In late May, the Kalamazoo County Health Department joined what looked to be a promising COVID-19 testing effort.
Working with the Michigan Department of Health and Human Services and the state police, three-person teams from the Michigan National Guard fanned across the state, testing staff and residents in long-term care facilities, inmates in county jails, and thousands of individuals at temporary drive-through sites.
The county’s Area Agency on Aging director, Samantha Carlson, was eager to see what that testing would reveal about infection in the county’s 167 long-term care facilities.
But one, two, then three weeks passed without a conclusive word from the lab processing those tests, a company in New Jersey called BioReference Laboratories. Along with Quest Diagnostics and LabCorp, it’s one of the largest in the nation.
“Unfortunately, it was past the time when (the results) could have been influential in these facilities,” she said. “It was mid-June. And that’s too long” — too long, that is, to mount an effective public health response, which would involve isolating the infected patients and tracking down the people they’ve come in contact with.
Kalamazoo County found local labs to work with, but other counties and facilities continued to rely on the state program facilitated by the National Guard. To date, that program has collected 72,581 samples, according to MDHHS. That’s about 4.6% of total tests completed in Michigan.
Some nursing facility administrators and local health officials say their communities’ test results have taken weeks to come back from BioReference, which MDHHS started contracting with in May.
“The first two times we did (testing with the National Guard), with the sheriff’s (department), the results didn’t come back for like a week to ten days,” said Marcus Cheatham, health officer for the Mid-Michigan Health Department, which covers Clinton, Gratiot, and Montcalm counties.
“The data were useless to the people who were tested,” he added.
In an email, a spokesperson for MDHHS acknowledged the delays, but said they were “mostly due to incomplete or inaccurate paperwork submitted” to BioReference by those collecting the samples — that could mean a health department, a nursing home collecting samples with kits supplied by the National Guard, or the National Guard itself. The department said ““Michigan has worked closely with the lab to work through these issues.”
Because MDHHS did not respond in detail to questions about delays at BioReference, it's hard to tell whether clerical errors or lab-capacity limits were the main cause of the delays.
Cheatham says his department dropped BioReference (and, by association, the National Guard) in late June. He’s now working with two local labs whose turnaround time for results is 48 hours — “but really, we want 24,” he said.
At the Meadow Brook Medical Care Facility, a county-operated nursing home in Antrim County, administrator Marna Roberston was shocked to hear from the National Guard that some of their tests, completed on June 17 for all staff, had gotten lost in transit.
“I didn't find out until the sergeant called me that afternoon saying, ‘Ooh, we have a slight problem,’” she said. “And I’m thinking, oh my gosh, it’s more than a slight problem, because we tested 200 staff and I want to make sure that, number one, we didn’t have to do it again.”
According to Robertson, some of those 200 tests were accidentally shipped to the Bureau of Laboratories in Lansing rather than to the BioReference lab in New Jersey. She suspects that the mixup explains why today, more than a month later, 10 results still haven’t returned.
That’s not to say the tests sent to New Jersey were processed at a meaningfully faster clip. Sixty staff members waited two weeks for their results.
Soon after, Meadow Brook’s part of the state was reclassified as a medium-risk zone on this map, which meant that, under MDHHS orders, it would have to complete weekly testing of staff. Robertson signed on with NxGen MDx, a lab in Grand Rapids.
Her facility began its weekly testing last week, and results have been trickling in after 48 to 72 hours.
Like Meadow Brook, the Mid-Michigan Health Department was able to drop BioReference and engage another lab. But for the rural and geographically enormous District Health Department 10, which covers 10 counties that include Oceana and Manistee, the National Guard was the best option.
“Our communities and the people that have gone through the testing have been very thankful for the opportunity to have that testing done,” said Kevin Hughes, health officer of District Health Department 10. “We don’t have a lot of opportunities for this, up in our area, our jurisdiction.”
As of Wednesday this week, the National Guard had administered 2,681 tests at pop-up sites across the 10-county jurisdiction; it also administered tests at the Crawford, Lake, Missaukee, Newaygo, and Wexford county jails. (Hughes says that most testing in the area has occurred at local hospitals.)
In June, when the testing started, Hughes was seeing turnaround times of seven to nine days. Officers and inmates at the county jails were some of those who waited the longest.
“That was another one of those situations where it impacts the credibility of the health department until you kind of go through and explain the situation,” he said.
Hughes says the turnaround time for last week’s pop-up sites was 48 to 72 hours. On Thursday, National Guard members are collecting samples at a pop-up site in Crawford County. That’s the last one on the schedule.
With the National Guard’s state contract set to expire this month, Hughes says they might find a local lab to work with.
Also on Thursday, MDHHS confirmed it would initiate a $42.4 million contract, paid for with federal funds for testing, with a private company called Honu Medical Group to fill the mobile-testing void left behind by the National Guard.
“We have to wait and see how much more of this testing we may be involved in,” said Hughes.
*This post was last updated on July 23 at 7:30 p.m.
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