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Minnesota has lagged behind other states on COVID-19 testing, but that might be changing

Issues with the testing supply chain both in Minnesota and nationally appear to be getting resolved.

Testing shortages began shortly after COVID-19 arrived in the U.S. The Centers for Disease Control botched the rollout of a test for the virus, then slowed processing of test results by insisting its labs be the only ones to confirm positives.
REUTERS/Lucas Jackson

On Tuesday, Vice President Mike Pence will fly to Rochester to learn about Minnesota’s coronavirus testing initiative in a walkthrough of the Mayo Clinic’s facilities with Gov. Tim Walz.

Walz is among several governors Pence praised in a press briefing last week for their states’ efforts to increase testing capacity, including Ohio Gov. Mike DeWine and Iowa Gov. Kim Reynolds.

The Minnesota initiative, a partnership between the state’s Department of Health, the Mayo Clinic and the University of Minnesota, would allow as many as 20,000 Minnesotans to be tested per day, Walz announced last week.

“This is not a state that’s just going to get through COVID-19, this is a state that’s going to lead this nation and the world out of this,” Walz said in his announcement of the $36 million testing initiative.

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That’d be a huge step up from Minnesota’s current testing capacity, which has so far lagged behind many other states.

Testing troubles

Testing shortages began shortly after COVID-19 arrived in the U.S., when the Centers for Disease Control delayed delivery of tests to states.

As the number of cases in the U.S. grew with tests in short supply, some states struck out on their own to develop criteria for testing as well as the tests themselves and sourcing the materials needed.

That’s resulted in a patchwork of testing methodologies as well as different criteria being used to determine who got tested in different U.S. states.

Early on in Minnesota, people with symptoms and travel history from an area with an outbreak of coronavirus were considered a priority for testing. As Minnesota’s own outbreak grew and testing materials became scarce, the Minnesota Department of Health asked providers to limit tests to people who were hospitalized, health care workers and people in close quarters, such as long-term care facilities and homeless shelters.

So far, Minnesota has fallen below many U.S. states in terms of cumulative testing through April 26, ranking 42nd among the 50 states and District of Columbia in tests per 100,000 residents, according to a MinnPost analysis of data from the COVID Tracking Project.

Tests completed by state per 100,000 residents
Note: Chart shows total tests completed since the beginning of the outbreak through 4/26 per 100,000 residents.

State health officials say that’s likely to change soon thanks to the new testing plan. Already, there’s been a rise in the number of tests completed: In the last week, Minnesota has averaged about 41 tests per day per 100,000 residents.

The previous week, Minnesota averaged 21 tests per day per 100,000 residents.

Daily COVID-19 tests per 100,000 people in Minnesota
Source: Minnesota Department of Health

Last week, Minnesota lifted its testing restrictions, joining others including Michigan, Illinois, Utah, IndianaNew Hampshire in now asking health care providers to test anyone who has symptoms of COVID-19.

Minnesota also announced priority testing for workers serving vulnerable people; communities of color and American Indian Minnesotans, who are more susceptible to COVID-19 related complications due to underlying health conditions; and critical infrastructure workers. The state also plans to aggressively test in places where the disease is spreading quickly and develop a tracing and isolation regimen to tamp down the spread of disease.

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In a media briefing Monday, Health Commissioner Jan Malcolm said it’s not so much about the number of tests, but more about the ability to test strategically: for example, testing people at the right time, and not, say, before the tests could detect an infection. As more information becomes available, that strategy could evolve.

“Applying the testing in the best, most current, evidence-based way is a big part of this strategy and a big value of working with the U and Mayo,” she said.

More tests

Being able to do as many as 20,000 tests per day would put Minnesota at 8,573 tests per 100,000 residents per day — about 56 times the benchmark Harvard School of Public Health experts say are needed to sufficiently track the spread of the coronavirus.

“That would put us on the high end of the range of what national sources are recommending in terms of testing volume needed to achieve clinical as well as surveillance kinds of goals,” Malcolm said Monday.

How will they get there?

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The state has been working in consultation with private companies to source supplies, and part of the partnership between MDH, Mayo and the U is having a centralized command center that can deploy supplies more efficiently: one part of the problem has been uneven availability of the equipment needed to test.

Another technique to sidestep the supply chain issues is using multiple testing platforms that require different supplies. The University of Minnesota has said it is able to do tests using routine lab supplies.

Minnesota’s isn’t the only state increasing its testing right now. In the 50 U.S. states and the District of Columbia, tests have increased from an average of 46 per 100,000 residents daily last week to 66 per 100,000 residents daily this week.

That probably indicates some of the supply chain problems that have slowed testing are improving, said Dr. Thomas Tsai, an assistant professor in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health.

As testing ramps up across the U.S., coordination will be an important part of minimizing the risk of bottlenecks in the supply chain.

“It’s the swabs, the transport tubes, the reagents from the tests, the actual machines to run the [molecular] tests, the supplies in terms of the PPE for the health care workers who are doing the tests and the lab technicians who are performing the test,” he said. “The supply chain is very complicated.”