Image of the BinaxNOW COVID-19 Ag Card
Image of the BinaxNOW COVID-19 Ag Card
Providers in some states are reporting reduced access to BinaxNOW test cards.

A national shortage of COVID-19 testing supplies  — stretched thin after a months-long delta variant surge  — is once again threatening safety at nursing homes dependent on testing to stay ahead of infections.

Test manufacturers, including the maker of long-term care’s preferred rapid test, have acknowledged supply-chain issues in recent days. At the same time, national laboratory firms are also reporting delays in processing hundreds of thousands of tests.

“We’re seeing unprecedented demand as case rates rise — and we’ve been scaling up manufacturing since delta became the dominant strain and new CDC guidance called for a reprioritization of testing,” Abbott spokesperson John Koval told CNN. “We’re working with our customers to ensure tests get to where they’re most needed and we’re ramping back up, as we did last year. There will be some supply constraints over the coming weeks as increased capacity comes online.”

Mass batches of Abbott’s rapid-result BinaxNOW tests were previously sent to nursing homes, and in March, the Department of Health and Human Services committed an additional $225 million to the production and delivery of another 50 million.

While providers in some states continue to receive BinaxNOW cards, it is often unclear whether they are part of the HHS stream or coming from state stockpiles. In either case, providers in some states have reported decreases in the number of cards they are receiving.

Labcorp and Quest Diagnostics joined Abbott in reporting increased demand, and those using the more accurate PCR tests are also facing challenges. 

On Monday, Kendal at Oberlin CEO Barbara Thomas described how testing issues complicated efforts to stamp out her Northeast Ohio life plan community’s first group of COVID cases last month.

The first positive came after a feverish resident took a rapid test. Contact tracing revealed that person had been around a staff member who was symptomatic earlier in the week and still quarantining at home while awaiting her own test result.

She “had not yet returned to work but neither had her test been confirmed. We didn’t know the status of her illness. You know how slow sometimes tests can be,” Thomas told fellow LeadingAge members during a coronavirus call. “Had it come back timely, we would have had a heads-up that we had a positive case. That would have put us immediately into testing our whole licensed area of residents. We didn’t have that test … It was a little backwards of what we consider ideal. But it is the case with testing: The labs are right now again overrun.”

Fear of shortages

Quest Diagnostics said this week it has seen a rise in demand for COVID-19 molecular diagnostic testing, but a spokeswoman said “the majority” of results are still delivered in one day. The company is adding molecular test instruments to bolster readiness in high-demand areas in the Southeast and Southwest.

While the shortages feel reminiscent of the pandemic’s early days for some, others haven’t seen significant challenges in securing supplies or quick test results.

Joseph Marek helps coordinate testing supplies including antigen & PCR tests for long-term care provider CommuniCare, based in Akron, Ohio.

“At this point, we have not had consistent issues with supplies and/or turnaround time,” Marek, vice president of pharmacy supplies, told McKnight’s. “Some sporadic issues, but nothing like last year at this point. Most states are providing the rapid antigen tests still,  which is very helpful.”

Besides Ohio, CommuniCare has facilities in Maryland, Virginia, Indiana, Pennsylvania, Missouri and West Virginia, which he says are “mostly” providing BinaxNOW.

Ruth Katz, senior vice president of policy for LeadingAge, told McKnight’s Long-Term Care News on Thursday that providers are concerned about possible shortages as rising cases coincide with the reopening of schools and workplaces.

“Some of our members have reported issues in getting tests or supplies,” she said. “State or local departments of health may be able to provide resources, however, we are monitoring this situation closely — both to ensure members have what they need and also to assess any additional financial strains brought about by testing issues.”

Fewer tests could also constrain facilities using routine testing as an alternative or in addition to staff vaccination mandates.

Thomas, whose community has instituted a vaccine mandate, had considered offering a routine testing alternative to any employee granted a legitimate religious exemption. 

“I will say our supply of testing has got us concerned, and so we’re modifying some of those practices,” she said. “I’m being not-quite-so-liberal with testing. But when it comes to somebody unvaccinated, we will continue to test and PPE will continue to be in place.”