Testing… Testing… 1, 2, 3

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by jgleaso1  4/20/2020 1:54:21 PM -- 

Though testing in northeast Nebraska is ramping up, we are still not testing enough. We will need improved testing in order to relax our restrictions.


After a month of being confined, spring is finally dawning in our neck of the woods and we are ready to step outside. We are lucky in northeast Nebraska that we can go outside and easily remain 6 feet (sometimes 6 miles) away from our neighbor. This is a luxury that city dwellers do not have.

However, our favorite restaurant may be closed, and our sporting events are not taking place. Our lives are still being hindered in many ways. So, what is it going to take to get back to a place that feels more normal?

Many experts agree that we won’t really be free until a vaccine is available – and this could take a year or two.1,2,3 It is also widely accepted that any liberation will come at a cost of a resurgence in cases. New outbreaks are occurring in countries that, we thought, had the disease under control.4 It is vitally important to identify new outbreaks before they get out of hand and be able to take steps to stomp it out immediately.

The only way to know who is currently infected with COVID-19 is to test for it. Currently, these tests are not available for wide use. According to the Nebraska Department of Health and Human Services (NDHHS), “While supplies are limited, testing will be reserved for hospitalized patients, and patients from vulnerable and high-risk groups (nursing homes, group homes, daycares, public safety, and healthcare workers.)”5 If you have had contact with someone who has tested positive and/or you have symptoms, you are requested to self-quarantine unless you are in a high-risk category, in which case you should discuss the situation with your doctor who may authorize a test.6

We don’t need to have testing for everyone, but we do need to have the tests available to everyone who has symptoms. We also need to have tests available for essential workers and especially our healthcare providers, including those working in long term care facilities. The helpers out there who are caring for our elderly and at-risk populations will need regular testing until two things happen: an antibody test is available to determine who is immune, and second, until we have some idea of how long immunity will last.

As NDHHS stated, the tests in Nebraska are limited. It seems that the tests in northeast Nebraska7 are even more limited. As of April 17, 669 tests have been administered in northeast Nebraska.8 The majority of these tests have taken place in Madison and Dakota counties (see Figure 1). Five of our counties have administered less than five tests.

Simulation Chart

Figure 2 shows the number of tests per 1,000 residents in each county. Those same counties with less than five tests also have the five lowest rates of testing based on their populations, ranging from 0 to 2 tests per 1,000 residents. On average for northeast Nebraska, there have been 5 tests for every 1,000 residents. To put this into perspective, the Nebraska test ratio is 7 individuals for every 1,000 residents while the U.S. ratio is about 10 per 1,000.

Simulation Chart

Two questions arise out of this information. Why are our testing rates lower on average within the state? What does this mean moving forward?

One thing to consider is that confirmed positive results per test range between 3% and 15% in northeast Nebraska with an average of 6%. Nebraska’s average positive rate is 8%. According to Dr. Gary Anthone, the state’s chief medical officer, test suppliers consider where the most positive results occur and send the majority of supplies to those areas.9 There are 36 states with higher positive test percentages than Nebraska.

The state is working on improving testing access in our area. The Nebraska National Guard set up a testing site in Dakota City on April 14, to test 75 pre-determined high-risk residents.10 Another testing site was set up April 17, in O’Neill and Bloomfield where 100 people were tested11 while another 100 individuals were tested in Norfolk on that same day to target Tyson employees and families.12,13

Testing is not the complete answer, however, and it definitely has some pitfalls. It serves as a short snapshot for those being tested. People who test negative today could test positive tomorrow, and vice versa. It’s also not feasible to test everyone.

Testing will be a key part of opening up our communities when the time comes. First, we need to see the rate of confirmed cases start to decrease. Not including the spike of cases today, the rate of new daily cases had been slowing. By 2:00 p.m. on April 17, 18 new cases had been reported in northeast Nebraska, 3 times higher than the next largest daily increase – which was the day before.

Once the number of daily new cases starts to regularly decrease, we may be able to lighten up our societal restrictions. We can understand how quickly this disease can snake its way quietly from one person to the next, quickly building up to an outbreak. We need to have a testing system in place that can detect an emerging outbreak before it’s too late. This would mean that we need a way to find those who are spreading the disease and who aren’t showing any symptoms.

We’re all anxious to find our new normal. Many of us need to get back to work as the bills continue to pile up. But we also know that doing this too early would mean putting ourselves and our neighbors at risk. We need the government and the private sector to find a way to improve testing capacity. Until then, like always, we wait.

1 https://www.livescience.com/coronavirus-covid-19-vaccine-timeline.html
2 https://www.theatlantic.com/health/archive/2020/03/how-will-coronavirus-end/608719/
3 https://www.businessinsider.com/coronavirus-vaccine-quest-18-months-fauci-experts-flag-dangers-testing-2020-4
4 https://covid19.who.int/
5 http://dhhs.ne.gov/Documents/COVID-19%20Guidance%20to%20Public%20and%20Testing.pdf
6 http://dhhs.ne.gov/Documents/COVID-19%20Guidance%20to%20Public%20and%20Testing.pdf
7 Northeast Nebraska is defined as the following 20 counties: Antelope, Boone, Boyd, Brown, Burt, Cedar, Cuming, Dakota, Dixon, Garfield, Holt, Keya Paha, Knox, Madison, Pierce, Rock, Stanton, Thurston, Wayne, and Wheeler.
8 https://nebraska.maps.arcgis.com/apps/opsdashboard/index.html#/4213f719a45647bc873ffb58783ffef3
9 https://www.omaha.com/livewellnebraska/health/coronavirus-testing-in-nebraska-has-lagged-that-of-some-states-but-so-have-cases-and/article_18b65239-f7d4-540d-a106-383d44a72c8c.html
10 https://www.siouxlandproud.com/news/local-news/national-guard-conduct-covid-19-tests-on-75-people-in-dakota-city/?fbclid=IwAR1Vc66GsJH_PpdgB1ei0loldAElX2szG8HoHdE5Sodt45o6M2SwmyomhG8
11 https://www.facebook.com/NCDHD/photos/a.10151555576007342/10158411650852342/?type=3&theater
12 https://norfolkdailynews.com/news/covid-19-testing-offered-free-for-some-in-norfolk/article_386bb9ea-81e5-11ea-b453-6f8fd782649a.html
13 https://elvphd.org/Current-News/covid-19-outbreak-being-investigated-at-tyson-foods-inc-madison

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