Delayed lab test results added to DHEC COVID-19 numbers

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Due to a delay in reporting by an out of state lab, approximately 15,000 test results from Augusta University Healthcare in Georgia, were reported to the South Carolina Department of Health and Environmental Control (DHEC) on Monday (Sept 21).

The test results cover a period of time from March 18 to September 17. They are reflected in DHEC’s Tuesday’s cumulative numbers and are assigned to the day the result was reported by the lab to the health care provider.

Approximately 13,000 of the results are negative and 2,000 are positive, however DHEC advises that the positive test results do not mean they are current active cases of COVID-19.

While the out-of-state laboratory didn’t report these results to DHEC, the lab is expected to have reported the results in a timely manner to the health care providers who submitted the specimens, who then relay the test results to their patients. Additionally, to comply with reporting requirements, providers are expected to report positive results to DHEC. This delay in the lab reporting results directly to DHEC means DHEC was unaware of the results for all South Carolina residents whose specimens were tested at Augusta University Healthcare and unable to perform contact investigations for every one of these positive cases.

“Different states have different reporting requirements and mechanisms in place for how laboratories report test results, which has resulted in delayed test results being reported not just in South Carolina but across the country,” said Dr. Michael Kacka, DHEC physician and Chief Medical Officer. “Many states’ public health agencies are working through these issues. The overwhelming majority of private laboratories are quickly reporting negative and positive test results to DHEC, however, we’re aware of out-of-state labs who may not know about South Carolina’s COVID-19 reporting requirements. We are continuing our outreach to private labs that perform testing of South Carolina residents’ specimens to ensure the information is relayed to us not just by health care providers but also directly from the labs performing the tests.”

The total number of individual test results reported to DHEC Monday statewide was 5,160 (not including antibody tests) and the percent positive was 14.3%.

On Monday (Sept. 21) DHEC reported the total number of confirmed cases since the first case was reported Mar. 6 at 134,884 and probable cases at 3,240, before the delayed lab tests were added.

With the 15,000 delayed lab tests added to Tuesday’s reported numbers, the total number of confirmed cases increased by 2000 positives to 137,406, and probable cases to 3,383.

DHEC routinely updates historical data to have it present the most current information available at any given time. As results that are newly reported to us are entered, some counties may see increases in previous days’ numbers. These test results will be reflected online, in the Testing section of the county-level dashboard.

As a reminder, the standard process for how COVID-19 test result notification works is as follows:

Health care provider collects a patient’s specimen
Health care provider submits the specimen to a lab
The lab performs the test
The lab reports the test result to the health care provider who submitted the specimen and to DHEC
The health care provider relays the test result to the patient and notifies DHEC
DHEC begins its case investigation of a positive case
The medical professionals who submit their patients’ specimens receive their patients’ test results directly from the laboratory that performed the test. These medical professionals are the first line of communication in relaying test results to their patients. ​They also report positive results to DHEC even before lab test results are received in our information system.

“The agency has been clear and transparent throughout the response that we regularly update historical data as we learn more information – this is true for any disease surveillance. You always update the past with what you have learned in the present,” Kacka said. “We will continue to make historical updates that are reflected online and will work to provide a more obvious illustration of these bulk historical updates while simultaneously working with private labs to eliminate delayed reporting.”

COVID-19 is an urgently reportable condition, per the South Carolina List of Reportable Conditions. Negative and positive test results are required to be reported to the agency within 24 hours. If DHEC has repeated delays in receiving tests from the same lab/facility, the agency has the authority to explore enforcement actions.