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Virginia Prescott spoke with physician, epidemiologist and journalist Keren Landman about why Georgia is behind in coronavirus testing, the effects it's having on how officials respond to the epidemic and potential help that is on the way.

We're looking at numbers from the Coronavirus Tracking Project and also the AJC analysis. Today showed that Georgia, so far, is among the states with the lowest testing per capita in the nation. These are state and commercial labs, about 20,326 tests processed as of yesterday. That was Wednesday, the first. This is compared with 45,000 in Louisiana, for example. How does this affect the response in the state? 

You know, Virginia, I think it makes it really difficult for us to know what the footprint of the disease is here right now. And in that kind of situation, officials and public health authorities are really flying blind. 

There are a couple of reasons that it's important to know how many people have been infected and how many people are actively infected. Now, number one, it helps reinforce the authority of a lot of stay-at-home orders and shelter-in-place orders. And as you know, the governor only really made the statewide shelter-in-place order yesterday. And it's not something that everybody is necessarily on board with. A lot of religious congregations are having a really hard time with that. But understanding that a lot of people in the community are ill or infected can really give a lot of weight to those orders. 

It also—especially with so many health care workers being infected— it helps preserve the materials that they need in the space that they need to isolate and quarantine people who have been either infected or exposed to infected people. That becomes really important when you start counting the number of masks and gowns that these health care workers have to use each time they encounter somebody that they suspect has been infected with COVID-19.

So if we're trying to minimize waste of those PPE, of those elements of PPE, then it's really helpful to know for whom we really need to use it and for whom we don't. For responders, first responders and people who otherwise need to leave the house to go to work, the guidelines are for people to stay home depending on the strategy of how they were diagnosed with COVID anywhere between a week and two weeks. If somebody can leave the house sooner because they know they have a negative result, that's a really good thing for the workforce and for economic recovery.

Right. So that lag up to 10 days now to get results, how accurate a picture do we actually have of the numbers in Georgia now?

Well, I think it's really heterogeneous. Different counties are doing different levels of testing. I spoke with somebody in a county in west Georgia that their hospital spent hundreds of thousands of dollars to buy their own tests and just test as broadly as they could amongst symptomatic people in their community. They had a real leg up in understanding what was going on and actually issuing a shelter-in-place order a week before our governor did, as a result. So it can give counties a really good idea of what's going on. But if counties are not doing that kind of testing, if the hospital does not have the resources to do that and it's not happening in conjunction with state efforts, they're not going to be able to do that.

So I think there's just a lot of variability within the state in terms of how officials are able to respond to the epidemic based on what we know about what kind of testing is available in those communities.

So currently, Georgia's testing about on the same level as Wisconsin, for example, a state of half the population. Also New Jersey, half the population, far less than hard hit areas like New York. 950 per 100,000 in the population compared to Georgia. 127. Any ideas as to why Georgia is so far behind? 

It's a good question. It's hard to say for sure. What I can say is that in speaking with private labs— one in particular called IPSUM that has a lot of testing available— they just—I believe it was just today or yesterday [that] they received emergency authorization from the FDA to conduct COVID testing using a really highly sensitive machine in their lab. They can conduct now 4,000 tests a day, which is, just to give you a little context, the new agreement that the public-private partnership that the state announced yesterday or the day before, the capacity of that partnership is 3,000 tests a day. So we're talking about doubling what the state capacity is right now if you include what this lab can do.

One of the owners of that lab, she has tried to reach out to state officials to try and offer their capacity. She said she's called the mayor, called the governor's office. She's called the DPA and she cannot get a call back. So some of that may just be difficulty and communication, not enough people and resources and just an overwhelmed public health system. 

All right. Well, that announcement was made this week by Gov. Kemp that the state would be partnering with Emory University and University of Georgia to process and to use their lab facilities for tests. Another big announcement that offers some hope. Abbott Laboratories also got FDA clearance for a test that could deliver results in five minutes. So what's the story here and what is the planned rollout for this? 

Yeah, I mean, your guess is as good as mine. I think the information is not clear right now exactly where those tests are going to go. The federal government is going to determine where those tests go. And it seems right now like the highest places to be prioritized are going to be the hardest hit places.

I think The Washington Post reported that the Detroit area would be among the first to receive this testing platform. Detroit has been very hard hit by this. One of their officials in the article that I read noted that one of the main reasons they need these tests is to clear their first responders to go back to work. Their firefighters, their policemen, and their frontline nurses to go back to work. And also, they've just had so many deaths. It's very important for them to help understand what's going on in their communities so they can sort of strategize from a public health standpoint.

But there are other places that need these tests as well. And there are also places where we just don't really know what's happening. Rural places and places throughout the South where this has not been a whole lot of testing. It's just been a broad-based delay in this region. So there's some discussion at the federal level now whether to prioritize places that are highest hit or places where there is the least knowledge and least understanding of the epidemic's footprint. And also, there's a little tension in trying to sort that out right now.

Well, the public has been getting mixed messages, I think, about whether or not making testing as widespread as possible is the right strategy. There've been arguments from the Trump administration and we just heard from you that it takes resources away from the people who are the most sick. Well, we've also heard that this is one of the best preventative measures. So where are officials coming down on this now? 

It really depends on what resources are being used to deploy the testing. If you're having to take an entire division of a public health department and put them on the phone and doing a lot of analyses to help get testing deployed in places where there is a huge uproar, where there are a huge amount of cases like New York City, for example, the focus cannot be on doing something that does not somehow scale up the health care capacity because that's what they really need right now. They need beds in the hospital. They need people doing the work. They need ventilators, they need PPE. 

And taking away from that effort seems like the kind of doing something that's lower priority. So in that setting, it really doesn't make sense to focus on testing as much as it might in other settings where there's still a little bit of time. We still haven't hit that real peak and in peak acceleration and increases in 10 in cases. So it still might make sense in other places to focus on testing. But if that responsibility to get those tests deployed has shifted off of the shoulders of public health people and it becomes something that can be handled by health care providers themselves and by these public-private partnerships, rather than just resting on the shoulders of the people in public health who are doing the other important work of handling the outbreak and scaling up capacity to respond, then it's not a bad thing for us to think about scaling up testing. It also is going to play an important role in understanding how we can pull back on some of these social distancing restrictions that are of such concern to the health of our economy.

You know, we won't know when we can reopen business if we don't know how many people in our country have already been infected. We're seeing early signs from southeast Asia that it's sometimes a bumpy road when you reopen for business and reopen for travel after this epidemic seems to be contained. They're seeing some new cases related to some of those reopening of borders and businesses. So testing helps do that in a thoughtful way. 

Where should someone go if they want to be tested at this point as far as you know?

The answer is still to call your healthcare provider. They are still the ones who need to make the order in order for you to get the test. They may, depending on what your provider's policy is or their resources are, they may do the tests themselves or they may send you to a drive-thru center to do the test. Resources are different all over the state and the people who know what's going on best near you will be the health providers in your area.