and face masks.
“Hospitals are starting to run low on test kits and PPE,” she said, noting that hospitals and nursing homes in particular are being asked to be as conservative as possible with the supplies they have on hand. “We have talked to nursing homes about conserving their PPE also. That was a hard discussion for them, I think. But we’ll see. And, as you may know, if you know anybody in a nursing home, there are some pretty strict regulations out right now.”
Mertz noted that she has been told that additional supplies of PPE are supposed to be on their way from the state, though exactly when those supplies will arrive — and in what quantities — is anyone’s guess.
“As far as the PPE supplies, they’re apparently in Indianapolis. We hear one thing from somebody, and a different thing from somebody else. So, I’m just waiting until they appear at our door, probably,” she said. “All we’ve heard is that they’re in Indianapolis. That’s all we’ve heard. But someday they will be delivered. Someday, when they say that, it will really be true. So, they may be dividing it up right now. They may call us tomorrow and say it’s on the way. We don’t know.”
Speaking to the supply shortages, Mertz noted that the county has to begin looking forward to what the virus’ spread might look like heading into the next few months, adding that she wouldn’t be surprised if the virus remained in the area well into the summer, if perhaps in a smaller capacity.
As such, she indicated that ensuring the county has enough supplies to handle a prolonged outbreak must be a priority for all involved moving forward.
“I already have a list of things we need to do probably this summer. We’ll probably still have it around, but not as bad as now. But we’ve got to have stockpiles of these things,” she said of the supplies. “But again, the test kits are really putting a damper on everything, and we’re helpless there.”