Getting a COVID-19 test in Grand County is relatively straightforward. Residents experiencing any one of a laundry list of symptoms, even mildly, can call Moab Regional Hospital, give them their information, and drive down to have a nurse take their vitals and stick a swab up their nose. There is no need to leave the car, and test results come back in two to five days via phone call or email.
As easy as it is to get a test, local health officials want to expand coronavirus testing even further because, once a person develops symptoms, it has likely already been days since they started unknowingly spreading the virus, health officials say.
Additionally, a person might never develop symptoms and still spread the virus. The Centers for Disease Control and Prevention itself promotes the working assumption that people who have COVID-19 but have no symptoms are at least half as infectious as people with symptoms.
What are the experts’ plans?
With those findings in mind, one of the next possible steps in stemming the tide of the pandemic is to regularly test people for the coronavirus even if they have no symptoms of COVID-19, a policy proposal that experts have pushed for the nation as a whole since early April and that local officials have since embraced.
One such proposal calls for every American to be tested for COVID-19 every two weeks, whether they show symptoms or not. That would require the United States to increase its testing capacity to be 67 times greater than it is currently, jumping to administer 22 million tests every day.
Another proposal imagines a digital contact-tracing system that requires all citizens to install a location-tracking app on their phones to allow an imagined nonprofit to track the people with whom COVID-19 patients came into contact before testing positive. This would bolster contact tracing efforts to a point that people could socialize in much the same way they had before at the cost of creating a nationwide digital surveillance system.
What is the federal government’s plan?
The administration of President Donald Trump provided guidance to the U.S. Congress on Sunday, May 24 that effectively left to states the responsibility to bolster testing capacity, but they did provide a target: 300,000 tests per day nationwide — far fewer than the plans calling for tens of millions daily tests.
According to one dataset, the Trump administration’s recommendation for 300,000 tests per day is less than the U.S. daily testing average of 330,000 so far in May. Experts took issue with the notion. “On the face of it, the idea that 300,000 tests a day is enough for America is absurd,” Dr. Ashish Jha, director of the Harvard Global Health Institute, told the New York Times.
Jha explained to the Times what made the number insufficient by totaling the amount of asymptomatic testing that would be needed to cover high-risk and high-exposure populations. This includes regularly testing individuals in nursing homes and meatpacking plants every two weeks, per experts’ recommendations. Nursing homes alone would account for 150,000 tests per day. Then, add in every person who makes a visit to a hospital for any reason — roughly 100,000 each day.
“Without having tested a single person for symptoms of COVID, we would quickly exhaust our entire national supply of testing if all we have is 300,000 tests per day,” Jha said.
What is the Moab hospital’s plan?
On May 1, the Southeast Utah Health Department released a joint statement about the top three measures that will be required to get Moab out of “wholesale social distancing.” They are widespread testing, strong contact tracing and supported isolation for anyone who tests positive for COVID-19.
“Continued attention to mitigation of disease spread through these activities will gradually replace the alternative strategy of wholesale social distancing and community-wide shelter-in-place,” the joint statement said.
The statement goes on to outline specific measures pursuant to the three goals, focusing most on how to expand local testing capacity with early testing of anyone with COVID-19 symptoms — that is, getting anyone with even mild or allergy-like symptoms a test — and testing individuals in “high-risk settings” even if they are not showing symptoms.
“Our ability to effectively manage this transition is contingent on our realization of widespread testing,” the joint statement said, since it will enable the entities to do early COVID-19 identification, spot asymptomatic transmission and reduce the spread of the disease.
What will the numbers look like?
In Utah, the number of tests administered in May has been equivalent to roughly one test per 900 Utahns each day, based on state data tracked by the digital news site The Atlantic. In Moab, that number is close to one test per 450 Moabites each day — twice the per-capita capacity of the state as a whole.
These population-based figures do not represent how many different individuals have been tested — healthcare officials and some high-risk workers are being tested on a regular basis while other locals have received no tests — but they do depict the relative strength of the statewide, nationwide and local testing regimens.
Moab’s testing rates are higher compared to the rest of the state and nation, but not as high as local officials want. Doug Caylor, executive director of the Moab Free Health Clinic and a liaison between Moab Regional Hospital and local businesses as health officials look to expand asymptomatic testing in Moab, said that he wants to expand asymptomatic testing to do roughly 200 tests each week.
Add symptomatic testing on top of that and the hospital would be doing one test per 240 county residents every day. Again, many residents would not get regular tests, but those at highest risk would. Caylor’s target rate is far less than the one in 15 imagined by some experts as a sustainable level in lieu of a vaccine; nevertheless, it is a much higher rate than the state as a whole.
How can the hospital reach this goal? By partnering with private laboratories administering COVID-19 tests and with local businesses to get employees on board with regular testing.
Local businesses and the Mayo Clinic will get it done
Caylor said that the hospital is working with the Mayo Clinic to test asymptomatic individuals. Each week, Caylor collects tests from a few hundred local employees to ship their nasal swabs off to the clinic. Within a few days’ time, the results come back to show where if anywhere COVID-19 is present locally.
The tests administered by the Mayo Clinic are different than those administered by public Utah labs, where tests from symptomatic patients are sent. State labs are not currently testing asymptomatic persons in large numbers, in part to reserve the associated labor and materials for fluctuations in symptomatic cases.
On the other side of the equation, local businesses and individual employees volunteering to take tests for the program would also enable this testing surge. The system is set up such that one-quarter of each high-risk business’ employees are tested each week. That means an individual employee participating in the program would get a nasal swab once every four weeks, but the business as a whole would effectively be tested each week.
Testing individuals once every four weeks is half as often as the hospital and many experts find ideal, but it does allow more individuals and businesses to participate in the program, thus expanding the program to more high-risk businesses and individuals.
See related story for details on what businesses can expect when they participate in the asymptomatic testing program. See the online version of this story for links to experts’ plans, the federal government’s response, information about COVID-19 testing and more.