Testing, Testing

Gov. Kate Brown Wants to Test 15,000 Oregonians Per Week for Coronavirus. It Might Not Be Enough.

And even that exceeds the state’s current testing capabilities.

By Julia Silverman April 18, 2020

When Gov. Kate Brown recently ticked off her priorities for easing up on the physical distancing requirements that have us all holed up at home and masked up in public, one item on her to-do list stood out: 

Oregon would need a “significant” ramp-up in its testing capabilities, the governor and state epidemiologist Dr. Dean Sidelinger say, with at least 15,000 tests administered each week. 

That’s a big jump from current testing capacity, which has so far captured about 35,000 people since late February, according to the Oregon Health Authority’s daily tracking. (Current testing levels also grossly underestimate the number of Oregonians who have coronavirus, since testing in the state is still fairly limited.) 

But Brown’s testing goals—ambitious and expensive as they sound—are likely nowhere near enough to allow kids to return to school, businesses to open their doors, and hiking trails to reopen. 

Instead, statisticians say that a true reopening would require a new normal of “test-identify-isolate-repeat"—essentially, mandatory testing for everyone in the entire state every two weeks, and isolation for those who test positive—until a vaccine becomes available in a year to 18 months' time. Those in high-risk jobs, like medical staffers, nursing home workers, and grocery store clerks could be subject to daily testing. 

That’s far beyond the scope proposed in Oregon, and light years away from where we are now.  

Approximately five weeks into the shutdown in Oregon, tests here are still reserved for the most at-risk populations, and have been hampered by a shortage of testing kit supplies, though more commercial labs and hospital systems have added testing capabilities as the weeks have slipped past. Those who can get tested include presumptive patients showing significant symptoms, particularly those from at-risk populations, like people aged 65+ and people with underlying conditions. Testing is also available—thankfully—for frontline health care workers and those in essential service jobs. 

Here’s what Oregon’s not doing, at least not yet:  

  • Offering voluntary testing to anyone who wants it, which is helpful to pinpoint asymptomatic still carriers of the disease who may be unknowingly spreading it. 
  • Antibody tests to screen for those who have had the disease without even realizing it, and may be immune, which could allow some people to get back to work and school. 
  • Attempting meaningful “contact tracing”—in other words, reaching out to those who share a household or a workplace with any patient who has been positively diagnosed with COVID-19, and encouraging them to get testing. 

All of these initiatives are expensive, time-consuming and will require scaling way up in public health staffing. And an effort like that can’t be undertaken in isolation, though there are signs that the federal government is preparing to help by redeploying census bureau workers and Peace Corps volunteers to assist with contract tracing. 

Other states, though, haven’t waited for the feds to step in: Massachusetts, for one, has already hired 1,000 people, at a cost of $44 million, to help track down potential new cases in those who have been in contact with coronavirus patients. 

Around Oregon, there are some signs of hope. In Corvallis, scientists from Oregon State are going door-to-door over the next four weekends with self-administered home test kits, in an effort to build a representative sample of COVID-19 infection levels in the community, the first true attempt in the state to quantify just how many people might basymptomatic. 

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