Covid test providers cut back despite concerns of another winter surge

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WASHINGTON — Covid testing labs and home test makers have cut staff after government funding cuts and falling demand, despite concerns from health officials that the country could face a new winter wave of infections.

It’s unclear what trajectory the pandemic will take as the United States enters the cooler fall and winter months that preceded past case spikes; some public health groups predict another winter wave of infections.

The severity of this wave will depend on whether the virus mutates to evade immunity from previous infections. But if the United States sees a surge similar to last winter’s, Americans could find themselves in a similar testing situation, with home tests selling out quickly and people facing long waits for test results. lab PCR tests, public health officials said.

Makers of rapid home Covid tests are performing only half the number of tests they were doing in February, when they ramped up production in response to the omicron wave, and the White House has pledged to buy 1 billion home tests, according to data compiled by Mara Aspinall, a professor at Arizona State University who has consulted with companies and institutions on testing.

Distribution of Covid-19 rapid home test kits to the environmental protection organization GreenRoots and Chelsea Community Connections in Chelsea, Mass., on December 17, 2021.Joseph Prezioso/AFP via Getty Images File

But since last winter, demand for testing has declined and the White House has run out of money to continue buying tests on such a large scale, which has forced some companies to cut capacity.

“There are certainly manufacturers backing down without full confidence that there will be a government or a market for Covid testing,” Aspinall said. “That being said, I think some of the larger vendors will remain engaged in the market. Some of the smaller ones, there is a question.

Labs that process PCR tests have also cut capacity by a third as more people turn to home testing, and public health guidelines have become more relaxed about testing for schools and hospitals. trips, according to data from Aspinall.

Opko Health’s bioreference labs, for example, grew from processing 3 million PCR tests in the second quarter of last year to 1 million in the same period this year. As a result, it has cut its testing workforce by more than 4,000 since its peak, including laying off 700 workers in June and July, the company said in its quarterly earnings report last month.

Companies that make Covid tests, equipment and supplies have also seen a sharp drop in Covid-related sales. Becton Dickenson saw its Covid testing revenue drop to $76 million in the last quarter from $300 million a year earlier, and executives said they expect demand to continue to fall throughout the year.

The number of reported Covid cases is currently a quarter of what it was at its peak last winter. But Chris Murray, director of the Institute for Health Metrics and Evaluation, estimates that only 4% to 5% of infections are reported, as many are discovered through home testing and not reported to public health departments, or they are not detected at all. He expects to see infections start to rise next month and continue to rise through the winter.

“The decline in immunity from the latest set of Ba.5 infections and the decline in immunity from vaccination combined with the fact that people are indoors should combine to mean that we should see infections starting to go up from October and increase a bit,” Murray said.

The Biden administration aimed to provide some stability to the Covid testing market by buying a steady supply of Covid tests to send to Americans for free. But Congress failed to pass a Covid spending package that included $2 billion for testing, and last month the White House announced it was ending its free Covid testing program.

With its remaining funds, the White House said this month it would buy an additional 100 million tests to stockpile in the event of a further increase, well below what the administration had hoped to do if its funding from Congress had been cut. paid, administration officials said.

IHealth Labs, one of the biggest beneficiaries of federal spending on Covid testing earlier this year, said it was now doing about a tenth of the tests it was doing in February. But the company said it was ready to ramp up production quickly – up to 50 million tests a month – in the event of another winter surge.

“We have to prepare for fall and winter. We don’t know if there is a new wave, but we need to be ready because it has happened over the past few winters,” said Jack Feng, CEO of iHealth. “We’re still confident there will be an end, but it always comes back.”

State and local governments are also lacking funding to provide free PCR testing, making pop-up Covid testing centers on street corners or at large gathering sites a thing of the past in many areas.

Many state and local health officials have largely diverted their attention from Covid, especially with the rise of monkeypox, and there is little talk of preparing for a possible winter surge, said Marcus Plescia, chief medical officer. from the Association. state and territory health officials. His group represents public health agencies in all 50 states, Washington, DC, five U.S. territories, and three freely associated states.

“Even the public health people seem to have this kind of wishful thinking that everything will be fine and maybe it won’t be, but I don’t think anyone is preparing. I think for the most part everyone is waiting to see what happens and they will prepare if the need arises,” Plescia said. “I think it’s kind of human for everyone to pause and wait to see what happens.”

Part of that mindset comes from faith in treatments, like Pfizer’s Paxlovid, that reduce the risk of serious illness, and new boosters specifically targeted at omicron, health officials said.

But as the virus continues to spread, there remains the threat that a new variant could develop that evades the immunity of much of the population from past infections and vaccinations, Murray said.

“There is only capacity, personnel, mental bandwidth to tackle Covid,” Murray said. “I think the problem now is that the public health community can be more focused right now on what’s going on and try to think of relatively small effects on the big picture for Covid, instead of putting a lot of energy in the kind of preparation plans if a bad variant comes up.”

Test makers and labs say they are in a stronger position than last year to be able to rapidly increase capacity in the event of a further increase due to investments they have already made in equipment and facilities. .

Abbott, one of the largest makers of home tests, said it has continued to perform “tens of millions” of rapid tests at its two facilities in Maine and Illinois, and has the capacity to produce 100 million tests per month if necessary. Abbott has seen its Covid testing revenue drop 29% in the last quarter, although its sales have nearly doubled in the past year.

“Maintaining our nationwide rapid test manufacturing infrastructure is essential for pandemic preparedness,” the company said in a statement. “This includes responding quickly to seasonal waves of Covid and new variants, and ensuring that rapid tests are readily available so that therapeutic Covid treatments can be delivered quickly.”

One of the biggest hurdles to scaling up quickly would be finding enough people to work in labs and production lines or collect samples from patients.

“One of our limitations, like all industries right now, is people,” said Alex Greninger, associate director of clinical virology laboratories at the University of Washington Medical Center. “Burnout is real. It’s hard to do. We’ve done about 105 years of testing in the last two and a half years. Imagine having to multiply your productivity by 50.”

The decline in PRC testing and the shift to home testing is also causing public health officials to be increasingly blind to the spread of infections, as few home test results are being reported to health departments. public, unlike laboratory tests. This could make it harder for test makers and labs to see a surge coming and accelerate accordingly.

There have also been other concerns about the accuracy of home tests, which tend to be less sensitive than PCR tests.

“I’m concerned that the public has become a little too reliant or confident in the sensitivity of home testing,” Plescia said. “I think they’re a good tool, but they’re clearly flawed.”

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