Carlos Osorio/AP Photo
A lab technician dips a sample into the Abbott Laboratories ID Now testing machine at the Detroit Health Center in Detroit.
Carlos Osorio/AP Photo
In mid-June, Gabby Costabile wasn't showing any symptoms, but she still wanted to get a COVID-19 test out of precaution, as she was returning to the Sirius XM office where she works part time as a producer. She went to the free walk-up testing site at Engine 24 on Georgia Ave. NW on Monday, June 15, and ended up waiting for just under two hours.
A pleasant woman came to her in line and took down her information — name, email address, birth date — and apologized for the long wait. Costabile was told the results would be sent by email in three to five business days, not including the day of the test. She would ultimately wait for weeks to get any answers from D.C. Health. In fact, she would never get her test results back at all.
After five days passed with no email, Costabile called the department's hotline (1-855-363-0333) and was told that she would have to wait until the following Monday for results. When she called that Monday, a full week after getting her test, she was told there was a delay in getting results back from the lab and that the health department would bump her case up to a supervisor.
"They said, chances are, if they don't have anything and if the test results never come back, it's possible that the results were just inconclusive," Costabile says. "That was a little disconcerting because you want a little bit of closure in situations like that. I'd rather know either way instead of not hearing at all."
Costabile never heard from the supervisor who was supposed to contact her, even after she called back multiple times, so she decided to go for a second test last week at the University of the District of Columbia Bertie Backus drive-through site. Her results came back negative five business days later, but she didn't walk way from the experience with "a whole lot of faith in the District's testing system," she says.
D.C. launched a few public testing sites in late March, but there was confusion about who could get tested. Over the past few months, the department expanded its program to include 11 free walk-up testing sites across the city, especially as thousands participated in the Black Lives Matter protests. Still, people complained of long lines that snaked around city blocks, so the city added even more public testing sites at fire stations last month.
In total, more than 120,000 people have been tested in D.C., according to the health department (and more than 91,000 of those are District residents). Of course, plenty have gotten successfully tested, provided with results, and treated when necessary. Many people report getting tests back within the 5-7 business day timeframe D.C. Health says is to be expected.
But that's not what happened to Costabile. Her testing journey, while concerning, isn't unique. More than two dozen people told DCist/WAMU they had similar stories, saying their tests administered over the past month have been reported lost, damaged, or inconclusive, or that they simply never heard back.
Some of these tests were included in the 407 testing samples taken June 12 at sites in Judiciary Square and Anacostia that were reported unusable because of heat exposure. D.C. Health says that tests at a Columbia Heights firehouse were also damaged by heat that day.
But the issues aren't limited to heat damage. While people who've gotten tested say they are generally impressed by the District's ability to provide free testing across the city, some have become less confident in the follow-up procedures, waiting weeks only to get no results and few answers when they call for more information.
One major factor is that LabCorp and Quest Diagnostics, two of the largest labs in the U.S., announced this month that their testing capacity is strained under increased demand, as outbreaks continue to arise in the southern and western states. These backlogs have caused delays in processing results, for both public health departments and private healthcare providers.
"If there are significant increases in testing, as we are seeing now, then it is possible that there will be a backlog in the [labs], either at the point of analysis or at the point of writing up the results and disseminating them," says Dr. Amira Roess, a professor of global health and epidemiology at George Mason University. "These are just a couple of the reasons for the delays we are seeing."
D.C. Health also tells DCist/WAMU that there was one week in which results from LabCorp were not properly integrated into its system. The department says it has since fixed that problem, and its COVID-19 call center "can now provide additional support in obtaining their results."
Some testing trips are more successful than others. Ethan Miller, a 28-year-old D.C. resident, says that he and his fiancé have each gotten multiple tests at various public sites over the past few weeks, waiting for hours at some and just minutes at others. One, from the Martin Luther King Jr. Ave. site in Anacostia, was damaged by the heat. At another site, his wife got results back in 36 hours. "I think it's just kind of hit or miss," he says.
In emailed responses, D.C. Health officials say the department is assessing its turn-around times often, and that, "frequently, we find that individuals miss the email with the link to the results, or it ends up in their spam folders. If they call in we re-rend their results." (The department didn't respond to a follow-up question about what "re-rend" means in this case.)
District resident Kyle Groetzinger says that he and his roommate never received their results after being tested June 23 at the Sherman Ave. NW firehouse site. After not hearing back for two weeks, he called the D.C. coronavirus hotline and was put on hold for an hour. Finally, the representative told him they couldn't find his results but that he should call LabCorp.
Groetzinger says that when he called LabCorp, he was told that his results were ready about a week after he'd gotten tested, but that D.C. Health had omitted his first name from his records. The error meant he couldn't receive his results in the LabCorp portal until he sorted the issue out with D.C. Health.
"I called again and I was on hold for more than two hours with the D.C. Health line," he says. "And I finally just sort of gave up. I may try to call again, but at this point, it's been more than two weeks since I was tested. It seems kind of like a fruitless endeavor at this point."
Another person DCist/WAMU spoke to named Joshua (who declined to provide his last name for privacy reasons) had a similar experience and said his main concern is "wasted effort all around." Midway through June, he says, a woman registering him for a test at the Georgia Ave. NW site had just found out that a family member had passed away from coronavirus-related complications.
"I told her that I'm sure [the family member] would be proud of her for making a difference mitigating the spread, even saving lives," Joshua says. That was before he waited a week and a half with no results, called the hotline, and was told to get another test. He got results at the end of June, but by then, he was disheartened, he says.
"Now, I feel like that was just a waste of her time, which hurts," Joshua says, speaking of the healthcare worker. "I'm lucky I could take time off to go get tested again. What about people who can't, or are losing out on work opportunities each trip?"
Other issues seem to be as simple as incorrectly entered birth dates or misspelled names. After struggling to find a number to call for answers, Ursula Sandstrom says she called the city's hotline to inquire about results from her June 23 test at the Sherman Ave. firehouse. She was told that her results had been ready since June 27, but under the "patient name" section of her records, her name was written as "Sandstron Sandstron."
Sandstrom says she doesn't recall the workers at the site taking down her email address and has no record of it on a copy of her patient form, so she's not sure how she would have gotten her results if she hadn't reached out herself.
D.C. Health told DCist/WAMU in an emailed statement that, "Occasionally, there is a data quality error which requires the laboratory to reject a sample. We have recently taken an additional quality step by allowing individuals to provide their own data to allow for additional data quality." (The department didn't respond to a question about what this method specifically looks like, and when it was implemented.)
Inconclusive tests can occur for a number of reasons including lack of testable sample material, a leaking tube, or data errors, per the health department.
According to Dr. Roess at GMU, test results can also be affected if there are problems at the manufacturing stage, if the reagents used are damaged, if the kits or samples are left in a vehicle, or if they are stored in a place with no temperature control for extended periods of time.
Some residents say that when they were notified of their inconclusive or damaged tests results, the health department assigned them another appointment without first vetting whether they could actually make it to that location at the given time, alhough they were given a number to call and reschedule.
"We have worked with residents who have been unable to obtain the test results to determine the best solution to get retested," D.C. Health said over email.
These issues aren't limited to just D.C.'s public health sites. Whitney Lee, an attorney in D.C., says that she got two tests through the George Washington Hospital system — one in March and another in April — and both came back inconclusive. She was showing coronavirus-like symptoms, so she paid out of pocket for a private company in D.C. to do an antibody test, which came back negative within hours, she says.
"I'm fortunate to have the privilege to be able to pay for a private test, but the fact that the initial COVID testing was such a mess was disheartening, and at the time, I worried a lot about people who couldn't afford to go to a private health center," she says. "For people who are in a position where they're more likely to get infected, people who have public-facing jobs, working at grocery stores, or cleaners at hospitals ... the ability to walk into a private clinic and shell out $300 might not be a viable option. That's great for such a small percentage of the population, but for everyone else, what are they supposed to do if they want quick and reliable results?"
There's no doubt that widespread testing is one of the most important tools public health officials have in fighting the pandemic, and that it's necessary to identify and prevent the virus from spreading. Health officials warn that reopening safely is dependent not just on the ability to offer tests, but to also turn around results in a timely manner.
There are some "rapid tests" that can provide results within hours if there is adequate staffing and resources at the labs, Roess says. Researchers worldwide are working to improve the speed and accuracy of tests, but these versions likely won't hit clinics for months.
Groetzinger, who never got his test results, says he does plan to get tested again soon, but doesn't know yet whether he plans to go through a D.C. site or a private provider.
"Broadly, I'm very proud of how D.C., compared to other cities, has addressed the issue. I mean, it seems like testing is available. You don't need to have symptoms [to get tested], you know? I'm pleased with, in theory, how they've addressed this crisis," he says. "I think I'm just concerned about our testing in a sense of, if we have these kinds of errors when cases are low, are we really prepared for what would happen if there was a spike?"