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State rolls out plan to administer as many as 20,000 COVID-19 tests per day

Gov. Tim Walz
Glen Stubbe/Star Tribune/Pool
Gov. Tim Walz: “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.”

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.”

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.
Glen Stubbe/Star Tribune/Pool
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.
Even so, while testing numbers won’t increase to full capacity right away, Malcolm said the public will see significant increases in testing availability very soon.

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.”

Comments (10)

  1. Submitted by Janette Dean on 04/22/2020 - 06:53 pm.

    Great to see the North Star State’s top institutions and government come together to protect Minnesotans and help lead by example in the nation and world. Go, Minnesota, and thanks to the majority of our state’s 2018 voters for much-needed Democratic gubernatorial leadership in our St. Paul capitol working for #OneMinnesota. We need unity from here on out, not divisive rhetoric and anti-science positions and policies.

  2. Submitted by Dennis Tester on 04/23/2020 - 09:09 am.

    Where are they going to find 20,000 people every day who are sick enough to be tested? “It is easier to be fooled, than to convince people they have been fooled.” Mark Twain.

    • Submitted by James Lehmann on 04/23/2020 - 09:33 am.

      From the article:
      He [Michael Osterholm] 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.”

  3. Submitted by Bob Barnes on 04/23/2020 - 09:18 am.

    A couple questions no one seems to ask or answer… how will they get to 20k a day when they can’t even consistently do 2k now? And where are they getting the supplies to do the tests? Have they been stockpiling them instead of doing more tests recently? We’ve heard for weeks how there weren’t enough swabs and reagents to do more testing. So if that was true then there’s no way they’ll get to 20k a day unless they’ve found a new supply. Something doesn’t add up. Is there a journalist out there that will ask the tough questions and get some real answers on how these tests are coming into existence when all along they’ve said the supplies aren’t there? Based on this story it almost appears like they’ve been stockpiling the supplies instead testing more people the last several weeks.

    The most important tests will be the antibody tests. It would be nice to have the media dig into why they’ve been dragging their feet on creating those and getting them out. Germany has been testing quite a bit already and so has Iceland. So why are we so far behind on the antibody tests when we’ve had cases since Jan 21st?

    • Submitted by James Lehmann on 04/23/2020 - 09:55 am.

      Also from the article:

      “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.”

      “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.”

      “Even so, while testing numbers won’t increase to full capacity right away, Malcolm said the public will see significant increases in testing availability very soon.”

      “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.”

      • Submitted by Bob Barnes on 04/23/2020 - 11:42 am.

        I read the article. There is no answer in there to my questions nor is anyone apparently asking these questions. The claim from Walz and others has been for weeks now that supplies for testing are not available (swabs, reagents etc). So how are they going to do 10 times as many tests if they still don’t have those items? Did they find new suppliers ? Are they still short on swabs and reagents? Have they been stockpiling them instead of using them to test more people these past several weeks? Have they made entirely new tests that don’t rely on those items? If they’ve been stockpiling them then there’s a serious problem that Walz et al need to answer for because he’s claimed we couldn’t do the tests.

        If you can’t do better than copy/paste the article then don’t bother replying.

        • Submitted by Jon Kingstad on 04/23/2020 - 01:38 pm.

          You’re right, something does not add p between where things stand as of today and the projected 20,000 tests a day. But the article does admit this:
          “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.””

          At this point, it’s clear it’s only a plan based on the expectation that the testing capability will be available and the hope it will be sooner rather than later. But the idea is to at least samples from many more people with the expectation the samples will be tested eventually.

          Some of us think that the government should have been on this a long time ago with adequate testing kits available. That didn’t happen so it would seem at least this Governor is doing the best he can to keep on top the situation.

    • Submitted by Gary DeVaan on 04/24/2020 - 12:20 pm.

      I read in another story a couple of weeks ago, that the U & Mayo designed the tests to not require as much or any of the reagents and supplies that are in short supply and had firmed-up their source for the material they did need. I do not recall where that was, but it’s my understanding.

  4. Submitted by Laura Summers on 04/23/2020 - 03:49 pm.

    This state initiative will surely go some way towards overcoming the supply problems and inadequate assistance arising from the federal level. I hope the $36 million will be enough.

  5. Submitted by John Kantar on 04/26/2020 - 08:13 am.

    This is a huge step forward, but it is important to recognize that until there is universal, ongoing rapid testing we will not be able to contain this disease. This is a very good start towards that goal and should have been put in place at the National level at least two months ago. It wasn’t and still isn’t.

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