Ashley Ausman of the DPHHS State Public Health Laboratory prepares samples for RNA extraction to conduct COVID-19 testing.

By Eric Dietrich, Montana Free Press, and Katheryn Houghton, Bozeman Daily Chronicle 3 mins ago

As Gov. Steve Bullock moves to roll back emergency measures enacted to slow the COVID-19 pandemic, he has said he’ll take a data-driven approach to reopening Montana’s economy  while minimizing the risk of a second-surge outbreak. 

State officials are keeping a close eye on the number of laboratory-confirmed cases. However, they aren’t tracking the number of Montanans who’ve been tested in each county, a metric national experts say is important to fully understand how the outbreak is playing out in different parts of the state.  

Testing has been in short supply across the country. Counting methods vary, but the U.S. has tested 4.6 million people, or roughly 1.4 percent of the population, according to data from Johns Hopkins University & Medicine’s Coronavirus Research Center. Montana has tested 11,875, or 1.1% of its population.

While some local health departments can provide figures on the number of tests conducted in their jurisdictions, those numbers are often imperfect. 

Since there’s currently no vaccine for the disease, public health experts say testing for COVID-19 doesn’t change how patients are treated. Testing does show how much of a presence the virus has in specific locations, which is a primary factor employed by elected officials, health experts and the public in determining how quickly to scale back social distancing and closure measures.

 

Two Bozeman Health employees help a patient learn how to self-sample at a drive-through COVID-19 testing site Thursday, April 23, 2020, in Bozeman.

Jon Ebelt, a spokesperson for the state Department of Public Health and Human Services, said the state has what it needs to understand how the virus is spreading in Montana communities.

 

“We receive every piece of data we need from counties,” Ebelt said.

Bullock unveiled a plan Wednesday to reopen Montana’s economy, citing the state’s comparatively low COVID-19 case counts and apparent success at flattening the outbreak’s curve. The plan involves three phases of easing social distancing directives, and lets local governments adopt more stringent rules at their discretion. As he monitors the reopening, Bullock said, he is considering the number of confirmed cases, including how many are new each week, as well as hospitalization numbers, testing capacity and supplies of protective equipment.

“Decisions are going to be driven by the ongoing data and the science, not politics,” Bullock said at an April 14 press briefing. 

However, health experts say county-level testing counts are valuable data. Aaron Katz, a health policy professor with the University of Washington School of Public Health, said without knowing how many people have been tested in each county, officials can’t see shortfalls in testing from one place to the next. Without that, it’s difficult to chart the state’s rate of infection over time.

“I don’t believe they should be promoting that they have zero positive cases in our county. It’s just that they haven’t been testing people.”

—Karen Swigart, Miles City

“When you don’t know that, it’s really hard to make a good judgment of when to loosen up controls,” Katz said. 

In an effort to assess what information is available on local COVID-19 testing, journalists with Montana Public Radio, Yellowstone Public Radio, the Bozeman Daily Chronicle, Lee Newspapers and Montana Free Press teamed up to ask the local health officials serving each of Montana’s 56 counties how many of their residents had been tested for COVID-19 as of April 8.

After two weeks of follow-up calls and emails, we heard back from 53 counties, with 43 providing a figure for how many tests had been conducted on their residents either as of April 8 or by the date they responded. The responses indicate there has been wide variation in how many COVID-19 tests have been conducted in different parts of Montana, from upwards of 1,000 tests in some urban counties to fewer than 10 — or none at all — in some rural counties. 

Those figures, however, come with significant caveats.

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While most local health departments provided figures on the number of tests conducted on their residents, many cautioned that their figures were imprecise. 

The state’s disease monitoring system, designed to identify and contain contagious outbreaks, is focused on tracking positive cases. Negative test results are a second-tier priority, meaning they’re not always reported to local health departments.