At New York University Langone Medical Center, lab workers handled an increase of as many as 300 swine flu tests a week during the initial epidemic in the spring and early summer, according to Irina Lutinger, the medical center's senior administrative director of clinical laboratories. If swine flu becomes a full-fledged epidemic this fall and winter, her staff of 45 in the lab's microbiology department could be forced to handle thousands of H1N1 tests per week, she said.
Much of the concern among lab directors owes to the fact that since at least the 1990s, fewer people are choosing lab work as a career. Even if they do, fewer training programs are around to serve students, experts say.
Citing federal statistics, the American Society for Clinical Pathology says that 138,000 new laboratory professionals will be needed nationwide by 2012, but fewer than 50,000 will be trained. California and other Far West states are weathering a 53 percent shortage of medical technologists in hospitals, commercial labs and other diagnostic facilities; followed by 46 percent in Arkansas, Louisiana, Oklahoma and Texas, and 42 percent in the Northeast.
"When (a lab worker) leaves, you get hit," Lutinger said. "We try to automate, but you need human intellect."
Hospitals like Lutinger's are coping with the potential surge in swine flu tests by drafting contingency plans. During a serious outbreak, all medical tests would be reviewed and prioritized, and excess tests would be sent to outside labs for analysis, she said.
There's also a growing trend among medical professionals and local health departments to recommend H1N1 flu tests only for the sickest patients or for particular surveillance studies.
Emergency room staffers at Montefiore Medical Center in New York City, for example, generally reserve swine flu testing for patients who clearly need hospitalization or have serious underlying hea
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