Nearly five million molecular tests have been carried out since the start of the pandemic as of Wednesday, but half as many Massachusetts residents make up the total number of individuals tested, according to the Department of Public Health.
That’s because more repeat tests are being conducted, and for a number of reasons. But the majority are taking place in nursing homes and on college campuses, where people are more likely to congregate and spread the virus, health officials say.
“There’s a lot of different reasons at this point why somebody would have been tested more than once,” Gov. Charlie Baker said earlier this month. “But I believe it is important for us to keep track of everyone who gets tested.”
Roughly one-third of Massachusetts residents have been tested for COVID-19 at least once, but the average number of subsequent tests among repeat test takers is unclear. Including testing mandates from travel restrictions and contact tracing efforts, that cohort is likely diverse -- encompassing not just testing at nursing facilities and colleges, but in hospitals and among frontline workers across a variety of industries.
Non-residents traveling to Massachusetts from elsewhere -- albeit likely a much smaller percentage of overall testing compared to other testing efforts -- are also counted as part of that total, according to Baker.
Officials have been tracking a significant rise in COVID cases among college-aged people, and some colleges and universities have instituted rigorous testing protocols to monitor virus levels.
“The fastest growing people of newly positive cases in Massachusetts are people between the ages of 20 and 30,” Baker said.
The state has been averaging around 65,000 tests per day, with daily yields of as high as more 90,000, according to recent data. Officials have been ramping up capacity to be able to administer at least 50,000 tests a day by the fall.
“We’re testing at 300% of the federal guidelines,” Baker said. “We are testing aggressively because we want to identify cases, and once we identify those cases, connect them to contact tracing so that people will isolate and quarantine and do all the things they need to do to stop the spread within their own communities and their own households.”
Retesting in long-term care facilities and at colleges and universities is part of the state’s so-called surveillance testing strategy. Health officials moved to adopt surveillance testing in all “long-term care settings, including nursing homes, rest homes and assisted living residences" in July after deaths among the elderly were shown to be disproportionately higher at the peak of the crisis than other demographics.
In March, an outbreak of COVID in the Holyoke Soldiers' Home caused up to 75% of the veterans living there to become infected. Seventy-six residents died. Former superintendent Bennett Walsh and medical director Dr. David Clinton have been indicted on 10 charges each in some of the deaths.
Under the surveillance testing program, providers should test 30% of their staff every two weeks if the regional COVID transmission rate where the facility is located is below 40 new cases per 100,000 residents on a seven-day rolling average, according to a Department of Public Health memo issued in July.
If it’s greater than 40 new cases per 100,000 residents, providers are expected to test all of their staff, health officials said. When there are positive cases, health officials instruct all of the infected person’s contacts to be tested.
The vast majority of tests conducted in Massachusetts are PCR tests, also known as polymerase chain reaction tests. Some epidemiologists have pushed for different testing strategies, saying that while the highly sensitive tests can detect individuals who may have been infected with virus, it doesn’t necessarily indicate if a person is still infectious.
Other experts cite the high cost of wide-scale PCR testing, favoring other method such as saliva pool testing, which is way of screening multiple people -- sometimes up to 25 at a time.
“It’s time for us to seriously consider other approaches,” said Douglas T. Golenbock, chief of the Division of Infectious Diseases and Immunology at UMass Medical School, adding that “we need cheaper way to test asymptomatic individuals.”
Golenbock said pool testing can cut down on the costs of transporting individual test tubes to laboratories for processing. New York-based Mirimus, a biotech company that’s developed a saliva-based pool test to detect COVID-19, takes saliva from two dozen people and processes it in one batch. Golenbock said the Mirimus is “much cheaper.”
“I think we’re going to see more of these types of inexpensive tests,” he said.
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