On Monday Jan. 3, four hours before South Windsor was to begin distributing its limited supply of at-home COVID test kits, police notified Town Manager Michael Maniscalco that cars were already lining up outside Rye Park.
Maniscalco wondered how the state ended up in such a precarious position.
Hours-long waits for COVID tests had become common as people flooded the state’s scattered testing sites – many waiting in vain, anger building. At a testing site in Bristol, someone threatened to pull a gun.
“We are almost two years into this pandemic, and you would have thought we’d have figured it out by now,” Maniscalco said. “They should have known, with winter coming, that cases would rise again and be better prepared. Omicron has just made it much worse.”
While Maniscalco has publicly criticized the state’s recent response to the omicron surge, other town officials in Connecticut have chosen to voice their anger and displeasure on private calls between Gov. Ned Lamont’s team and local officials, sources said.
Many are asking how state officials — who trumpeted how quickly they were able to set up COVID testing back in 2020 — seemed so unprepared and surprised at the surge of testing demand that was needed between Thanksgiving and the early weeks of 2022.
On Wednesday, Lamont said he hoped the omicron variant would be the last big surge of the virus in Connecticut, but he agreed that the state should maintain significant testing capacity in case another wave comes.
“It behooves us to keep these tests available,” Lamont said. “We want to be able to respond quickly if there is another flare-up.”
Lamont also acknowledged that having testing available at hospitals or through primary care providers is not the same as free, community-based testing opportunities, especially when the spread of the virus is so rapid and widespread.
“So can we do better? Absolutely,” Lamont said. “But that’s been the effort from the very beginning, to make sure that nobody is left behind. If somebody is left behind when it comes to vaccination or tests, that is bad for you, and that’s bad for the community.”
Health providers acknowledged that the speed at which omicron spread through Connecticut and the rest of the country was overwhelming, but they said the state should not have been caught flat-footed by the sudden demand for testing.
Ken Lalime, the CEO of the Community Health Center Association of Connecticut, recognized that planning for a once-in-a-century pandemic is difficult to do. Running complicated logistics networks in any industry is hard, he said. But there is even more pressure to get it right when it comes to health care, he said.
“It’s tough to manage for a spike, to such a large testing need,” said Lalime, whose group represents the 16 federally qualified health centers (FQHCs) in the state.
“But that’s the job of the Department of Health — to make sure that their patients in the state, that their citizens, are cared for,” Lalime said.
Not enough providers
The long lines for testing in December can be traced back to last summer, when many of the state’s contracts with testing providers expired.
At one point, the state had testing contracts with 11 different groups, ranging from the state’s two largest hospital chains, Yale New Haven and Hartford HealthCare, to several laboratories across the state. But those contracts — signed in the spring of 2020 when testing was ramped up — expired at the end of June 2021, according to state records.
By that time, the state had decided to cut back on testing and focus resources on mass vaccination clinics. Hospitals transformed mass testing sites into mass vaccination clinics or just closed them completely. Jabs replaced swabs as the key metric state officials followed and publicized.
In July 2021, the state signed only four new testing contracts, with Sema4 being the largest contractor, in charge of 15 of the 23 state-sponsored testing sites that would remain open.
The other contractors were Wren Laboratories, a small Meriden-based company that had developed a saliva test; Genesys Diagnostics, another smaller lab based in Montville; and Quest Diagnostics, whose experience was more tailored to processing tests than collecting them.
None of the new contractors, except Sema4, had much experience operating testing sites. Absent were many of the hospitals and the community health centers that had done the bulk of the COVID testing during earlier phases of the pandemic.
“When the state went out for its procurement of a network of providers, I don’t know that they got enough providers,” said Lalime, who has advocated for the state to increase its testing capacity.
“It may have been enough for the middle of the summer. Obviously, it was not enough to handle the surge that is out there right now,” Lalime said.
The surge
The numbers for just the state testing sites show that when they came on-line in August, they were doing only about 1,200-1,700 tests weekly from all 23 sites combined.
Those numbers started to increase as the state and many private employers set parameters for people to return to work. Many who were not vaccinated needed to provide a weekly negative PCR test result to their employer.
The mandate created a whole new category of people who needed to be tested, regardless of whether they felt they had COVID or had been exposed to someone who had the virus.
From the middle of September through the week before Thanksgiving, the state-run sites averaged about 7,800 tests a week, according to DPH data.
But from there, the numbers started to climb, jumping up to more than 13,000 during the Thanksgiving holiday week and climbing to nearly 30,000 just before Christmas, as omicron arrived.
During the late fall, some health directors noticed residents in their towns and districts were seeking more testing.
There are many other places where people can get tested in addition the state-run sites, including urgent cares, pharmacies or FQHCs. Most tests are done by appointment only, or health insurance was required, unlike at the state-run drive-through sites.
In the Ledge Light Health District, which covers the southeast corner of the state, Health Director Stephen Mansfield made separate deals with Sema4 to run two testing sites in Groton and New London.
Mansfield said the most recent surge in COVID-19 cases was one of the most difficult times in the pandemic for people to find testing.
During earlier spikes, Mansfield said, the community-based testing sites in his area were limited by the number of hours the testing staff could work and the number of samples they could take in a given day.
But this time around, he said, the testing sites were limited by the number of samples the laboratories could process.
Some days, the testing sites in the New London area were told they could test 300 people. Other days, it was capped at 250, Mansfield said. It was dependent on what Sema4 could handle in its lab.
At the height of the omicron wave, that meant Mansfield and his team were often turning people away.
"Generally, we reached capacity before we even opened up the line," he said. "And the last thing we wanted was residents sitting in line for a couple of hours and being told a test is not available to them."
The state hasn’t picked up Ledge Light’s testing sites, and with Sema4 shutting down testing soon, he isn’t sure the two sites will remain open much longer.
Expanding testing options in some places
Vernon officials also restarted their own testing program in the fall, two days a week, on Sundays and Tuesday afternoons. They made a separate deal with Sema4 because Town Administrator Michael Purcaro said, "They realized there was a high demand for testing, and people were having a hard time finding it."
The site has been so successful that the state has taken over running the site and is increasing the number of days it will be open.
On Tuesday, Lt. Gov. Susan Bysiewicz, Department of Public Health Deputy Commissioner Heather Aaron and Jackson Laboratories President Charles Lee held a press conference to announce the Vernon site would be expanded to five days a week and would be operated by Griffin Hospital and Jackson Laboratories.
Bysiewicz said with COVID positivity rates coming down but still high, "We need to keep ourselves and our community safe."
"We can do that by getting tested, and the town of Vernon and the state of Connecticut have made it easy for people in this area to just come on in and get tested," Bysiewicz said.
The Vernon site is one of at least six new testing sites that the state is setting up by the end of the month, even as the post-holiday demand starts to taper off.
Besides Vernon, there will be new state-run test sites in Darien, New Haven, Old Saybrook, Putnam and Waterbury. The state also will be expanding the sites' operations to 40 hours a week.
The state hasn't said which company will be replacing Sema4, which has told state officials it will no longer do testing as of Jan. 31. Sema4 is operating 15 of the state's 23 sites. Aaron said that DPH has a contract with Jackson Labs to take over at least some of Sema4's testing duties. The state is searching for partners for Jackson Laboratories that would collect the samples at the sites, as Griffin will be doing in Vernon.
North Central Health District Director Patricia Sulik said the expansion of the testing at the Vernon site is needed for the entire area.
"We have the public's attention. People want to be tested, and then we found there weren't enough testing resources," Sulik said, adding that "everyone working together has brought together this new site today."
DPH officials also have reached out to several hospitals and to FQHCs that did testing in 2020 to see if they could add more testing now. Hartford HealthCare is opening up to five new sites where they have hospitals, including Torrington, Meriden and Norwich, that will offer an additional 150 tests or so a day by appointment only.
'Not something you do overnight'
Last week, the demands for testing at one of the four testing sites in the Ledge Light Health District finally started to show some signs of slowing.
The testing site was allotted 400 tests on Friday, Jan. 14, but only 100 or so people were lined up in cars at the start of the event. Even so, Mansfield expected that the demand for testing was likely still outpacing the supply, especially at free community-based sites.
"There is still a dearth of testing in Connecticut," Mansfield said.
If Connecticut is going to continue to have standby testing available to handle future surges, Mansfield said, the state will likely need to set up more permanent sites to deal with those demands.
Lalime said it will be important to either maintain the testing sites or have an expansion plan ready to go more quickly than this time to avoid the testing hysteria when the next variant surfaces. Community health centers, emergency rooms and primary care practices can't serve as a backup for testing when cases surge, Lalime said.
"I don't think they're backing away from the fact that it's their responsibility," Lalime said. "I think right now they are trying a lot of different mechanisms to try and build up capacity. It's just not something you do overnight."
Aaron said it takes the state "seven to eight days working with the different testing sites to get everything set up and running."
"Our plan is to continue to expand and to hold the sites even if this thing starts slowing down," Aaron said. "If it slows down, then we will slow down a bit too, cut hours if necessary, but we will continue to build and keep open sites as long as possible wherever they are needed."
