Shortage of workers, flight delays contributing to slow delivery of rapid tests

Rebeca Andrade had been waiting for days for a delivery of rapid COVID-19 tests to help keep her school open. The superintendent of a school in Salinas, Calif., Andrade said she wanted to test children once a week to slow the spread of the omicron variant and protect the community.

But even as rapid tests to keep schools open were pushed to the highest levels of government, Andrade fell short.

Indeed, 350 miles away, some 17 million tests — including some earmarked by the California Department of Public Health for schools like Andrade’s, as well as nursing homes, homeless shelters and day care centers – sat waiting on giant pallets for days.

Like so many other vital goods, valuable rapid home tests have been trapped in the supply chain, caused by a combination of workers calling in sick with omicron and bottlenecked warehouses already operating at overcapacity to manage the massive demand for testing.

The affected tests are some of the test kits produced by iHealth, which are made in China and have been purchased by at least 15 states.

“The delays we have experienced during this time, I know is sometimes out of our control, but it is something I would say really critical and a priority for us to continue to provide in-person learning for everyone. ‘one of our students,’ Andrade told ABC News.

As of Thursday, the distribution company that handles iHealth shipments from China, XChange Logistics, had worked through the millions of pending tests, to deal with delays on three of iHealth’s charter planes carrying about 25 million tests, said the company told ABC News.

At the same time, the distribution company said it still sends 20 truckloads of tests a day from its Los Angeles warehouse, which is the largest distributor of iHealth tests.

For iHealth, which received clearance for its rapid home tests from the Food and Drug Administration in December and can manufacture up to 200 million tests per month, producing the tests has proven to be the easy part.

Getting them to customers is the challenge.

“I hope that one day the American people can take the test on the same day,” said iHealth chief operating officer Jack Feng, referring to the timing of shipping from China and delivery to United States.

XChange Logistics said its warehouses struggled 200-300% capacity last week.

And the stress of moving so much cargo has been compounded by the fact that workers have tested positive for COVID-19 – which usually means 8-10 more workers need to be quarantined due to their exposure, a said Frank Filimaua, general manager of the company.

Over the past month, up to 30% of XChange Logistics’ workforce has been absent with COVID-19, Filimaua said.

“It certainly has an impact on the lack of manpower and the shortage of ground handlers,” he said.

Under normal circumstances, with no shortage of manpower and such a high-demand product, it would take 24-48 hours to get the tests from planes to trucks and on their way to customers.

But it instead took five days on average, Filimaua said.

He estimated that it would take another two weeks for the company to get back up to speed.

The supply chain backlog is the “biggest key factor as to why it’s difficult to get these kits to schools, doctor’s offices, hospitals and consumers”, he said.

“Everyone just highlighted and highlighted port congestion and container congestion,” Filimaua said. “No one really focuses on what’s happening at international airports. It’s the same effect, but I would say even a higher degree of challenges and impact on the supply chain and on consumers.”

After ABC News contacted the White House this week about the millions of pending tests, iHealth said the Biden administration has stepped up efforts to help the company, which has also contracted with the government to provide 250 million tests to Biden’s efforts to distribute 1 billion free tests to the public, Feng said.

Agencies like Health and Human Services and the Department of Defense have started helping iHealth get its tests through customs faster using priority tags, and will help test-packed charter flights from China from the first week of February, Feng said.

“They help us a lot,” Feng said.

Feng also said some states have also mobilized resources by sending ground crews to warehouses to help move tests around.

A Biden administration official told ABC News that the White House “continues to actively engage with manufacturers and distributors to help them expedite their timelines and get testing to the American people.”

The official said the government was coordinating charter planes for the 250 million iHealth rapid tests it contracted for Biden’s plan, and was also working to ‘break bottlenecks’ at Los Angeles International Airport. , where most shipments from China arrive, working with the airport and with Customs and Border Protection to ensure that every shipment “trucks out of the airport as soon as it lands.”

The official also noted that the Biden administration quadrupled the monthly supply of rapid home tests in the United States from fall to December.

Experts note that the supply chain issues facing iHealth are not unique to this testing company.

Some of the problems stem from “general supply challenges,” said Mara Aspinall, manager of the National Testing Action Program at the Rockefeller Foundation, which links testing companies to state governments.

“But more and more, we’re hearing that – like every other essential business – manufacturers, shipping lines and others have so many people with COVID that they can’t fully take advantage of the technology capacity, and so supplies are slowed down,” she said.

While iHealth is one of the most prolific producers of rapid tests in the United States, other companies are also key to meeting the huge demand. ABC News contacted several other major rapid test suppliers, including Roche, Siemens, Abbott and Ellume, and those who responded said they were doing everything possible to meet demand, including opening new production lines to increase the production of tens of millions of tests per month.

“There are currently tens of millions of tests in various settings and supply chains,” Abbott spokesman John Koval said. “We’re building BinaxNOW in the US because it protects against unpredictable supply chains and it’s what allows us to produce at scale and reliably, which is what we do.” As a result, Koval said, the company aims to be able to produce 100 million tests per month.

With more and more rapid test products on the market, there is also more competition for distributors. This was a particular challenge for iHealth, a new company that lacked the big pharma relationships that had existed for years.

“I think it’s hard to secure a consistent freight provider for so many of these companies because there’s no program where when you get an EUA [emergency use authorization from the FDA], you receive immediate distribution assistance,” said Andrew Sweet, managing director of COVID-19 Response and Recovery at the Rockefeller Foundation.

“That’s part of why we’re where we are,” Sweet said. “It’s really up to the individual manufacturer to have those relationships in order to get their product to market as quickly as possible.” As a result, Sweet said, companies with existing relationships may “jolt.”

“They are more successful than others,” he said.

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