As the state starts allowing businesses to reopen, it’s focusing on robust testing as a way to keep coronavirus infections down.
But there’s a lot you can learn from testing data, besides just who has the disease. State researchers are working to understand where it is, what symptoms people have and how to prepare for future outbreaks.
To stop the spread of the coronavirus, public health workers must first know who has it.
But there have been obstacles. State Chief Medical Officer Dr. Anne Zink recently ticked off different things that limit testing.
“It’s the swabs,” she said. “It’s the having a clinician think to do it. It’s having a place to do it. It’s making sure there are no barriers to do it. It’s the viral medium. It’s the transport. It’s the machine to do it on. It’s the reagents. It’s the little plastic parts of the reagent machine.”
The state has made progress on several of those things she listed. It’s added trained staff in state labs. It’s converted lab equipment to be used for the tests. It’s gotten more supplies, including having a Palmer manufacturer make swabs.
All of this has allowed the state to ramp up the number of Alaskans who are tested and expand the definition of who should be tested — basically, anyone who has any symptoms of the virus.
Experts nationally and in Alaska have varying estimates about how many tests should be done — some of the numbers are much higher than what the state is doing. Zink said she once told Gov. Mike Dunleavy the state would benefit from 2.5 million to 3 million tests over four to six months.
At this point, Zink basically rejects putting a number on it.
“We don’t have a set goal,” she said. “Our set goal is to keep Alaskans healthy, and we will test whatever we need to do to get there.”
The number of reported tests of Alaskans has increased each week, reaching more than 4,000 the week beginning April 19. Zink said the state labs can handle more than 7,000.
“The goal is to really make sure we’re testing broadly and widely across all populations and all regions in our state,” she said.
There are three types of places where that testing is taking place: state labs in Anchorage and Fairbanks; commercial labs in the Lower 48; and hospitals and clinics. The state and commercial labs have increased their capacity and speed in recent weeks, while the hospitals and clinics have come online as a new source for testing.
Starting this week, all public health nursing clinics will start offering the test free of charge. The state has worked out deals with Fred Meyer and Carrs to begin offering tests in tents outside their stores. And it’s aiming to ship more test kits to rural areas.
Right now, Alaska has the lowest rate of positive tests of any state. It doesn’t rank as highly in the number of tests per resident — it’s 11th.
“Here in Alaska we lucked out, I think, so far, with relatively very low numbers of positive COVID, and even fewer fatalities,” said Dr. Bernd Jilly, who directs the state public health labs. “So that’s really good.”
Jilly said testing will be crucial to answering basic questions that scientists are still struggling with.
“I think it’s very important, because we are nowhere near done with this thing,” he said. “And because this is a brand new disease, we have no idea how it’s going to behave.”
Jilly pointed out that we don’t know how long COVID-19 patients maintain immunity once they recover, or even if the disease can return after hiding in the body, like shingles and herpes.
“We don’t know, so the more testing we can do, the more people can get a good picture of this,” Jilly said. “And the thing is, if we can catch people early in the course of their disease, we can sequester them, limit their interaction with susceptible folks and, you know, keep it as much at bay as we possibly can.”
Jilly sees potential in using blood tests in the coming months to get a better sense of what share of the population has contracted the virus.
“Those are these big-question tests and studies that are done, usually after the fact, so that we could be better prepared for the next time it happens,” he said.
For example, if there is another increase in cases in the fall, the testing the state is doing now will allow it to know more then.
Blood tests aren’t helpful in diagnosing patients. And there have been problems found with the precision of some of the blood tests that are being marketed.