Laboratory Organizations Ask HHS for Permission to Focus Scarce Testing Resources on those in Medical Need

With no hope that manufacturers will pick up the slack and furnish the reagents, swabs, PPE and other desperately needed COVID-19 testing supplies before the end of the year, laboratories are in the position of having to ration the resources that they do have available. And they are calling on the U.S. Department of Health and Human Services (HHS) for help in making those difficult decisions. Specifically, they want the agency to establish new testing guidelines that prioritize testing patients who are ill, symptomatic or in other immediate medical need at the expense of the asymptomatic.

Providers to HHS: Let Us Focus on the Medically Needy

On Aug. 11, seven healthcare organizations sent a letter to HHS asking the agency to update its COVID-19 testing prioritization guidelines. “We are increasingly concerned about the serious strains being placed on testing services for COVID-19, the impact those strains have on our ability to provide timely medical care to our patients, and ultimately on our ability to contain the spread of this dangerous virus,” the letter begins.

“Without improvement in available supplies, we simply do not have the resources to meet the huge demand for testing.” Since we cannot test everyone, please tell us whom we should test is the basic thrust of the request. More precisely, the organizations are asking HHS to clarify that the priority should be testing those with medically indicated need for COVID-19 testing, including persons who are symptomatic, have known exposures to the virus and/or in need of pre-procedure testing.

While acknowledging society’s need for broad testing for performing medical surveillance and ensuring safe reopening, the letter recommends that testing of asymptomatic individuals without exposure to COVID-19 be assigned a lower priority. “During critical public health emergencies. . . limited testing resources must first be directed towards those who need them most—those at immediate risk of infection and serious illness,” urges the letter.

Takeaway

And, so here we are. After months of warnings and vain pleas for help overcoming the supplies shortages, laboratories and healthcare providers are now facing a “Sophie’s Choice” about which of their patients to serve at least through the end of 2020. Adding to the dilemma is the increased demand of COVID-19 screening of the asymptomatic in connection with schools, athletics, business and other reopenings. Having failed to fix the problem, the political powers that be must step up and make some hard choices about how to deal with its consequences.  

The 7 Signatories

The signatories to the HHS letter requesting COVID-19 test prioritization guidance was signed by seven of the most powerful and respected medical and laboratory organizations in the U.S., including:

• The American Medical Association
• The American College of Medical Genetics and Genomics
• The American Society for Clinical Pathology
• The Association for Molecular Pathology
• The Association of Pathology Chairs
• The College of American Pathologists
• The Infectious Diseases Society of America