Despite the United States conducting more COVID-19 tests than ever, most states — including Tennessee, Alabama and Georgia — are falling behind on testing as their outbreaks grow more severe and slow processing times resurface as a national issue.
Tennessee health commissioner Dr. Lisa Piercey acknowledged the problem during a news conference on Tuesday, citing a backlog at labs that are struggling to keep up with high influxes of samples.
"We've got a lot of testing right now. ... The problem right now is lab throughput and getting a reasonable turnaround time," Piercey said.
Testing remains a cornerstone of the public health response to COVID-19 until a safe, effective vaccine is readily available. Until then, finding out who's infected, isolating those people and identifying people they've contacted so those people can be tested, too, are key to containing the virus. There's also a great economic need for testing as more businesses begin relying on testing employees to safely return to work.
Although the state is working on some creative strategies to improve the situation, Piercey said some labs across the state are taking between five and six days to run a sample once receiving it in the mail.
"It's going to take a few weeks to get that under control," she said. "We would always want to expand testing as much as we can. Right now, we've got to fix the lab issue."
Tennessee was an early leader in COVID-19 testing after a slow rollout nationwide, outpacing all of its neighbors and being one of 10 states to reach testing benchmarks established by researchers at the Harvard Global Health Institute in May.
Now those same researchers, who developed new benchmarks based on the evolving pandemic, rank Tennessee in the bottom quarter of states when it comes to testing enough to suppress the pandemic. Georgia and Alabama, which have more severe outbreaks and less testing than Tennessee, have even farther to go to catch up.
In order to "mitigate" or manage COVID-19, Tennessee would need to conduct 27,894 tests per day, or 408 tests per 100,000 residents, according to Harvard's estimates. Georgia would need to perform 64,048 tests (603 per 100,000 residents) and Alabama 41,577 tests (848 per 100,000 residents).
Far more testing would be needed to successfully detect emerging hot spots in advance and actually "suppress" the pandemic, researchers say.
Tennessee now is testing at the rate of 312 daily tests per 100,000 residents, whereas Georgia and Alabama are conducting 200 and 188 daily tests per 100,000 residents, respectively.
About 13 states now are meeting the mitigation target, while only four states — Connecticut, Montana, Alaska and Hawaii — are testing enough for suppression.
"It is time to invest in building the capacity and infrastructure to test millions of Americans every day, symptoms or not. It will save many lives and billions of dollars," according to the website globalepidemics.org, where the testing benchmarks are outlined in detail.
Piercey said during Tuesday's briefing that while some authoritarian countries have effectively suppressed COVID-19, achieving full suppression in a democratic nation such as the U.S. is likely unattainable.
"Our goal is to mitigate the spread and to minimize the number of cases as much as possible," she said.
In addition to fixing the lab backlog, Piercey said the state's positivity rate — which is hovering around 9% — needs to come down (although it compares favorably to Georgia and Alabama at 16% each).
"That's a two-part effort — one is having enough testing to make sure we're getting a wide enough sample," she said. "But it's also that illness surveillance curve going down — actually less people being sick."
The Harvard researchers wrote that while testing has doubled in the nation from around 250,000 to more than 550,000, on daily tests "we are nowhere near where we need to be."
"We need to build capacity to test millions of people every day – around 4 million based on our latest modeling," they said. "That is an ambitious goal, but it is how we can suppress the virus, revive our economy and return to a new normal."
Contact Elizabeth Fite at firstname.lastname@example.org or follow her on Twitter @ecfite.