Experts push for increased testing
County surveillance will halt spread, they say
Memphis and Shelby County have one big tool left in their pandemic toolbox — assurance testing. People just need to use it, local experts and testing lab leaders say.
In Memphis, there is not a testing supply problem, unlike earlier in the pandemic. There's now a demand problem — people aren't using testing enough. And Dr. Manoj Jain, one of the architects of the city's now-robust testing program, would like that to change.
Jain and Jim Sweeney, CEO of Poplar Healthcare, want more small businesses and other groups to use the city's pooled and surveillance (assurance) testing programs, saying that greater adoption from the private sector would help quell the spread in Shelby County.
Fewer cases could allow for economic activity to recover further. Less infection could also mean fewer people in the hospital and fewer deaths as Shelby County awaits mass vaccination. Over the past seven days, Memphis-area hospitals have averaged about 500 people in the hospital. Leaders have called for volunteers to ease the shortage of medical workers.
If existing testing is not used more, Jain said, the county could struggle through the pandemic until vaccinations likely end it in mid-2021. If wider testing — assurance testing from businesses, churches and schools — is adopted, it could reduce infections in the near-term.
Projections from New York University, which Jain ordered, show that increased testing for a population of
about 1 million people — going from about 3,000 tests a day to 30,000 — could bring the pandemic almost under control by mid-february and case rates could decline in December.
At 10,000 tests a day, case rates could start declining in January. At roughly 3,000 tests a day, which is close to Shelby County’s current rate, the pandemic would keep spiking until March, and new daily cases could surpass 1,500.
“You can see how the epidemic abates very quickly if we’re able to do the assurance testing,” Jain said while showing the projections during an interview Saturday. “The labs have the capacity to handle that.”
Local capacity underutilized
For at least the past two months, there have been 13,000-plus free tests available each week at community testing sites in Shelby County. Most weeks, 70% or so get used.
There’s enough capacity that the city of Memphis is staging free asymptomatic each weekend in December. More than 400 people — out of about 2,500 — tested positive this past weekend.
Labs like Poplar Healthcare and American Esoteric Laboratories also have capacity far beyond that — they can provide testing to businesses for a flat fee using pooled testing as part of the city of Memphis’ Test to Protect program. To Jain and Sweeney, all the city needs is more adoption from the private sector.
“If we started doing our workplaces…, that would be a great way to find out who is positive and get them out of the workforce, get them out of the social circles, and isolate them and quarantine their contacts. That’s the way we’re going to bring epidemic the pandemic down,” Jain said.
Sweeney said, “I think the business community could be more proactive in testing. I applaud the city governments, not just Memphis but other municipalities and other entities that interact with the public, because they’re engaged in assurance testing, and they are doing it the right way… because they are protecting their employees.
The Poplar Healthcare CEO said he and AEL have enough capacity to add hundreds of small businesses.
“There’s room for the private sector to get more involved. I think the other fear is: people are afraid of finding out what happens if I have a positive,” Sweeney said.
How pod, pooled and assurance testing work
Pooled and assurance testing have been underway in Shelby County for months after Poplar Healthcare received emergency approval from the Food and Drug Administration. City of Memphis first responders have been tested since late-july.
The city program is designed for small businesses and other institutions to do pooled testing — testing multiple people, up to 20 — at the same time with the same test kit. The businesses are charged a flat fee for the service by AEL or Poplar Healthcare — about $250.
Pod and pooled testing are more or less the same thing. A group of a people, a pod, all self-swab their noses. Everyone’s swab is tested the same. If the test comes back negative, everyone in the group is in the clear. If it comes back positive, everyone in the pod must get an individual test to find out their status. That would be free for an employee at a community testing site because, if they’re in a positive pool, they’ve been exposed to the virus.
Assurance testing, also known as surveillance testing, is the regular use of testing to be assured you don’t have the virus. The city’s pool testing program is similar to what NBA players did when the leagues resumed play in Orlando this summer. Players were tested every day to make sure the virus had not crept into the bubble. Unlike the city’s program, NBA players were tested individually.
Businesses that participate in the city’s Test to Protect program use pool testing about once a week. Private and public schools in Shelby County use pooled testing, too.
Jain estimates that 50% of infections are asymptomatic, meaning about half of the people who are infected aren’t showing symptoms and could be walking around infecting people without knowing it.
Assurance testing, he said, stops clusters from spreading undetected for too long, preventing at least some infections and reducing further transmission into the community.
The business case for doing it
Government restrictions early in the pandemic cut consumer spending and stopped all sorts of activity. In Shelby County, severe, widespread business restrictions have been gone since May with some restrictions on bars and restaurants returning in November.
But, nationwide, people have not flocked to dine at restaurants, despite indoor dining being open. Part of reason the broader public hasn’t shown up at restaurants, economists estimate, is because they’re worried about infection.
That’s something that Sweeney also noted. He said assurance testing could maybe change some consumers’ minds.
“What better way to, to one, know that your staff is okay. And number two, to convince the public that your facility is okay to come in and enjoy dinner,” Sweeney said.
How to participate
If businesses or other institutions want to participate, they can contact Dr. Jain, Sweeney or AEL.
• Manoj Jain, manoj.jain@emory.edu
• Poplar Healthcare, Jim Sweeney: j.sweeney@poplarhealthcare.com
• Labs: AEL (Sonic), David Smalley: dlsmalley@ael.com
Samuel Hardiman can be reached by email at samuel.hardiman@commercialappeal.com or followed on Twitter at @samhardiman.