Drive-thru COVID Testing

Sydney Rogers, a specimen collector and processor, gives a COVID-19 test to a patient at the drive-thru testing site on Wednesday, Nov. 18, 2020, at Bozeman Health Deaconess Hospital.

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With coronavirus cases climbing, Gallatin County’s testing system is strained.

Throughout much of the pandemic, it took about two days for test results to come back. Last week, the turnaround time increased to three days, according to the county’s weekly COVID-19 report. This week, it’s four.

There is also significant variability in test turnaround times because tests from symptomatic and higher risk individuals are often prioritized. In some cases, it is taking a week or longer for people to receive test results, said health officer Matt Kelley.

“It’s a problem because the people who are getting tested need to wait longer before they get a result. That keeps … staff out of schools, out of the hospital. … It also makes our contact tracing less effective. When people don’t know whether they have the disease, they’re more likely to spread it.”

The strain on the testing system is largely because more people are requesting tests as cases of COVID-19 keep climbing. This week, the seven-day rolling average in Gallatin County reached 140.6 cases per 100,000 residents, a 5% increase over the preceding week.

In recent weeks, Bozeman Health, one of the primary test providers in Gallatin County, has scaled back the number of tests it performs because it could no longer process tests in a timely manner, said Louis Mendiola, a deputy incident commander. The health care system is now focusing its testing on those who are symptomatic and in higher risk groups, such as first responders and health care workers.

“We believe that this is a temporary shift,” Mendiola said.

To expand testing, Bozeman Health is adding new analyzers, which are used to process the tests. Once those are up and running, the organization will be able to go from processing about 300 tests per day to more than 700.

“As we bring on additional testing capacity, we’ll be able to have a more wider, broad ability to test all members of our community at some point in the future,” Mendiola said. “Time to be determined.”

Even with the new equipment, Mendiola said Bozeman Health may struggle to expand testing because the organization is short staffed.

“We still need help,” he said. “If there were a call to action, that’s it.”

Kelley, the health officer, said to conserve resources, there are situations in which the Gallatin City-County Health Department is no longer recommending testing.

“For instance, if somebody is a close contact who just recently became a close contact, it might not make sense to send them to the test site right away,” he said. “We’ll advise them to stay home, monitor themselves for symptoms.”

Even though the testing system is strained, local data indicate more testing is needed.

The rate of tests in Gallatin County that are coming back positive has been increasing for weeks, a sign that more testing needs to be conducted to avoid missing a significant number of COVID-19 cases.

This week, the county’s positivity rate averaged 22.8%, according to its weekly COVID-19 report. That rate is above the state’s average positivity rate of 18% for the first weeks of November, according to the Montana Department of Public Health and Human Services.

Over the summer, Bozeman Health piloted a surveillance testing program — large-scale testing of asymptomatic individuals that could help the county detect more COVID-19 cases — in Big Sky, but, due to a laboratory backlog, it took weeks for some people to get their results, making them of limited value.

Given the testing constraints Bozeman Health has been unable to say if, or when, it will be able to do more surveillance testing.

Bozeman Health isn’t alone in the struggle to expand testing.

Gov. Steve Bullock rolled out a statewide surveillance testing program in the spring, which was then paused when a national testing backlog led Quest Diagnostics, the out-of-state lab Montana was contracting with at the time, to stop processing the state’s tests.

While Montana has since contracted with new laboratories, surveillance testing remains limited.

After spending months expanding testing, the Department of Public Health and Human Services reported that during the first two weeks of November, about 33,000 tests were conducted each week, a drop of about 8% from each week in October.

It is likely that when flu season arrives, more people will seek COVID-19 testing due to the similarity of symptoms. That is likely to further strain the testing system.

“That’s a big deal, and I’m pretty worried about it,” Kelley said.

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Perrin Stein can be reached at pstein@dailychronicle.com or at 582-2648.