Is a COVID test necessary for everyone?
Governor says ‘yes,’ but New Mexico Health Department, CDC disagree
With thousands of New Mexicans being vaccinated daily and new COVID-19 cases declining, the state’s coronavirus testing capacity has expanded to more than 110 locations and now includes free at-home testing.
But as the pandemic wears on, there are still mixed messages about who should be tested.
“Get tested” has been the mantra of
Gov. Michelle Lujan
Grisham.
Yet according to the Centers for Disease Control and
Prevention’s website,
“Not everyone needs to be tested.”
The state Department of Health COVID-19 website echoes the CDC recommendation, recommending that those without symptoms get tested only if they have had close contact with someone who has tested positive, are scheduled for surgery, or if they live or work in a congregate setting.
And the Journal has found that some testing providers in the state won’t test just any asymptomatic person. Applicants are screened beforehand to
assess their risk of having contracted the disease or potential for exposure.
For those who don’t meet that criteria and don’t have symptoms, there’s always the new state-funded athome testing option. But they will still need access to a computer.
Dr. David Scrase, secretary of the state Human Services Department and a top adviser on COVID-19 to the governor, told the Journal last week, “We haven’t let up in our desire to test people. I still think anybody can get a test.”
Scrase points to the new option announced by the governor in December for the free self-administered COVID-19 saliva tests, which are taken at home.
A DOH spokesman said that 24,516 of those tests have been ordered and that at least 12,134 people have taken the test and returned the sample.
The at-home tests are available regardless of exposure risk, whether people are symptomatic, and whether they have come into close contact with a confirmed positive individual — factors considered by DOH-advertised test sites run by some private contractors.
Participation requires online videoconferencing through Zoom.
The state hired a national company, Vault Health, under a $4 million contract to run the at-home program.
Results, which are reported to the state, are to be available within 48 hours of receipt of the sample.
Meanwhile, the state DOH website shows about 130 testing locations statewide that offer asymptomatic testing, but each has its own criteria, and at least one requires an upfront payment online.
As of last week, the website showed CVS Pharmacy had 14 locations offering asymptomatic COVID-19 testing. But there is a screening process to determine whether a person is at risk for being exposed or meets other criteria for a no-cost test.
For those who are not eligible, the pharmacy chain
offers a COVID-19 test for $139.
Those tests are aimed at people who, according to its website, “need to show a negative COVID-19 test result for travel, recreation or leisure.”
Reasons to test
Testing helps the state identify people with the virus, and then alert those who might be exposed to isolate.
The overall goal is to reduce the number of new cases, which has dropped to fewer than 600 a day on a rolling seven-day average in New Mexico.
But testing is also a key to reopening business in the state, which has one of the strictest stay-at-home orders in the country.
Under the state’s reopening criteria, counties must have both an average COVID-19 test 14-day positivity rate of less than or equal to 5% and a new case incidence rate of no greater than 8 cases per 100,000 during the past two weeks to operate in the “green,” with the fewest number of public health restrictions.
A status of “yellow” loosens some restrictions, such as permitting limited indoor dining, but counties must achieve either of the two criteria. The most restrictive status is “red,” when counties meet neither metric.
As of last week, one county
met the “green” criteria, and seven others fell into “yellow” status, although overall, state’s overall positive test as of Saturday was about 6 percent, according to the DOH website.
New Mexico unveiled the red-to-green tiers for counties in late November.
Weeks later, the governor issued a news release announcing new, free athome saliva testing.
“We need more New Mexicans to get tested,” she said in the Dec. 22 release. “And right now testing is one of the best ways to get New Mexico from ‘red’ to ‘green.’ We can drive down county positivity rates, help more businesses and workers get safely back on their feet and keep more New Mexicans healthy.”
Scrase said he believes the state can assess whether it is testing enough people for COVID-19 by looking at the test positivity rate, “and I want that to be below 5%.”
“In general, when it gets below 5%, only less than 1 out of every 20 people is positive when we do the testing,” he said.
He said the state is seeing counties turn from “red” to “yellow” because their positivity rate has fallen to 5% or lower.
Some counties have met that goal, he said, because “they had a big campaign to do more testing and to get more people in.” And here’s the math: if you have
ten positive cases out of 100 tests, that’s a 10% positivity rate.
“But if you do 200 tests (with the same 10 positives), you’ll get down to 5%,” Scrase said. “But remember the fundamental reason we test is to identify cases, isolate them, identify their contacts, quarantine them and prevent spread.”
He said the positivity rate criteria give counties incentives to push testing by “coming up with a plan and see what they can do to make this work.”
2.4 million tests
There’s no public data on the number of people tested in New Mexico, only tests performed, which include those administered by employers who routinely screen employees for COVID-19 to ensure against an outbreak. More than 2.4 million COVID-19 tests have been performed since the beginning of the pandemic in New Mexico, recently earning the state third place nationally in the number of tests performed per capita.
But in November, as the virus surged, testing capacity was strained, particularly in southern New Mexico.
For instance, on Nov. 1, the state was averaging about 9,000 tests a day, and the positivity rate in Luna County had hit more than 30%.
Later that month, the DOH contracted with two private COVID-19 testing firms, Vault and Curative. Curative, as of Tuesday, had performed 190,442 COVID-19 tests at about 30 different drive up or in person locations around the state, according to a company spokesman.
Last week, Luna County’s positivity rate, while still relatively high, had been cut in half.
The state, meanwhile, boosted its average daily tests to about 13,600 (according to a seven-day rolling average reported on Saturday).
Presbyterian Healthcare Services, the University of New Mexico and Lovelace Health Systems have discontinued testing for asymptomatic community members, the DOH site says. Presbyterian will continue to also test those with an exposure to a known COVID-19 infection.
The website shows that Curative, a national testing firm created in January 2020, is a major provider offering COVID-19 testing to asymptomatic people in New Mexico.
Applicants seeking testing must first take an online questionnaire assessing medical risk and exposure.
Applicants are asked whether they have symptoms, are employed as essential workers, have come into contact with someone with COVID-19, have gone to any retail or grocery stores, gas stations or restaurants in the past 14 days, and whether they have spent any time with five or more strangers in the past two weeks. There’s also a question as to whether they wear a mask in public.
Someone who answers “no” to all of the questions and wears a mask is informed they “aren’t eligible at this time” to be tested.
“There are specific requirements for age and other health history or conditions that may prevent you from being eligible,” the website says.
A spokesman for Curative told the Journal in an email last week that the “ordering physician” in the firm determines the criteria “under which they deem a test to be medically necessary.”
The state’s DOH COVID-19 website also draws a line on who should be tested.
“To reopen safely, NM must conduct thousands of COVID-19 tests daily,” the website says. “However, it is neither possible (nor necessary) to test everyone. Data from tests are like photographs – a snapshot in time. Thus, in NM, the State will prioritize testing.”
Scrase said, “Testing is as important as it’s always been. I don’t think the state can let our guard down until we get to two-thirds (vaccinated), and assuming no outbreaks or strains, we should see a significant drop-off.”