BOISE — Gov. Brad Little on Friday unveiled a sweeping new COVID-19 testing strategy that calls for sharply ramping up testing across the state, including in rural “testing deserts” the state has identified.
The strategy, which a governor-appointed task force of both public- and private-sector experts has been formulating over the past month, calls for expanding Idaho’s testing capacity, now at roughly 18,000 to 23,000 tests per week, up to at least 150,000 tests per week.
“The testing demands of COVID-19 are unprecedented,” said Dr. Christopher Ball, director of the Idaho Bureau of Laboratories and co-chair of the testing task force.
Little, at an in-person but socially distanced press conference in the Capitol’s Lincoln Auditorium, said, “A strong economic rebound can only occur with a combination of efforts, and expanded and targeted testing is a big part of our strategy.”
“We have an impressive team of very capable local clinical and laboratory and research experts from across the state helping us navigate this crisis, and I sincerely appreciate their help,” the governor said.
The new strategy lays out five priority groups for testing, with the first two to be targeted right away. “An example of a Priority 1 is any symptomatic health care worker,” Ball said. Another example is residents of nursing homes, whether or not they show symptoms. “For this group, testing that provides a same-day result is ideal,” he said. Priority 1 testing alone is estimated to require about 17,000 tests per week.
In Priority 2 are, for example, inmates and staff in correctional facilities, “where early detection is critical to prevention of facility outbreaks,” Ball said. That adds another 26,000 tests per week.
In Priority 3 would be asymptomatic employees at “an essential ... business that has a high volume of public-facing work, for example a large retail grocer.” That would add another 86,000 tests per week.
“The takeaway message from these recommendations is that we will need to build incredible testing capacity, plus the ability to respond to all of those testing results with appropriate clinical and follow-up care,” Ball said.
Asked about the cost of the testing strategy, the governor's press secretary, Marissa Morrison, said in an email, "The total costs of the testing strategy are still unknown as there are many variables. Not all costs will be borne by the state, however. Idaho will be receiving $55 million of CARES Act funding specifically targeted at testing and contact tracing costs."
Elke Shaw-Tulloch, administrator of the state Division of Public Health, compared the coronavirus pandemic to fighting a wildfire, “something we in Idaho know well,” she said. The spread of the virus can be thought of as flying sparks from a wildfire, and the goal is to throw a blanket on them to douse them before they set off blazes.
“The spark is the virus, and the blanket is our epidemiological investigations and contact tracing,” Shaw-Tulloch said. “The fire can have an increased chance of exploding into a wildfire with every spark that is unsuccessfully extinguished or gets flamed into an area that does not have sufficient firebreaks.”
Figurative firebreaks include the safe practices Idahoans have been told to observe: Social distancing, good hand hygiene, wearing masks when out in public, and staying home when sick.
“Testing in this analogy represents the fire spotter searching for the sparks,” Shaw-Tulloch said, and Idaho needs lots of those fire spotters.
The new strategy recommends focusing on molecular diagnostic testing for now — the type of testing, typically done with a nasal swab, that tells if a person currently has the virus — rather than serologic, or antibody, testing, which tells whether someone has developed antibodies from a previous infection. Ball said antibody testing may be useful later.
As of Thursday, Idaho ranked last in the nation — 51st among the 50 states and the District of Columbia — for per-capita testing, according a ranking by the Kaiser Family Foundation. But the state officials said they believe that’s because Idaho has only been reporting its molecular diagnostic testing results, not its antibody testing; other states have been reporting both.
On other comparisons of per-capita testing that are limited to diagnostic testing, Little said Idaho ranks closer to the middle of the pack. In the COVID Tracking Project/Vox News ranking on May 11, for example, Idaho ranked 43rd.
Testing doesn’t stand alone as a way to corral the coronavirus, all three officials warned; it only works in combination with contact tracing, treatment and monitoring.
Little said he liked Shaw-Tulloch’s wildfire analogy.
“The whole goal of this is to scale up testing with tracing to where we can do what Idaho likes to do in a good fire season,” the governor said, “and that’s get on those fires early and put ‘em out, and do all the management processes, like these,” gesturing to the face mask that he wore at the press conference, but lowered to his chin when he spoke, along with handwashing, social distancing and other mitigation measures. “If we do all of those things, we’re basically doing the things to minimize the danger of that fire, and that’s our goal.”