Top GOP state lawmaker wants random sample testing for COVID-19. But NC is not there yet.
North Carolina health officials are not conducting random testing for the coronavirus, despite a push from one of the state’s top Republican lawmakers to provide policymakers with better tracking of the virus and more complete data on the outbreak.
Dr. Zack Moore, the state’s epidemiologist, outlined the state’s influenza surveillance network and how it was being updated to track COVID-19 to media in a conference call Monday.
The News & Observer and Charlotte Observer previously reported on the effort to use the influenza tracking system for the new disease. North Carolina has more than 1,300 lab-confirmed cases, a number that Moore said does not accurately capture the true number of infected people in the state.
“We know that there are limits in testing capacity,” he said.
Instead of containment efforts that can be done with extensive testing, state health officials and politicians have turned to mitigation efforts. Gov. Roy Cooper issued a statewide stay-at-home order that took effect Monday night and will last through the end of April.
Senate leader Phil Berger, a Republican, wants the state or academic partners to undertake random sample testing to get a better sense of the virus. Such testing would involve a sample of the state’s population to extrapolate the prevalence of the disease and the virus in the population.
“If the true data supports the most stringent measures, then presenting that data to the public will increase compliance and confidence in government. If the data does not provide such support, then easing of current restrictions will be possible to do safely,” Berger said in a statement last week. “We must immediately conduct random sample testing to know the answer.”
What the state does have right now is a surveillance system, a network of doctors and hospitals that report patients with flu-like symptoms and send samples to the state lab that has been in place for decades for influenza, which is tracked by age group and geography. It is being tweaked slightly to help track COVID-19, the disease caused by the coronavirus. The state’s Department of Health and Human Services added details about its network to its public-facing case count page Tuesday morning.
“This really is a new virus. There’s still a lot to be learned,” Moore said.
But he acknowledged that the system has limitations when it comes to tracing the full extent of the virus’ spread — including in people who show mild symptoms and don’t seek medical care and in those who are infected and show no symptoms.
That’s where random sample testing could be useful, especially for policymakers considering not only the health impacts but the economic impacts of statewide shutdowns of many businesses.
Unemployment claims in North Carolina soared last week.
But there are still severe projections about the potential loss of life.
Dr. Anthony Fauci, the nation’s leading infectious disease expert, estimated between 100,000 and 200,000 Americans could die as a result of the disease. A University of Washington study projected up to 2,400 deaths in North Carolina. President Donald Trump announced Sunday night that the federal government was extending its social distancing guidelines through the end of April.
Using up supplies
Moore said in an attempt to get a more complete picture, health officials are studying the outbreak in other countries and working on other types of research, including the possibility of random sample testing. It also includes phone and internet surveys to reach those not seeking medical care and, hopefully down the line, blood testing to find antibodies.
He said the state’s research community is gearing up to do work in those areas.
“It does need to be done in a scientifically appropriate way, so that we can take those results and understand what they mean from one group to a larger population,” Moore said. “I also think it’s important to recognize this is a not a one-and-done thing. If this is going to be undertaken, it has to be done repeatedly over time. We know things are changing so quickly that the proportion of people who might come up positive this week is not going to be at all the same as it’s going to be next week or the next week.”
There are also concerns about the number of tests, testing supplies and personal protective equipment for those conducting the tests. Current state guidelines say that those showing mild symptoms do not get tested unless they fit into a high-risk category.
“In order to get the right number of people and right frequency of tests we have to be thoughtful and responsible about how this is done, so that it gives us the right data, but doesn’t use up all the supplies and things that we’re concerned about,” he said.
More data released
The state is releasing more information, including the number of patients hospitalized with the disease and the age and gender of those who have died. Moore said health officials are considering sharing data on the number of patients using a ventilator and the state’s ventilator capacity.
State Sen. Andy Wells, a Republican from Catawba County, called for random sample testing early last week, too. Berger followed up, saying that “world-renowned scientists at Harvard and Stanford have been recommending this for some time.”
“Government leaders are making decisions without the benefit of relevant and obtainable data. Unfortunately, they don’t know how prevalent the virus is and has been in the population. Therefore, we do not have sufficient, reliable information to understand true hospitalization and fatality rates,” Berger said. “... We owe it to the hundreds of thousands of newly unemployed North Carolinians to check the math.”
This story was originally published March 31, 2020 at 3:01 PM with the headline "Top GOP state lawmaker wants random sample testing for COVID-19. But NC is not there yet.."
