The Sentinel-Record

AP: Most states fall short of coronaviru­s testing thresholds

- A. CASSIDY, MATTHEW PERRONE, JASON DEAREN AND NICKY FORSTER Dearen reported from Gainesvill­e, Florida; Perrone, an AP health writer, reported from Washington, D.C.; and Forster, a data journalist, reported from New York. Associated Press writers Michelle

ATLANTA — As more states begin to relax their coronaviru­s lockdowns, most are falling short of the minimum levels of testing suggested by the federal government and recommende­d by a variety of public health researcher­s, an Associated Press analysis has found.

Three months into an unpreceden­ted public health emergency, the White House has largely resisted calls for a coordinate­d plan to conduct the millions of tests experts say are needed to contain the virus. What federal officials outlined recently isn’t even an official benchmark, and AP’s analysis found that a majority of states are not yet meeting it.

With no specific guidelines, states are left to figure out what a successful testing program should be while they simultaneo­usly try to reopen their shattered economies. If states don’t have robust testing, public health experts say they will be unable to detect outbreaks quickly enough to contain them, which could lead to more shutdowns.

“It’s dangerous and irresponsi­ble,” said Lawrence Gostin, a public health specialist at Georgetown University.

In many states, testing has been limited to hospitaliz­ed patients, high-risk individual­s and front-line workers. But most public health experts agree that containing the virus will require a massive expansion of testing that eventually includes millions of patients without symptoms, which is not happening now.

A testing blueprint released

Monday by the Trump administra­tion lacked any metrics state officials could use to make informed decisions. Instead, the document made clear that states are responsibl­e for testing, saying the federal government is the “supplier of last resort.”

The closest the White House has come to issuing a benchmark does not actually appear in the document. At a recent briefing, senior administra­tion officials said the government would provide each state with enough tests, swabs and related materials to screen at least 2.6% of their population­s in May and June. Those hit harder by the outbreak would be eligible for additional assistance.

It was unclear how the 2.6% figure was reached. When asked about it, officials with the U.S. Department of Health and Human Services described it as 2% of state population­s per month without explaining the discrepanc­y. Officials also did not respond to questions about whether the administra­tion has a target for how many daily tests should be done nationwide or when it would issue more details.

Only about 40% of states currently meet even the 2% testing threshold, according to AP’s analysis. The percentage is expected to rise as states increase their testing capabiliti­es. The AP based the monthly testing rate for each state on the average number of new daily tests over the most recent 7 days. The data is from the COVID Tracking Project and includes counts up to April 30th.

A White House spokesman said Friday that the administra­tion’s testing threshold is only a suggestion and that states are ultimately responsibl­e for deciding how to reopen in a

“safe and responsibl­e manner.” The administra­tion says it is working to expand testing and has been highlighti­ng plans first announced in March for additional testing sites at retail pharmacy chains.

States that do not meet the administra­tion’s testing guidance, based on their current screening rates, include some that have been moving into the early stages of reopening, such as Colorado, South Carolina and Texas. Georgia, which has moved aggressive­ly to ease restrictio­ns and lift its stay-at-home order, is just under the 2% threshold.

Louisiana and Kansas, where Republican lawmakers have been putting pressure on Democratic governors to reopen, are falling short, according to the AP analysis. In Kansas, the governor and top health administra­tor expect to reach the 2% mark this month.

Florida, which announced its first phase of reopening will start next week, also falls short but has said it will be able to test

30,000 to 40,000 people a day if needed. Michigan, where the Republican-led legislatur­e has sued the Democratic governor over the state’s stay-at-home order, is on track to test 2.2% of its population.

Former health officials and experts were critical of the testing blueprint and said the 2.6% or 2% population metric was too vague and didn’t take into account guidelines from the Centers for Disease Control on who should be tested.

“Why don’t they say, ‘We’ll test everybody with any symptoms of coronaviru­s and all their contacts?’” said Dr. James Curran, a former assistant U.S. surgeon general who worked at CDC for

25 years. “If that amounts to 2% that’s fine, but the guidelines are not to test 2%. The guidelines are to test who needs it.”

Many experts already say the national testing rate falls short of what is needed to safely ease social distancing guidelines.

Researcher­s at Harvard have calculated that the U.S. needs to be testing roughly 500,000 people per day before considerin­g easing restrictio­ns this month. That’s a nearly 150% increase from the recent daily tally of approximat­ely 200,000 tests.

“I’ve described it and I still describe it as an absolute bare minimum,” said Ashish Jha, director of the Harvard Global Health Institute.

More than half of states are not testing their population­s at the daily rate recommende­d by Jha and his colleagues. The Harvard team developed their statistics in mid-April and noted that projection­s for U.S. cases have increased since then.

Many states hardest hit by the crisis failed to reach the team’s testing recommenda­tions, even if they were already testing more than 2% of their population­s, according to an AP analysis using state-by-state figures provided by Harvard. States falling short of the Harvard numbers include many of the epicenters of the outbreak, including New York, New Jersey and Massachuse­tts.

Jha and his colleagues based their testing targets, in part, on the number of tests needed to screen enough people to push positive results below 10%, the level that the World Health Organizati­on considers sufficient to contain the outbreak. More than 16% of U.S. tests nationwide are positive for the virus, according to figures compiled by the COVID Tracking Project website. That compares with a rate of about 3% in South Korea, a country praised for its aggressive testing.

Former CDC director Tom Frieden has recommende­d double the current testing levels. He said the U.S. should be testing at minimum 400,000 people a day.

Officials in at least 20 states have indicated their testing capacity is not adequate and said they are taking steps to address this, according to a review by the AP. But there is little consensus among states on how many people should be tested or whether that should include those with no symptoms.

Georgia, where in-person dining at restaurant­s is now permitted with restrictio­ns, has not said how many people it would like to test but recently touted its ability to test over 20,000 people on a single day and has encouraged more people to get tested. New Jersey, which has a slightly smaller population and a higher number of COVID-19 cases, has said it would need to conduct 20,000 to 30,000 tests a day to reopen.

Ohio wants to increase testing from 7,200 per day to 22,000 by May 27. Washington state, which has seen one of the largest U.S. outbreaks, has reported averaging 4,650 tests a day and wants to do more than 22,000 but lacks the necessary supplies.

Most states have convened advisory panels to help in setting guidelines, but they run the gamut in terms of expertise and will result in a patchwork of policies that experts say may be ineffectiv­e in containing a virus that doesn’t respect state borders.

“Treading water on testing is not going to get us out of this,” said Jeremy Konyndyk, a disaster preparedne­ss expert who helped lead the Obama administra­tion response to Ebola.

 ?? The Associated Press ?? MINIMUM LEVELS: People line up on April 23 at Gotham Health East New York, a COVID-19 testing center in the Brooklyn borough of New York. An Associated Press analysis finds that most states are not meeting the minimum levels of testing suggested by the federal government and recommende­d by public health researcher­s even as many of them begin to reopen their shattered economies.
The Associated Press MINIMUM LEVELS: People line up on April 23 at Gotham Health East New York, a COVID-19 testing center in the Brooklyn borough of New York. An Associated Press analysis finds that most states are not meeting the minimum levels of testing suggested by the federal government and recommende­d by public health researcher­s even as many of them begin to reopen their shattered economies.

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