Puzzling shipment of testing swabs adds to list of supply woes

The way the swabs arrived in Washington this week confused state health workers.

By Lewis Kamb / The Seattle Times

SEATTLE — Earlier this week, workers at a state health department warehouse in Tumwater expected to receive a large shipment of 68,000 nasal swabs to help expand coronavirus testing in Washington. Instead, they received a surprise substitution: dozens of boxes marked “Cotton Comfort Swabs” packed with what appeared to be thousands of Q-tips.

Typically unsuitable for medical tests, the Q-tip style swabs prompted Reed Schuler, a senior adviser to Gov. Jay Inslee, to place a head-scratching call to the White House coronavirus task force.

“I asked, ‘What exactly is this shipment we’re getting?’ And they said, ‘Oh sorry, ignore the packaging. You were supposed to get a memo explaining that shipment,’” Schuler said Friday.

The task force later sent a memo from U.S. Cotton, LLC, explaining the Q-tips actually were swabs produced specifically for nasal specimen collection.

“The packaging used (comforts for baby cotton swabs) for a portion of the initial FEMA production does not accurately reflect the contents,” a memo signed by company president and CEO John B. Nims said. “Be assured that the printed packaging does contain the FDA approved sterilized polyester spun swab for specimen collection of COVID-19.”

But the way the swabs arrived in Washington this week —22,000 in bulk, packed into the scores of mislabeled boxes —puzzled state health workers, Schuler said. The nasopharyngeal (NP) and nasal swabs widely used for specimen collection typically come individually wrapped in sterile packaging to avoid contamination.

“Having boxes full of swabs in bulk raises questions about sterility and whether we can use them at all,” Schuler said.

The state must now conduct quality assurance tests before determining whether and how it can use the swabs to enhance the state’s coronavirus testing, he said. That could involve taking laborious steps to individually package each swab before distribution, what Schuler described as “just another obstacle in a wild saga to expand testing.”

The surprise shipment marks the latest wrinkle in the Trump administration’s promise for more testing supplies that has fallen far short of the state’s expectations, Inslee’s office has said. In late April, the administration pledged to supply the state weekly shipments totaling 580,000 medical-testing grade nasal swabs in each May and June.

But so far, Washington has received only about 60,000 swabs halfway through May —roughly 10% of the amount Adm. Brett Giroir, the U.S. Health and Human Services (HHS) Department’s assistant secretary, has pledged to deliver by month’s end. Along with the same promise made for June, the federal agency also agreed to send enough transport media — chemicals used to preserve specimens during shipment to labs —to cover about three-quarters of the promised swabs.

An HHS spokesperson said in an email early Saturday that Washington is scheduled to receive “a shipment of swabs and media every seven days,” with shipments scheduled for Saturday and Monday.

“Once Monday’s scheduled shipment is complete that will account for the first two waves of shipments of COVID-19 testing supplies and media for the month of May,” the email said.

In late April, President Donald Trump introduced U.S. Cotton, a Cleveland, Ohio-based firm, among several companies the White House had enlisted in what the president called an “unprecedented drive to expand the states’ capabilities” for coronavirus testing. The new Q-tip style swabs briefly were referenced by officials as a more convenient addition to testing kits planned for distribution.

State officials also have been scrambling to locate and buy missing items needed to supplement the federal supplies and build testing kits, which are assembled at the warehouse by crews of National Guard soldiers and AmeriCorps volunteers.

Since the outbreak of the new coronavirus, which causes the illness COVID-19, exploded in late February, Washington has struggled to provide widespread diagnostic testing. Inslee, with an eye toward a phased-in easing of social distancing restrictions and reopening of businesses, public spaces, schools and other aspects of Washington’s society, has set a goal for a massive expansion of testing and contact tracing in the months ahead.

Last month, Inslee called for ramping up testing levels to 20,000 to 30,000 tests per day and expanding a trained crew of 700 investigators to 1,500 tasked with tracking down those who had contact with someone who tests positive. The idea is to identify and separate exposed individuals from society at large to tamp out new transmissions.

Since then, statewide coronavirus testing has steadily climbed, in recent weeks to more than 6,000 tests per day. The governor also announced this week nearly 1,400 contact tracing personnel are now prepared.

Inslee’s testing goal has no deadline, but his office and public health officials want expanded testing in place for the coming flu season, which typically starts in the fall. By then, broad testing statewide will be crucial to determine whether patients are sick with COVID-19 or with other flu-like illnesses, they said.

But Washington can’t attain its testing goals without the federal government’s help, Schuler said.

The Trump administration, in turn, has said it stands ready to support states, but also encourages governors who want more testing to find necessary supplies on the open market to supplement or supplant any federally-distributed supplies.

This week, Schuler said the governor’s office has held several phone conversations with federal officials from three agencies to raise concerns about the lagging and missed shipments of promised testing supplies. In response, he said he’s heard explanations about shipping mix ups and renewed promises that shipments are on the way.

“It’s kind of like everyday they tell us, ‘It’s coming tomorrow,’” Schuler said. “But it’s starting to feel like, ‘Yeah, we’ve heard that before.’”

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