Erie County leaders have been frantic in their attempts to lay their hands on the material needed to conduct more Covid-19 tests.
They've repeatedly called the Governor's Office and the Centers for Disease Control and Prevention. They've appealed to members of Congress. They've waited on hold for as long as four hours to plead directly with suppliers.
"We are beg, borrowing and stealing them," said Benjamin Swanekamp, the county's deputy budget director and former Health Department policy director.
Testing material has been provided in spurts, but not enough to sustain the county Health Department effort to monitor of community spread of the coronavirus disease even though Erie County is the largest county outside the New York City region and has been conducting tests for counties in Western New York.
The lack of testing materials caught Erie County off guard. Two days ago, the county was rapidly going through its initial supply of 450 test kits at the same time it was announcing the loosening of restrictions on who could be tested and quietly setting up a drive-thru specimen collection site for an influx of patients at Twin District Firehall in Lancaster.
The original intent was to monitor the spread of the virus and continue to provide information about where infected individuals might have come into contact with people.
"We didn't anticipate how this would escalate," said Erie County Health Commissioner Dr. Gale Burstein. "And we also didn't anticipate that there would be these huge shortages in the laboratory materials that, in the past, have been very easy to obtain just in the regular ordering mechanisms."
County Executive Mark Poloncarz said part of the issue was that the county underestimated how many tests the state would ask Erie County to perform on behalf of other counties.
He rattled off six other counties, among others, who have been depending on Erie County's testing capacity.
"That's why we've been calling and demanding and pleading to get more tests," he said. "It's very, very distressing."
Third-party manufacturers that the county has reached to have said all their supplies must be shipped directly to the CDC.
"It's not like Erie County is dropping the ball," he said. "No one is even handing the ball to us. They're not even giving us the ball, so at this point, there's limitations on what we can do."
He blamed the federal government for rejecting the use of other tests being used around the world and having the CDC develop its own protocols and testing agents, creating a bottleneck.
"We're like every other public health lab in the United States, working behind the eight ball because we were relying on the federal government and the CDC to provide us this," he said. "They didn't."
County officials said the state helped obtain 400 swab test kits for Erie County on Wednesday. In addition, supplies of chemical reagents, which are needed to perform the tests, were provided through the efforts of Rep. Brian Higgins.
Swanekamp estimated that with the existing supply, the county will max out at testing between 500 and 550 Erie County residents, not including tests done for other counties.
As of midday Thursday, the county had collected a total of 523 specimens. Of that number, 29 were positive, 179 were negative and another 315 were pending. Poloncarz said he expected all the specimens that were collected would be tested within the next few days. Late Thursday, the county announced 32 tests for Covid-19 that were conducted by the Health Department came back negative.
Relaxed guidelines as to how many specimens must be taken from someone being tested for Covid-19 should enable existing material to go further than it has in the past, he said.
"Unfortunately, it's not enough," Poloncarz said. "I think we can test for the next six months and continue to come up with positive cases."
Health officials are conserving what little testing material the county has left for high-priority cases, so the Health Department will not be able to loosen testing standards for county residents or provide further testing for other counties.
"Now that we know that there may be limits, we are working together to rethink who we are going to allow to get tested by our public health lab," Burstein said. "We'll take it on a case-by-case basis."
People counted as high priority would include health care workers who interact with patients and those already hospitalized and showing symptoms that suggest a Covid-19 infection.
Burstein said doctors can still request tests for Covid-19 on behalf of their patients through private labs Quest or LabCorp. Burstein cautioned, however, that those tests have a turnaround time of five days, considered a long time compared to the one-day turnaround time for the Erie County Public Health Lab.
She and Poloncarz urged people to behave as if Covid-19 has spread in the community and to continue practicing proper hygiene and social distancing.
"I think we already have our answer in terms of community spread," she said, "so I don't think we really need to do a mass screening right now because we already have the answer that it's here."