”I got tested for #COVID19 10 days ago and I don’t have a result! What’s taking so long????” This is a question I have heard many, many, times over the last 9 months. It is not everyone’s reality, but it does happen sometimes (Long thread alert) 1/14

Let’s talk about #COVID19 testing from the pathologist’s perspective (physicians like me who review and sign off on the validation studies in our labs so you can get tested amongst many other jobs; I need to do a what a pathologist does thread, but I digress) 2/14

In order for you to get PCR testing, it requires a swab and viral transport media (or VTM; it helps preserve the virus so the mRNA can be extracted later for testing, if it is present in the patient). Both of these items have been in short supply throughout the pandemic 3/14

Yes, we can also test for the virus in saliva (also a PCR test) which has helped ease the burden of swab and VTM shortages and has helped us decrease the time it takes for us to release your test result (we call this turnaround time or TAT) 4/14

Once your swab (or saliva) makes it to our labs, we run your test. In the case of smaller laboratories, we may have to send your test to a larger lab (often known as a reference lab or a commercial lab) to run the test. That may add to TAT 5/14

Many smaller labs have the capacity to run some #COVID19 testing on site and they do so. No matter where your test is analyzed, there is an important matter to discuss. #Reagents 6/14

Reagents are the chemicals we use in the instruments that analyze your sample. We don’t control how much we get from the suppliers; that happens at a much higher pay grade than ours. This is called allocation and depends on many factors, like disease prevalence in an area. 7/14

Allocation determines how many tests we can run on our instruments. So, if an instrument can perform 1000 tests per day, but we only have enough reagent to run 500 tests per day due to our allocation, we can not do more than that, no matter how much we want (or need to). 8/14

#Pathologists have tried to address this problem by doing something we don’t love doing. In the usual scenario we run 2 platforms, a primary and a back-up in case a primary instrument isn’t working for whatever reason 9/14

However, with #COVID19, labs are easily running 5 or more different platforms in order to get results out as quickly and efficiently as possible. This is another method to combat reagent allocation issues as well as decreasing TAT. 10/14

We’ve gotten better at getting #COVID19 results out to our patients in the US since the beginning of the pandemic. There is a lot available to us now compared to last Spring. There are a lot of people working behind the scenes to make sure you get the most accurate result. 11/14

Take a moment to thank your friendly neighborhood #Pathologists, #MedicalLaboratoryScientists, and #MedicalLaboratoryTechnologists who are working behind the scenes day in and day out to make sure you get your result quickly and accurately 12/14

Also, help us help you. Please #WearAMask , #WashYourHands , practice #SocialDistancing, and #StayHome when you can. It will help keep everyone healthy. Wishing you all health and safety this holiday season! 13/14

Tagging some friends for good measure: @PathologyPatty @bluehatcomics85 @ChaseTMAnderson @uche_blackstock @docmosho @jennybencardino @theglasspusher @01sth02 @instapathbio @BrainsSlicer @MLegiste @NicoleJacksonMD 14/14