As we consider the coronavirus outbreak in the US, there’s a big, dark cloud hanging over us: a lack of effective testing. Without accurate tests, we have no idea how many people have been infected, and to whom they might have transmitted the virus.
Colorado seems to be somewhat confused about the importance of that big, dark cloud.
A week ago, the Aspen Daily News quoted Aspen Valley Hospital CEO Dave Ressler, who was making the claim that testing for the virus was “no longer an effective use of resources.”
“With respect to testing, we know that the community has been anticipating testing, and we came out as a community aggressively once it was identified we might have the virus in the valley because we needed to know,” he said. “The testing was never intended to be a treatment of the symptoms and it doesn’t change the course. It doesn’t serve anybody’s purpose to continue that testing, considering there are limited resources.”
But we had heard Colorado Governor Jared Polis refer to the importance of testing, that same day.
“Aggressive and sustained testing is a powerful tool for fighting [transmission of the virus]. It’s not necessarily clinically important, but it’s important because many [symptomatic people] want to know, ‘Can I get back to work in three or four days, or do I need to self-isolate for 14 days?”
Compared to many other countries, the US has been extremely slow to roll out diagnostic testing for COVID-19, apparently due to a combination of manufacturing problems, chronic under-funding of health services, and an apparent lack of planning and foresight.
“I think that we could have probably controlled this, if we had effective testing.” That’s Columbia University virologist Angela Rasmussen, quoted in a March 6 article about the US testing debacle on VOX.com
When a person gets a confirmed diagnosis, they can be put in isolation where they won’t spread the disease. Additionally, people with whom they’ve been in close contact can be identified and put into quarantine, so they don’t spread the virus if they’ve become infected, too.
Better testing, paired with aggressive public health actions, can help save lives.
When I checked out the COVID Tracking Project on Sunday, March 22, it appeared that about 180,000 US citizens have been tested for COVID-19.
The nation with the most successful testing program thus far, measured on a per capita basis, has been South Korea. They had tested about 315,000 citizens as of March 20 — in a population one-seventh the size of the US. China has tested more citizens (320,000) than South Korea, but has a population 28 times larger.
When I visited the Colorado Department of Public Health and Environment (CDPHE) website on Saturday, I found some vague advice about testing… but I was unable to find any information about where one might go to get a test done.
On March 11, Colorado announced its first drive-through testing station, in Denver. Apparently, many folks trying to access the station experienced considerable frustration, to judge by a March 19 article in the Wall Street Journal:
Feeling sick on Friday, Rachael Willingham went to the doctor, who gave her an order for the new coronavirus test and sent her to a mobile clinic the Colorado health department had set up.
When she arrived at 9:45am, a half-dozen police officers were blocking the entrance. She returned to the clinic that afternoon, but was told testing was over for the day.
Ms. Willingham called a number for the state health department and was told to come back Saturday at noon. She did, only to find testing had been moved to the Denver Coliseum. When she got to the stadium, she waited in a line of hundreds of cars for almost two hours, only to be turned away again with no explanation.
“It’s making this worse,” the 29-year-old said of the confusion over testing. “It’s contributing greatly to the sense of fear.”
Denver’s drive-through experiment was shut down after less than a week of sporadic testing, with no announced date for re-opening. A drive-through site in Colorado Springs closed after less than a week of testing, citing a lack of test kits. San Juan Basin Public Health ran a temporary, two-day mobile testing operation in Durango last Friday and Saturday. I have no news on how that turned out.
It appears there’s currently only one drive-through testing site operating in Colorado at the moment — in Salida — and it’s capable of testing only 100 people per day, and only if they have symptoms and a doctor’s order.
Meanwhile, it’s one thing to get tested. It’s something else again getting the results back. I’m reading about Colorado test results taking longer than 10 days to arrive, or not arriving at all. (In South Korea, coronavirus test results are reportedly texted to the patient the same day.)
But is Colorado actually doing better than most of the nation at testing?
According to the COVID Tracking Project website, Colorado has so far run about 3,700 virus tests. Only about 360 were ‘positive’ — suggesting that 90% Coloradans with pertinent symptoms do not have COVID-19.
Several states have done more tests than Colorado, including New York (45,000) Washington (23,000) California (13,000) Florida (8,000). Those are just rounded numbers, on my assumption that the reporting, at this point, is uneven and perhaps unreliable. The proportions testing ‘positive’ for COVID-19 are also uneven. Nearly a quarter of those tested in New York, for example, showed ‘positive’ results.
38 states have thus far tested fewer citizens than Colorado. Delaware appears to have tested only 81 people, according to the Tracking Project. Alabama has tested only 152.
From a March 18 Colorado Sun article:
But the United States, as a whole, has an abysmal testing record compared to most of the rest of the world. And Governor Polis on Monday talked about how limited and slow testing is hampering the state’s response to the public health crisis…
…“We know we need to test as much as possible,” Polis said.
A British company called SureScreen Diagnostics had reportedly sold 175,000 COVID-19 test kits you can use in the comfort of your own home. The test requires one drop of blood and gives 98% accurate results, the company claims, within ten minutes. The kits reportedly cost about £6. (About $7 US)
The British government is warning people that such test kits may not be accurate.
But better than nothing?