Massachusetts far surpassed Governor Charlie Baker’s daily goal of completing 3,500 coronavirus tests, propelled in recent days by a commercial laboratory in suburban Marlborough that accounted for much of the surge.
Quest Diagnostics’s laboratory roared to life in recent days, reporting more than 7,800 new tests over a two-day period. A company spokeswoman attributed the spike to high-capacity testing machines that began running late last week.
Quest has now performed nearly half of all coronavirus tests in Massachusetts, and is providing test results, according to the company, in four to five days on average.
Quest’s breakthrough made good on Baker’s pledge last week that Massachusetts was on the cusp of dramatically ramping up testing as commercial and academic labs processed more cases. Baker predicted Wednesday at a press conference that daily tests would “significantly exceed” the state’s goal, and he urged the state to brace for a deluge of new cases revealed by the stepped-up pace.
“We will find more people who test positive because we are going to be testing far more people than we were testing two weeks ago,” Baker said. “That’s a good thing because it's going to make it possible for us to do the isolation and the tracing and the tracking work that everybody believes is fundamental.”
With the flood of new test results released Wednesday, positive COVID-19 cases increased to 1,838, a 60 percent jump from the day prior.
The Massachusetts State Public Health Laboratory also posted a significant number of new tests, reporting the results from 715 additional people. That number is nearly double the output of a lab that state officials had initially said could process up to 400 tests a day.
The significant jump was also notable because prior to Wednesday the state lab had fallen short of its testing capacity for six out of the previous eight days, according to a Globe analysis of testing data. Baker administration officials said the spike in results was attributed to lab staff working additional hours and shifts Tuesday and Wednesday.
It’s unclear how much lag time there is between the day a test is taken and when the results are reported by the state.
For weeks, physicians and patients have raised alarm about a grave shortage of tests and a wait for results that can stretch as long as a week.
State officials across the country have scrambled to ramp up testing with a combination of public, academic, and commercial labs, which in Massachusetts are now handling the bulk of the work. Baker said Wednesday that now anyone exhibiting flu-like symptoms “should be able to get tested … because we’ve ramped up our testing capacity.”
Massachusetts has long been a global leader in medicine and home to the nation’s first health department, established in 1799 and led by Paul Revere. The slow return of test results has fueled a shortage of protective gear, forcing medical staff to waste face shields and masks on patients who ultimately are not infected. A letter sent Tuesday by the Massachusetts Nurses Association to Baker and other state officials underscored the consequences, warning that the “virus is ahead of us.”
“At this point we should assume that all patients are COVID-19 positive,” read the letter written on behalf of 23,000 nurses. “The inability to effectively segregate patients quickly, as well as the lack of available testing with quick results, has left us with co-mingled patients.”
Massachusetts had one of the earliest known cases of COVID-19 in the United States, when health officials announced Feb. 1 that a college student tested positive for the virus after returning from Wuhan, China. Over the next month, few people were screened as the federal government limited testing to the Centers for Disease Control and Prevention.
By the time federal officials approved the Massachusetts public health lab for testing Feb. 28, the state was on the cusp of an outbreak. The infection had already circulated at a conference in the North End held by the neuroscience company Biogen that has now been linked to 99 cases of COVID-19.
Nationally, public health experts have laid much of the blame on the federal government, saying its missteps have hampered testing efforts across the country.
But within the state, the Baker administration has faced criticism for a lack of transparency.
“We need to get more tests out there and we need to get test results sooner,” said Attorney General Maura Healey, who has been critical of the Baker administration’s handling of the crisis. "We are concerned about what we are hearing from firefighters, nurses, and others we have spoken to, and the need to triage tests for these people and getting quick test results is really imperative.”
The Baker administration has made many improvements around testing and transparency, Healey said in an interview Wednesday, but concerns remain about turnaround time for results from the state lab. Some first responders have waited as long as five days, she said, stuck in quarantine and off the front lines because they don't know if they're infected.
Healey also expressed concern that the Baker administration had urged hospitals not to release specifics about coronavirus cases.
"More information is better. More transparency is better," Healey said. "It is critical.”
To meet demand here, the federal government helped launch a drive-through testing facility operation for first responders in a CVS parking lot in Shrewsbury last week. Still, a dearth of equipment, and slow turnaround times, have bedeviled many frustrated physicians and patients. Beth Israel Lahey Health continues to limit testing to the most seriously ill patients and caregivers because of a national shortage of swabs.
Nasal swab specimens from residents most likely to be infected and those at risk for serious illnesses are sent to the state’s public health lab for testing, according to guidance the state sent health care providers March 13.
That includes swabs from health care providers and EMTs who worked with patients while experiencing even a mild illness such as sore throat, patients in long-term care facilities who show acute respiratory illness, and anyone who had close contact with patients confirmed to have COVID-19.
On Thursday, Baker held a press conference at Quest Diagnostics’ laboratory in Marlborough and pledged “an enormous increase in the amount of testing that takes place on a daily basis here in the Commonwealth of Massachusetts.” The administration set a goal of testing 3,500 people a day to match the efforts of South Korea, which has successfully slowed the virus.
Most public health labs across the country were short-staffed before the coronavirus outbreak, and were not able to run tests now round the clock, compared to larger commercial labs, said Kelly Wroblewski, director of infectious diseases at the Association of Public Health Laboratories. Most labs, she said, are operating now on 12-14 hour days.
"They are designed to detect threats when they first happen and respond to local outbreaks," she said."They are not designed to do large scale testing for an entire population.”
As for transparency, Wroblewski said, many states struggled to communicate detailed results early on because they didn't have systems in place to do that on a large scale and had to build them on the fly.
“The systems didn’t exist to share data in real time in an easy to digest form,” she said.