File this one under “better late than never.”

Over the weekend, Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, ordered the state lab that processes tests for COVID-19 to commence operating 24 hours a day, seven days a week.

“Every HETL (Health and Environmental Testing Lab) staff member certified to conduct COVID-19 testing is working in rotating shifts to provide 24-hour coverage,” Jackie Farwell, spokeswoman for the Maine Department of Health and Human Services, said in an email Sunday morning.

Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention Gregory Rec/Staff Photographer

Good news indeed. Especially when you consider what preceded it.

Friday afternoon, I heard from an old acquaintance who’d just arrived home from a drive-thru COVID-19 testing center operated by InterMed on Foden Road in South Portland.

I’m not going to name him out of respect for his family’s privacy concerns. But in an email and several subsequent phone calls, he made two things eminently clear: First, he was sick, possibly with COVID-19.

Second, he was dumbfounded to hear that his test results would be delayed because, as he was told by InterMed staff, the Maine CDC lab “isn’t open on weekends.”

For the record, that was only partially true. In an earlier email Friday evening, DHHS’s Farwell told me the lab was in fact open on Saturday but closed on Sunday.

“Given that running tests is highly sensitive and precise work, allowing staff to rest on Sunday ensures they are in a position to effectively perform their jobs,” Farwell explained.

Our patient wasn’t placated. More on him in a minute.

Now, let’s turn to the Maine doctor who called me Sunday morning. He asked that his name be withheld because he was not authorized to speak for the hospital with which he is affiliated, but his complaint was strikingly similar to that of the patient, with whom he has no connection.

The doctor said he learned on Saturday that any COVID-19 tests submitted by the hospital to the Maine CDC for processing after 1 p.m. on Thursday “would not be completed until Monday.” And, he was told, any tests collected over the weekend, rather than be rushed to the Maine CDC posthaste, “would not go out until Monday.”

Why?

“The state lab closes weekends,” the doctor said he was told.

Again, not entirely true. But by late last week, the clear perception on the front lines of the COVID-19 battle was that the state lab saw no need to keep the lights on beyond normal business hours.

Besides, Saturday operations notwithstanding, the fact that the state lab has been closed at all in the midst of a coronavirus pandemic was, in itself, a stunning revelation.

Each in its own way, the patient’s and doctor’s stories shed light on why COVID-19 testing – the sooner the turnaround, the better – is so important as this viral pandemic ramps up across Maine, the United States and the rest of the world.

The patient, who’s 73, had just been on a 10-day business trip to the Southwest that included eight airline flights, two board meetings and two basketball games.

Upon returning to his home in Greater Portland on Thursday, he felt ill with “either a horrible cold or something worse.” So, he immediately self-quarantined, called his primary care doctor and ultimately found himself on Friday getting three swabs – one for influenza (he tested negative) and the other two for COVOD-19 – at the InterMed drive-thru in South Portland.

Twice, during his visit to his doctor and then his drive through the testing site, he was told his tests would take between three and 10 business days to complete.

When he asked why, the providers, clearly frustrated, told him about the Maine CDC lab being closed.

Contacted on Sunday, InterMed spokesman John Lamb said the three-to-10-day wait involves more than just the test processing by Maine CDC. In cases where the influenza test is negative, but the COVID-19 test is “presumptive positive,” Lamb said, that test must then be sent to the U.S. Centers for Disease Control and Prevention in Atlanta for final confirmation.

“There’s a lot of factors and that’s why the (time) range is so wide,” Lamb said.

Fair enough. But as his test winds its way through the state-federal labyrinth, consider what’s happening at our patient’s end.

Upon being advised that he needed a COVID-19 test, he called the CEO of the company on whose board he sits to alert folks there that he was ill and might have the novel coronavirus. That, in turn, led to the self-quarantine of almost a dozen people with whom he’d had close contact on his trip – all of whom now wait on tenterhooks to hear whether he’ll test positive.

Little wonder that virtually every sector of our economy is either going into a protective crouch or shutting down altogether. The longer it takes to determine whether someone has COVID-19, the farther outward the fear of contagion ripples.

The patient had nothing but praise for the way he was received and treated by InterMed. But upon hearing that the Maine CDC lab was in fact closed on Sunday, his frustration boiled over.

“There’s just a lot to be learned, which I hope Maine CDC is learning, about being prepared,” he said. “And the fact that other countries, and for that matter, other states, were able to be prepared, suggests that someone wasn’t paying enough attention.”

Back to our doctor.

His concern, he said, is that even a suspected COVID-19 patient must be kept in a “negative pressure” hospital room, from which no air can escape into the rest of the facility. Such rooms are in limited supply throughout Maine – especially when you consider the looming spike in demand over the coming days and weeks.

With only so many negative-pressure rooms to go around, the doctor said, expediting tests to quickly determine whether a patient actually has COVID-19 “really helps us free up resources.” The longer the test takes, the longer the patient – with or without COVID-19 – ties up that room.

In her email on Friday, DHHS spokeswoman Farwell noted that all COVID-19 tests submitted to Maine CDC are completed within 24-48 hours and that the tests were being processed “every day, except for Sunday.”

“Should the demand for testing require additional processing, Maine CDC will bring other staff in to accomplish that,” Farwell said at the time. “Maine CDC is continually reviewing the demand for testing and will adjust appropriately to meet it.”

On Sunday, not long after I emailed Farwell with the tale of the frustrated doctor, she announced a new policy. Due to “a rapidly evolving situation and based on an increase Friday night in the number of requests for testing,” she said, Maine CDC Director Shah has decided the lab will now operate “every day of the week.”

So, all’s well that ends well.

Still, the experiences of our doctor and our patient illustrate why, in addition to our entire health care system shifting into overdrive sooner rather than later, clear and consistent communication is vital to preventing this pandemic from turning into a mass panic.

That includes not only working 24/7, but also providing detailed accurate information immediately to a public now riveted to every uptick on the COVID-19 count.

Which brings us to one more needed improvement.

As of Sunday morning, Maine CDC had reported three “presumptive positive” tests processed by the state lab and three “preliminary presumptive positive” tests processed by non-governmental labs such as MaineHealth’s NorDx Laboratories.

Yet, throughout the weekend, the Maine CDC’s online “COVID-19 testing data” table showed only three cases – two presumptive positives and one preliminary presumptive positive – posted as of Friday.

Why the discrepancy in totals?

The chart isn’t updated on weekends.


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