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Test every nursing home worker weekly
The contract with the state of Florida was probably among Curative's largest, in the hundreds of millions of dollars. It aimed to keep nursing homes open and visitation going while making sure employees with Covid did not expose residents, so every employee was tested and those with Covid were excluded.
Florida put the contract out to bid, and the other labs said it was too crazy: no one could test that many facilities with so tight a turnaround. Curative bid, said it could make it work, won, and delivered.
The established labs are built for efficiency. Quest and Labcorp are ultra efficient machines in a low-margin industry, and they get 1% extra margin by optimizing one part of the process. Asking them to 10x capacity is the opposite of what they are built for, and the people there don't know how to scale. In the pandemic the supply chain broke down as well, so Curative threw all that away and started from scratch.
Why are big labs optimized for steady volume?
High-throughput analyzers are costly, so labs keep them running near full use to spread that cost across many tests. Routine blood work is reimbursed at low prices, which leaves thin margins. Process tweaks that cut a tiny percentage of cost matter a lot at that scale. Equipment, courier routes, and staffing are planned around predictable daily volume.
Why were nursing homes a testing priority?
Residents of long-term care facilities are older and often have chronic conditions, which raised their risk of severe Covid. A Kaiser Family Foundation analysis found that residents and staff of these facilities accounted for over a third of US Covid deaths by early 2021. Staff move between the community and the facility every day, so they are a route for the virus to enter. Regular staff testing was meant to catch infections early.
Why does state bidding favor big labs?
State contracts often require proof of capacity, past performance, and financial strength. Large companies can meet those tests more easily than newer firms. The nursing home program asked for fast turnaround across many sites. Few labs could document that ability at the time.
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