MONROE — After finally getting testing materials to use in its lab, Monroe Clinic began in-house testing for COVID-19 this week.

The in-house testing is currently only for COVID-19 symptomatic patients who are critically ill or requiring hospitalization, said hospital spokesperson Laura Lippold. Clinic staff will continue sending tests, including outpatient tests, to other labs as it has been doing.

“We have to sort of tier our testing based on the supplies that we have,” said Dr. Darren Pipp, Monroe Clinic’s chief medical officer. The in-house testing “is for cases that we need decisions on, that we need those results back soon.”

Across the country, COVID-19 lab testing materials are limited and in high demand. The scarcity has opened up a market for a variety of fast tests that can be administered in a drug store or even at home and provide an answer “in as little as five minutes,” like Abbott’s ID NOW test.

But while the Food and Drug Administration has granted “emergency use authorization” for some rapid tests, they are not vetted. A recent study of the Abbott test, for example, found it had a false-negative rate of nearly 15%, which the company disputed.

“There are a lot of false claims,” said Dr. Ross Molot, a pathologist and Monroe Clinic’s medical lab director.

Not all tests are created equal. A blood test for antibodies only shows if a person had a previous infection. Molot noted that these types of tests are not appropriate for acutely ill patients.

The test the Monroe Clinic uses is the same test used at labs across the state and is “the gold standard,” Molot said. It takes 45 minutes to run the test. It uses a swabbed specimen and detects for nucleic acid from the new coronavirus, SARS-CoV-2.

Tests sent to outside labs also take about 45 minutes to run, but have a turnaround time of one to two days due to transportation.

“It’s really delayed by location, not by the (testing) instrument,” Molot said.

Kay Verink, director of laboratory services at Monroe Clinic, said the hospital has always had the instrument available to run the COVID-19 test and a microbiology team to oversee it.

What was missing were the test kits, which they requested — and waited on.

Pipp likened the situation to “a pair of shoes you order off Amazon and they’re back-ordered.”

The test kits have finally arrived, but not many.

“We don’t yet have that unlimited number of kits,” Molot said. The Monroe Clinic lab could theoretically run 60 to 100 tests per day, if it had enough tests kits.

In the meantime, “yes, we do have faster (turnaround) available, but ... it’s not a free-for-all on testing right now,” Lippold said.

That means doctors have to “very thoughtfully triage” who gets the in-house test and whose test gets sent to an outside lab, Pipp said.

The Centers for Disease Control issued guidelines in March for how to prioritize testing in the face of limited testing supplies.

“We can make decisions outside of those guidelines. But again, we’re still limited by supplies,” Pipp said, noting that hospitals across the country are “moving in unison” when it comes to supply chain issues and testing.

“It is of course frustrating for those of us in health care,” he said. “Everything is changing so rapidly, new information is coming ... It is hard to give a consistent response to things. We all feel some frustration.”

Testing has ramped up statewide since Gov. Tony Evers started bringing on new labs in early April to expand capacity. Verink said the increased number of labs and longer hours of operation did improve speeds.

“Because of the increased capacity, we saw better turnaround,” Verink said.

In the end, testing can only do so much.

“If you’re ill, you should isolate yourself anyway. Testing doesn’t change that,” Pipp said. “We are certainly not trying to minimize testing. We are just having to allocate it to where it’s needed most.”

Ultimately, though, “any increase in testing, whether it’s here or done elsewhere provides ... better epidemiological data.”

The latest numbers

After going two and a half weeks without reporting new confirmed positive COVID-19 cases, Green County reported one more April 23, bringing the total number of residents who’ve tested positive to 10.

There is no known connection between the tenth person to test positive and the previous nine, all of whom have fully recovered, according to Mike Sanders, public information officer for the Green County Emergency Operations Center (EOC), which is now meeting two days per week instead of three.

“We’re moving in the right direction but we’re going to have to keep vigilant,” Sanders said. “The good news is the county’s doing well and following the governor’s orders, and that’s helping us keep the numbers low, which will also help us support the bounce-back plan. One leads to the other.”

Sanders also reported that “a side benefit of everyone doing a better job of hand-washing and essential workers staying home when they are not feeling well is that we seem to be seeing less infectious illness of other types throughout the community.”

Lafayette County reported its fourth COVID-19 case April 21. The health department said the previous three have recovered.

As of April 23, the state reported 258 negative tests so far in Green County and 75 negative tests in Lafayette County.