Florida, home to millions of elderly residents, doesn't have enough coronavirus tests. Could it be the next epicenter?

MIAMI — In Naples, a city in southwest Florida where the median age is 66, a hospital abruptly stopped a drive-through testing site this week because they ran out of testing kits.

Doctors in Winter Haven, a city in Central Florida where a quarter of the population is 65 or older, are waiting up to 10 days to get results on coronavirus tests.

And in South Miami, in a neighborhood surrounded by retirement homes, the president of a community hospital took out a $380,000 loan on his own house to secure the delivery of 1,000 test kits a week for the next few months.

The Sunshine State has come under fire after its beaches remained jammed with spring breakers last week and Gov. Ron DeSantis has ignored calls to issue a statewide shelter-in-place order. That may contribute to Florida becoming the next hot spot for COVID-19, a chilling possibility considering that the elderly are the most likely to die from the disease and Florida is home to nearly four million people 65 and over, the second-highest number in the U.S. behind California.

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Yet hospitals and doctors around the state say they still don't have nearly enough testing kits and can't get the ones they have analyzed fast enough, echoing complaints from state health officials across the country. Health officials have completed 27,000 tests so far in Florida, while New York is doing more than 18,000 tests a day.

That lack of testing availability means the number of people infected in Florida is likely far higher than the 2,355 coronavirus cases counted by the Florida Department of Health as of Thursday. And it has left hospital administrators scrambling for more testing kits, buying their own laboratory equipment to process tests in house and pleading with people to stay home to slow the virus' spread.

"We need many more specimen collection and testing sites that return results in 24 hours or even same day," said Kim Savage, a spokeswoman for the Sarasota Memorial Health Care System, which operates a hospital and a dozen urgent care and outpatient care centers in southwest Florida. "Collecting a sample on a Tuesday and then not getting test results back for a week is not effective."

DeSantis, the state's Republican governor, has issued orders closing down bars and nightclubs, suspending public schools and ordering restaurants to scale down to take-out and delivery only. He ordered anyone flying to Florida from New York, New Jersey or Connecticut to self-isolate for 14 days upon arrival, and his Department of Health has distributed 2,500 testing kits capable of processing 625,000 samples.

But DeSantis has resisted calls from Democrats, physician groups, local leaders and presidential candidate Joe Biden to issue a shelter-in-place order similar to those in New York and California.

"While other large states continue to take strong, urgent, and sweeping action to stop the spread of COVID-19, Florida has not," Biden said in a statement.

That combination has left hospital officials across the state fretting that the tests available so far will not meet the demand. Hospital administrators are now trying to round up testing kits through the private market that has pitted states against states, hospitals against hospitals, and the federal government snatching up what it can.

A shortage of tests isn't Florida's only issue: Results take 'seven to 10 days'

In Naples, officials at NCH Baker Hospital Downtown opened a drive-through testing site outside the hospital last week. But after doing 280 tests in seven days, the hospital had to shut down the facility this week after it ran low on testing kits.

NCH spokesman Shawn McConnell said they still have tests available for patients whose symptoms are severe enough to require hospitalization, but couldn't risk running out of those tests and were forced to shut down the drive-through.

Hospital officials are also struggling to find labs that can turn around tests quickly. Last week, doctors at the Gessler Clinic in Winter Haven were getting test results back from private lab companies Quest Diagnostics and LabCorp within two days.

"Now it's up to seven to 10 days," said Jose Martinez-Salas, a pulmonary physician who is part of the clinic's coronavirus task force.

That lag is making it difficult for Gessler to accomplish its goal of becoming a first line of screening for people who may have the virus but don't need to be hospitalized. The clinic sits across the street from Winter Haven Hospital, and Martinez-Salas said they're creating a "cough and fever clinic" so that every person who develops a cough in Winter Haven doesn't end up in the hospital's emergency room.

"No hospital is equipped to handle that kind of influx of patients," he said. "That's not good for anybody."

But with such a delay in testing, Martinez-Salas and others worry their efforts won't be enough.

Tallahassee Memorial HealthCare, which serves a 17-county region in north Florida and south Georgia, is seeing 8-day turnaround times for tests from LabCorp, prompting the system to explore other options to speed things up, according to spokeswoman Stephanie Derzypolski.

Jackson Memorial Hospital, the largest trauma center in South Florida, has been sending its testing kits to the Florida Department of Health and private labs. But they're also waiting days to get results, so the hospital is bringing testing capabilities in-house to "expand capacity and shorten processing times," according to spokeswoman Jennifer Mooney Piedra.

Don't expect government to 'magically solve' shortage of coronavirus test kits

Some hospitals have found creative ways to solve those problems. Larkin Community Hospital in South Miami has been scouring the entire country for test kits and lab equipment.

In January, the hospital leased a machine from Massachusetts-based Hologic that is capable of performing over 1,000 tests a day and could cost the hospital $1 million a year. As the hospital waits to get approval to start using the machine, it contracted with BioReference Laboratories in New York to do fast-track testing. Larkin ships off its completed tests at 6 p.m. each night and receives results within 48 hours.

But Larkin still found itself without enough test kits to swab patients. With so many hospitals competing for the kits and the international inventory so limited, the only way Larkin could secure a purchase was to buy from Georgia-based Path-Tec in bulk — 50,000 tests worth — and pay all of it up front, as opposed to normal times when it would pay each time a batch of testing kits was delivered.

With the hospital already over-extended from leasing the testing machine, Jack Michel, Larkin's president, took out a home equity line and made the $380,000 payment himself.

"It was not easy telling my wife," he said.

Those test kits allowed Larkin to open up its own drive-through clinic in the Miami neighborhood of Hialeah, with plans to expand in other parts of South Florida in the coming weeks. The hospital has received some blowback because it's charging $150 per test, but Michel defended the charge as a regrettable but necessary way to get more tests out to the public.

He said many people are capable of, and willing to, pay the fee, so he sees his drive-through testing site as a way to provide tests to people who can afford them in order to keep the hospitals and state-run clinics available for those who can't.

On Friday, DeSantis told reporters he's asked the state attorney general to look into a Miami hospital that's charging for coronavirus tests. He did not identify Larkin Community Hospital by name, but he cited a Hialeah drive-through clinic that was charging $150 for tests and said such actions were not acceptable during the ongoing epidemic.

As of Wednesday, the clinic had tested 909 people with 103 testing positive for COVID-19.

"We cannot rely on the government," Michel said. "I had no obligation to put a lien on my house to get this done, but this is an unprecedented event, it's affecting the entire world, and we can't just expect the government to magically solve it."

Contributing: Jeffrey Schweers of the Tallahassee Democrat.

This article originally appeared on USA TODAY: Coronavirus tests in Florida are scarce. Could it be next epicenter?