After more than a month of shortages that have hampered Minnesota’s ability to track and contain COVID-19, a group of public and private health officials announced on Wednesday an initiative to substantially increase testing for the virus — something Gov. Tim Walz has said would be key to considering lifting stay-at-home restrictions.
As part of the initiative, the Minnesota Department of Health, the Mayo Clinic and the University of Minnesota will create a central lab that will allow as many as 20,000 people to be tested per day, while also establishing a virtual command center — operating in partnership with the state’s health systems — that will monitor testing needs across the state to coordinate the response.
The $36 million effort is funded by the $200 million COVID-19 Minnesota Fund, which was established by the Minnesota Legislature, and has previously been used to buy personal protective equipment, ventilators and other supplies. Ultimately, the partners say they will be able to provide both molecular tests, which identify current infection with COVID-19, and serology tests, which identify past infection and suggest a person may have some immunity. Since the beginning of the outbreak, Minnesota has tested approximately 49,000 people.
At a press conference Wednesday afternoon, officials from the organizations involved in the testing initiative explained how the ability to test more Minnesotans will change the state’s strategy, allowing it to be more proactive in testing, tracing, and isolating those who could spread the virus.
“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, adding that the plan would put Minnesota at a higher rate of testing than anywhere else in the U.S. and potentially the world.
Testing shortages
A sequence of shortages has stymied widespread COVID-19 testing efforts in Minnesota as well as other U.S. states.
First, delays in the delivery and processing of tests from the Centers for Disease Control left states with limited capacity to test for COVID-19. As states ramped up their own efforts, high demand globally on the items needed to conduct and process kits — lab chemicals, swabs and personal protective equipment — limited testing.
In mid-March, the Minnesota Department of Health asked providers to limit testing to those for whom a positive test would have the most significance for care: health care workers, the hospitalized and people living in close quarters. People with symptoms who were unable to get a test were given any care they needed, then sent home and asked to isolate with the assumption they may have the virus.
With more testing, MDH priorities have shifted. At the press conference Wednesday, MDH Commissioner Jan Malcolm said her agency is changing its guidance to ask health providers to test anyone exhibiting symptoms that could indicate COVID-19.
“[We’re] sending out the word: Test every symptomatic person. That’s your job in the health care system. It’s our job to build this system to make it happen,” Malcolm said.
Also added to the priority list: people living in congregate settings and the homeless; staff serving vulnerable people; health care workers; communities of color and American Indian Minnesotans, who are more susceptible to COVID-19 related complications; and critical infrastructure workers.
Both the U and the Mayo clinic have said they can increase testing capacity despite the continued pressure on the supply chain.
One benefit to the new testing strategy is ensuring accuracy. Many of the dozens of tests on the market have had little to no scientific review and are often not as effective as they claim to be.
Dr. Jakub Tolar, dean of the University of Minnesota Medical School, said testing accuracy partly relies on how you collect and preserve a sample. Serology tests, which use blood, tend to be more accurate than the molecular tests that rely on swabs from the back of a person’s throat. Tolar said while no test is 100 percent perfect, the U’s serology tests are “pretty accurate.”
Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, noted that while the U, Mayo and the state may have some variance in testing accuracy, they also know how to interpret and use that data effectively to guide public health strategy.
Far from over
While officials said the testing initiative will change the way the state responds to COVID-19, they cautioned against believing things will change overnight.
As far as 20,000 tests a day go, “I would be kidding if I said that’s going to be tomorrow,” Malcolm said. “We’re sending out a message today to make it more clear that we’re standing behind the health systems to assure that if they collect those samples they’ll get processed.”
Andrea Walsh, the CEO of HealthPartners, said the coordination efforts would help her clinics go back to offering drive-through testing services, though not immediately. “Will it be there tomorrow? No. Will it be there in the coming days and weeks? It will,” she said.
While the Walz administration says an increase in testing is a prerequisite to easing restrictions on public life, the U’s Osterholm cautioned Wednesday’s announcement does not signal an imminent return to normalcy.
“While it’s very hard for Minnesotans to hear this, it’s very important they understand we are in the very first innings of this game,” Osterholm said. “This is not going to get over with any time soon.”
He estimated fewer than 5 percent of Minnesotans have been infected and said the virus “will not rest” until at least 60 to 70 percent of the state is infected or a vaccine is developed. Testing is critical to mitigating the disease, but he urged people to “take this seriously.”
Walz agreed, noting a higher volume of tests will not bring a sudden end to social distancing. “This is not a pass that everything is back to normal and it’s all easy from here on out,” he said. “It’s one tool in a toolbox that leads us in that right direction.”
Walz was also clear on whom Minnesotans should hold accountable if they do not get the tests they need: “Me,” He said. “Me on that.”
