MOUNT VERNON – Knox Public Health is planning to introduce community testing for COVID-19 in the coming weeks, Health Commissioner Julie Miller said Wednesday.
The initiative, currently in the planning stages, is the result of expanded testing capacity locally over the last two months. Knox Public Health has accumulated diagnostic tests from a variety of sources and is now considering how best to utilize them.
Community testing would allow Knox Public Health to gain a better sense of where the virus is hidden in Knox County, and how prevalent it is. As of Friday morning, Knox County had 23 confirmed cases, four probable cases and one death due to COVID-19.
“My hope… is to see what kind of more true numbers might we have,” Miller said. “Are we as fortunate as it appears? Or do we have hundreds with mild to no symptoms, and we just haven’t tested enough people [to find it yet]?”
Testing so far has been limited to patients who meet strict criteria, set forth by the Ohio Department of Health, given the lack of resources at the state and national level.
Only those deemed most at-risk have been tested locally. That list has included senior citizens; people who have been exposed to someone with COVID-19; people who have traveled abroad in recent months; healthcare officials; people with pre-existing health conditions; or people who have reported severe symptoms, such as coughing, a bad fever and shortness of breath.
Miller reported Wednesday that 318 specimen tests have been sent from Knox County since the pandemic began, and 268 have come back negative. Of the county’s 23 positive cases (three of which are still active), there have been 13 from Mount Vernon, five from Centerburg, three from Danville and two from Fredericktown.
Community testing has been sporadic throughout Ohio, as each community has dealt with different levels of testing capacity. Knox Public Health has collected diagnostic tests from various sources in recent weeks, with the goal of implementing community testing this summer.
The health department has received regular shipments of swab testing kits from the ODH since April 15, made possible through Ohio State University’s Wexner Medical Center. Each county has received shipments from the ODH based on hospital bed capacity, EMS personnel, long-term care bed capacity, law enforcement personnel and healthcare worker personnel, according to ODH spokesperson Melanie Amato. (Knox Public Health has reserved some of these tests for long-term care facilities and the county jail, Miller said, in case an outbreak occurs and mass testing is needed.)
The health department has also received testing kits from Knox Community Hospital, and has purchased its own tests as well. Miller did not know how many tests Knox Public Health has accumulated over the last several weeks.
What might community testing look like? Local health officials are currently considering several options.
The first, Miller said, would be to use a screening process to determine who gets tested. Knox Public Health published a Facebook post last Friday asking people to respond if they felt they needed a COVID-19 test. It asked whether people were experiencing symptoms (cough, shortness of breath or difficulty breathing, fever, chills, muscle pain, sore throat, new loss of taste or smell – or other less common symptoms including gastrointestinal symptoms like nausea, vomiting, or diarrhea), and if so, if they’d be willing to take a drive-thru test in Knox County.
As of Friday morning, nearly 300 people had responded to the post. Knox Public Health could then reach out to these individuals, Miller said, and further screen their symptoms (similar to the process taking place with the COVID-19 call line). Community members who meet the state’s testing criteria would then receive an appointment for drive-thru testing in Mount Vernon.
The other option, Miller said, would be to “open it up as a true community event,” which would allow community testing to occur on a first-come, first-serve basis. In this scenario, Knox Public Health would administer a set number of tests to community members, and there would be no screening process.
The first option would allow Knox Public Health to obtain quicker results, as pre-screened tests following the state’s criteria are sent to the Ohio Department of Health for a 24-hour turnaround. Tests that do not follow the state’s criteria must be sent to private labs, which traditionally have slower turnaround times. The ODH has implemented this protocol in order to speed up the process for patients who are deemed most at-risk.
The other aspect to consider in community testing, Miller said, is location. While she said she’d love to set up testing sites in “all four corners of the county,” along with Mount Vernon, doing so may not be feasible from a resource standpoint. Whenever a test comes back positive, Knox Public Health is charged with contact-tracing every individual that patient has come in close contact with since they began experiencing symptoms.
Although Knox Public Health has been training its employees to do contact tracing and has received a handful of volunteers in recent weeks, Miller said it would not have the manpower to handle hundreds of positive cases at once.
“Let’s say we do 100 tests in the city and we get 30 back positive – and this is hypothetical – we would have to contact-trace for those 30 individuals,” Miller said. “Do we want to put ourselves at risk of having to do a whole county, 150 or more at one time? No.”
This means Knox Public Health might consider starting with one community testing location in Mount Vernon, to serve as a gauge for how to handle the process moving forward.
Miller said Lisa Dudgeon, the health department’s nursing director, is heading up the community testing initiative and will offer updates on the planning process during next Wednesday's Facebook Live session. Miller expects community testing to begin in Knox County “the first week of June.”
Regardless of how the process unfolds, Miller said the health department aims to use community testing as a way to better understand where the virus is hidden in Knox County.
“We’re going to try to do as many tests as possible," she said.