PLATTSBURGH — North Country health and elected officials want to see more available COVID-19 testing and, just as important, quick turnaround of results to ensure they are useful in curbing spread.
“Obviously we want the test kits, but the second part of that is the tests have to be turned around much more quickly than they have been,” Clinton County Legislature Chair Mark Henry (R-Area 3) said.
“It is almost worthless to get a test and then have to wait a week for the results."
Though testing in the United States has evolved and is better off now than in March 2020, the country is neither where it could be nor where it should be compared to other nations, said Dr. Wouter Rietsema, an infectious disease specialist and vice president for population health and information services at University of Vermont Health Network, Champlain Valley Physicians Hospital.
“For better or for worse, we have not full-scale — at a national level or at a state level — invested in making testing widely available for anyone who needs it for any reason at any time," he added.
Rietsema described testing in the United States as a patchwork, even in the hospital. The Plattsburgh facility uses limited supplies of rapid PCR tests saved primarily for those who are admitted or a staff member with milder symptoms, and the "classic" PCR tests that go to a lab in Burlington whose result turnaround is about 24 hours.
"That’s not really desirable, that’s just because that’s what we can get our hands on," Rietsema said.
RAPID AT-HOME TESTS
Antigen tests, which detect proteins from the virus that causes COVID-19, have also been added to the mix since the start of the pandemic and constitute the approved rapid at-home tests currently available.
This week, in response to the omicron variant-fueled spike in cases, President Joe Biden announced the federal government would begin mailing out up to 500 million at-home tests to those who request them next month.
Gov. Kathy Hochul said 5 million at-home tests would be distributed in the state by Dec. 31: 2 million to school districts, 1 million to county managers, 1.6 million to New York City and 400,000 to state-run vaccination sites.
In total, the state has ordered 37 million, and plans to launch a portal through which residents can request the kits.
Clinton County Health Department Director of Health Care Services Debra Tackett said state resources will be allocated to counties based on size and need. Henry confirmed Clinton County has received a pallet of these tests, which are to be used primarily for schools, but did not know the exact quantity.
LAYER OF PROTECTION
According to Rietsema, the value of rapid at-home tests is limited. Those who are sick and test positive with one of those kits most likely have COVID, he said, but for those who are symptomatic and test negative still have about a 10% to 15% of being infected.
CCHD Principal Public Health Educator Molly Flynn noted that those who test positive with an at-home test, or who are symptomatic but test negative, should contact their medical providers for confirmatory lab testing.
Rietsema added that the tests' accuracy is middling among the asymptomatic.
Though these tests by themselves are not enough, they present another layer of protection, he explained.
“The best layer is vaccination, the next best layer is masking, then we have public health layers of isolation and quarantine, and then we have testing."
State Assemblymember D. Billy Jones (D-Chateaugay Lake) said he and other officials want to see more mass state-run testing sites set up in the North Country, including the return of the one formerly funded by the state and staffed by CVPH at the hospital's Wellness Center on New York Road.
He also stressed the need for timely results, in the 24- to 48-hour range.
“Here we are almost two years into this. We should have proper, appropriate, timely testing for every American."
State Sen. Dan Stec (R-Queensbury) similarly said the supply of both tests and vaccines should have been figured out by now, and that a cold weather spike was anticipated.
"We should not be surprised about that and we should have been prepared for it," he said.
“The government’s responsibility is to make this stuff widely accessible, easily accessible," Stec added, acknowledging that the state is not the entity manufacturing supplies. "You can’t tell people to get tested, get vaccinated and not have materials available.”
Rietsema does not believe the Wellness Center site will be stood up again. He said he has heard about another state-run site where result turnaround is four to five days, which he described as "useless."
“If we got an invite to set up a testing site, I think we would push back hard and say, ‘If you’re going to set up a testing site that has a five-day turnaround, it is not worth our time and effort.'
“I’d rather have a lot more of those at-home tests, frankly.”
Overall, Rietsema is frustrated with the challenges seen by rural areas compared with urban centers, where any limited resources tend to be concentrated as they can reach more people.
“And I think you’re hearing more and more of that in the media that rural America is suffering a lot more through this pandemic in many cases, in part due to testing, in part due to just lack of health care infrastructure and then, of course, due to the fact that vaccination rates are often less in rural America.”
Rietsema pointed to how other countries, such as in Europe, have national testing programs that they have invested a lot of money in to ensure timely results.
Based on how well vaccine development and deployment went, he believes the United States could have done the same, but government leaders have been resistant to it in the interest of protecting the economy.
"I think once we got to that point, then developing a national testing program was always going to be difficult,” Rietsema said.
He does not foresee the United States' testing infrastructure stepping up.
“We’re going to muddle through,” he said, disappointed.
The area is in for a rough January, with a fairly explosive number of cases, Rietsema said. Last winter's highest spikes occurred in January following the December holidays.
Even if omicron makes people less sick, as early data seems to suggest, a higher number of infections would offset hoped-for relief for the hospital.
“If it’s half as likely to hospitalize you, but we get more than double the cases, then our hospital still gets the same number of people,” Rietsema said.
That’s compounded by breakthrough cases among the vaccinated and hospital staffing struggles across the country, which in turn affect available services.
Rietsema reiterated his push for people to get vaccinated. Henry and Jones concurred.
"It works, it’s effective and it’s the tool we have against COVID," Jones said.
“Get a booster, wear a mask," Henry said. "Everybody knows by now what they need to do. I would encourage them to be particularly vigilant over the holidays.”
Information on where to get vaccinated is listed on page A8.
Go to tinyurl.com/uaa2tmcc to find a testing site near you anywhere in New York State.
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