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State prepares for vast increase in COVID-19 testing

State Department of Transportation information signs are urging people to “protect New Mexico” and get tested for COVID-19. But not everybody who contacts the state gets a test.

Richard Kraft, a 65-year-old real estate broker in Albuquerque, found that out recently.

“I saw the highway sign and thought I would do the right thing and get tested,” Kraft said.

When he called the state hotline, he was referred to one of the local clinics.

But when he called the clinic, he was told he couldn’t be tested. He didn’t have any of the symptoms for the coronavirus.

Testing for people without symptoms is still focused on certain groups such as first responders, front-line workers like grocery store clerks, and people who have been in contact with someone who has tested positive. As a real estate broker, Kraft doesn’t fall into any of the categories of people who can get tested.

“We don’t have 2 million tests for everyone in the state,” Gov. Michelle Lujan Grisham said.

But the circle of who is tested has widened as the state ramps up testing to its goal of 42,000 a week.

The state will now test someone displaying any of the following symptoms: fever, cough, shortness of breath, chills, repeated shaking with chills, muscle pain, headache, sore throat and/or loss of taste or smell.

“Not enough New Mexicans are coming to us seeking to get tested,” Lujan Grisham said Thursday.

The state also is going to do more surveillance and sentinel testing, state officials said.

A Walmart pharmacist conducts a COVID-19 screening in the parking lot of the store at Wyoming and Academy on Thursday. The tests are offered until May 10. (Adolphe Pierre-Louis/Albuquerque Journal)

The projected number of tests is substantially higher than the 7,400 tests a week the state has been averaging through April. The state, hospitals and clinics had conducted more than 70,000 tests as of Friday.

The state Department of Health projects it will need to process 6,000 COVID-19 tests a day once a pilot project with the Centers for Disease Control and Prevention kicks into gear.

Lujan Grisham has said repeatedly she believes testing is key to easing the restrictions in her stay-at-home and business closure orders.

As of Saturday, there were 3,732 confirmed cases of COVID-19 in the state and 139 people have died.

Last week, the CDC committed $6.6 million to the state for COVID-19 testing and contact tracing.

According to Health Department spokesman David Morgan, the state has contracts with out-of-state laboratories to increase its testing capacity.

Wider scope for testing

Even before the CDC pilot project begins, the state has increased the number of people doing tracing from 60 to more than 100 public health workers tracking down people who have been in contact with someone who has tested positive.

More than 150,000 people have been contacted by the state’s contact tracing program.

A state Department of Transportation sign tells New Mexicans to get tested for COVID-19. (Jim Thompson/Albuquerque Journal)

The CDC pilot project will expand the rate of testing as well as the number of testing sites from the current 64 around the state.

The state began testing in March, but only for those people with virus symptoms that included a high fever, dry cough and shortness of breath.

While the state is not doing universal testing, over the last six weeks it has expanded testing to include:

• Employees and residents of nursing homes and elder care facilities whether they have symptoms or not.

• People who have no symptoms but who live with or have been in close contact with someone who has tested positive.

• People without symptoms who are in group homes, jails or homeless shelters.

State Health Secretary Kathy Kunkel said the CDC pilot project will allow increased testing in the state’s prisons.

The testing locations are posted on an interactive map on the DOH website. Most require an appointment and some sort of pre-screening either through a teleconference or questionnaire.

Many of the sites are drive-up but some are “walk-in” where a person will be screened before testing.

There is no cost for the tests for people who meet the current criteria.

The Department of Health has a portal on its website that allows someone to check their test results.

“We can test more,” Kunkel said. “We want to test more.”

Testing processes, labs

The Department of Health laboratory employs a testing method that is used to detect people with an early active infection, called nucleic acid amplification testing (NAAT).

The same kind of testing process has been used for years to detect everything from malaria to sexually transmitted diseases.

There are two systems for running the tests and both rely on nasal swabs for the test samples.

The DOH lab is a high-throughput reference laboratory, meaning it is capable of running a large number of tests at the same time. The DOH gets results back within 24-48 hours.

Rapid test platforms like Cepheid GeneXpert and Abbott ID Now machines can provide test results in less than an hour and are used in smaller labs, like the ones found in area hospitals.

The rapid test platforms are not capable of running large numbers of tests at once.

The larger laboratories running tests from New Mexico include TriCore Reference Laboratories, LabCorp, Mayo Clinic Laboratories, Quest Diagnostics, BioReference Laboratories and Jewish National Laboratories in Denver. TriCore is a not-for-profit headquartered in Albuquerque and co-sponsored by Presbyterian Healthcare Services and the University of New Mexico Health Sciences Center.

These laboratories report results back to the state Department of Health.

Morgan said, “All the labs running tests are highly reputable and skilled in the performance of these tests.”

Tests at private reference laboratories cost about $200 a test but that’s not being charged to the people being tested.

The majority of the diagnostic tests in New Mexico are being run through these large laboratories that are reviewed by the CDC and have to meet and maintain federal standards.

Lujan Grisham is discouraging the use of any home test kits for several reasons.

She said many of the tests on the market are not approved by federal regulators and may be inaccurate.

“I need to know the results of the tests to make decisions,” Lujan Grisham said.

Key to restart economy

Increased testing for active coronavirus cases and tracking down everyone who was in contact with someone testing positive are the keys to keeping COVID-19 at bay, once the state begins to restart its economy, according to state and national experts.

The National Governors Association, Johns Hopkins University and the CDC are all recommending following that course of action as states reopen their economies.

Lujan Grisham is also committed to staying the course.

“If I don’t know who is positive (for the virus), I can’t stop the spread,” Lujan Grisham said at a recent news conference.

According to the National Governor’s Association most recent report:

“There is consensus among public health experts and federal leaders that preparing for the next phase of COVID-19 containment will require significant preparation by states to scale up testing, surveillance and the public health workforce necessary to identify active cases and limit the risk of outbreaks as economic functions gradually resume.”

The state is in talks with Accenture, a professional services firm, to develop a support center to help coordinate the contact tracing efforts.

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