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5 Tips to Maximize COVID-19 Testing and Reopen with Confidence

Hint: Don’t wait for an outbreak to begin testing.

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As schools, office buildings and tourist destinations open their doors once again, leaders continue to look for guidance on how to do so as safely as possible, for as long as possible and with as little threat of transmission as possible.

RAPID TESTING CAN HELP.

Over the last few months, NIC has been working with our partners, Impact Health and Next Marketing, on a turnkey, rapid COVID-19 testing solution, TourHealth.

Florida engaged TourHealth with great success, testing more than 90,000 people in eight weeks – and delivering most results within hours through an easy-to-use mobile app.

In addition, the University of Mississippi in Oxford turned to TourHealth to test asymptomatic student, faculty and staff, as well as the state of South Carolina and the Alabama Department of Corrections.

As you make important health decisions regarding easing COVID-19 restrictions for your community, it may helpful to remember these five tips to maximize COVID-19 testing so you can reopen with confidence.

1) UNDERSTAND THE TESTING OPTIONS.

While some leaders are using mass temperature checks and daily self-monitoring to screen for common COVID-19 symptoms, others are taking a more progressive route with diagnostic tests for the virus. There are two leading tests for diagnosing COVID-19:

  • Molecular (PCR): The PCR test identifies an active infection by searching for the virus’s unique gene sequences through a nasal or mouth swab. The samples are then sent to a lab with results returned in approximately 48 hours. These tests are the most widely available.
  • Antigen tests identify an active infection by detecting specific proteins on the surface of the virus and use a nasal swab sample. Results can be obtained in as quickly as 15 minutes. In addition to the quick turnaround, a big selling point for these tests is that they can be processed onsite at the point of care. Antigen tests are critical in helping leaders understand the current COVID-19 situation in real time. These COVID-19 tests are in extremely high demand right now across communities, government facilities, college campuses, as well as nursing homes.
New testing solutions are being developed rapidly. Saliva testing was recently approved by the FDA and can be self-administered with results being ready within three hours. Some organizations have identified the need for home testing solutions, and saliva testing would make home tests more attainable.

“Determining the type of test isn’t a one-time or one-size-fits-all answer,” said Dr. Benjamin Gerson, Medical Director for Impact Health. “What we know about COVID-19 and testing is evolving, so we urge leaders to continuously research testing options and trends. For example, a major trend we see right now is advances in saliva/oral fluid testing. Look for more availability in upcoming months. Anticipate also increased interest in and availability of testing for antibodies.”

As Dr. Gerson mentioned, antibody tests are also increasingly popular for their ability to detect if someone has been infected by coronavirus in the past by measuring antibody levels to the virus in the blood. The tests are delivered by a finger stick or blood draw and may turn around results that same day or within three days. Antibody tests do not diagnose active coronavirus infection at the time of the test or show that an individual does not currently have a COVID-19 infection.

In Florida and Mississippi, TourHealth is using the rapid antigen test to turn around same-day results. Ninety-five percent of those tested receive their results within two hours. Providing results quickly has been critical for Florida, specifically, where coronavirus cases spiked due to tourism over the summer. In just 45 days, TourHealth tested 80,000 people in Florida alone.

TourHealth COVID-19 will begin soon in the Myrtle Beach area of South Carolina with three locations using the PCR swab test, the same test being used in Alabama where TourHealth is administering 26,600 PCR tests in 33 locations over 41 testing dates. In all deployments, TourHealth is providing intuitive, consumer engagement solutions to assess, schedule, and deliver results.

TourHealth has access to all diagnostic tests for COVID-19 and can customize a program to meet the needs of all communities.

2) BE PROACTIVE ABOUT TESTING.

In a recent interview with NPR, Dr. Ashish Jha, dean of the Brown School of Public Health, recommends communities start widespread screening of the highest-risk people … before they show symptoms of COVID-19.

"It is a paradigm shift," Jha told NPR. "What I think new testing capacity allows us to do is actually play offense — go and hunt for the disease before it spreads to identify asymptomatic people before they spread it to others. It really becomes about preventing outbreaks — not just capturing them after they've occurred.”

That’s the goal at the University of Mississippi, where testing for asymptomatic students, faculty and staff began in early September.

The university’s Sentinel Testing Program, in partnership with TourHealth, is designed to provide university officials with a better understanding of the virus’s presence in asymptomatic carriers and how it spreads on campus.

Each week, a random sampling of students, faculty and staff are invited to take a free asymptomatic coronavirus test. The results are usually delivered in within hours through the Gov2Go app and help officials to adjust protocols while identifying asymptomatic carriers who may have otherwise spread the virus through the university community.

3) TEST RESULTS MARK ONLY A PLACE IN TIME. PLAN FOR REPEATED TESTING.

When bringing large groups together regularly, it is important to determine a COVID-19 testing cadence. Results are only representative of the place in time when the test occurred. As we have seen recently in several outbreaks, there is no guarantee that one will not contract COVID-19 once receiving a negative test, so it’s important that everyone still practice the CDC recommended guidelines for hand washing, sanitizing and wearing masks.

The cadence of testing is an important decision that leaders need to make based on the local risk of community spread and area demographics. While weekly or bi-weekly testing might be enough for those in low risk areas who can generally maintain social distance; more frequent COVID-19 testing might be required for areas in higher-risk scenarios.

At the same time, when a test is administered does make a difference when it comes to COVID-19. Someone can test negative one day and positive the next without additional known exposure to the virus.

To help ensure accurate results, testing labs must be certified by the Clinical Laboratory Improvement Amendments of 1988 (CLIA).

However, no laboratory test is perfect, said Dr. Gerson. False negatives and false positives don’t necessary indicate that there was an error. Something called Bayesian Statistics influences how a laboratory test will perform. Regular repeat testing helps address the problem of false results.

TourHealth provides onsite COVID-19 testing that can be customized to fit a community’s needs. Testing sites can be can set up for short-term, one-time tests for events, or even long-term repetitive testing for universities, government facilities and workplaces.

At the University of Mississippi, we’re offering testing two days a week through the end of November. In Florida, we are well into our second month of testing five to seven days a week, testing more than 90,000 people.

4) LOGISTICS WILL BE COMPLEX. CATER TO YOUR POPULATION.

Reopening takes planning. Look at the demographic you are serving. Is it an area with higher rates of tourism or younger people? Then antigen COVID-19 test sites that use an app to locate testing locations, schedule appointments and deliver results might be the best solution. For example, South Florida is a popular tourism spot with a lot of people on-the-go. TourHealth uses Gov2Go technology to test thousands of people each day across the country.

Parts of South Florida also have an increased elderly population, which means quick test results are critical, but using an app or online technology isn’t always the best way to communicate with this demographic. TourHealth also made sure written instructions and a support phone number with live English and Spanish-speaking agents were provided at all test sites for those who would prefer a more personal testing experience.

Communities need to be flexible, leveraging both technology and more traditional forms of customer service, in order to help engage and communicate with various populations.

5) DOCUMENTATION AND REPORTING ARE CRITICAL.

Another procedural consideration is appropriately documenting COVID-19 test results for community members and providing reports to governing health departments.

Many individuals are required to provide documentation of a negative COVID-19 test before returning to work or school, so it’s important that test vendors are able to quickly provide proof of test results in writing either via email or in another user-friendly format. TourHealth provides results in two ways, via email and the secure Gov2Go platform.

All testing operations are typically required be licensed by multiple oversight agencies to ensure that the verified reports are delivered to the appropriate governing bodies. TourHealth streamlines reporting by integrating results with government reporting requirements to ensure compliance and quality assurance.

WHAT’S NEXT?

While testing for COVID-19 is a top concern right now, communities also need to prepare for flu season. There’s a strong possibility that individuals will need to be tested for both COVID-19 and influenza. Fortunately, there is a test that can do both, simultaneously detecting COVID-19, influenza A/B and respiratory syncytial virus (RSV). The single-panel test, which detects multiple types of infections, can help doctors diagnose patients and make decisions about treatment options.

At the same time, communities may need to roll out large-scale solutions for administering the flu vaccine and, hopefully someday soon, a coronavirus vaccine.

TourHealth can do all the above.

IN CONCLUSION

Leaders are under extreme pressure to reopen and do so safely. With some many factors to consider, having a trusted testing partner is extremely important.

TourHealth is a COVID-19 testing solution created in partnership with NIC, Inc., Impact Health and Next Marketing. It leverages 80 years of combined experience and bringing together industry leaders in digital solutions, health care and logistics. Featuring online engagement, assessment and scheduling, as well as in-person clinical testing and logistics, TourHealth is a comprehensive and scalable COVID-19 testing solution that offers rapid results. Learn more at www.TourHealth.com.

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Doug Rogers is the senior vice president of strategic initiatives at NIC Inc., a leading digital government solutions and payments company, serving more than 7,000 federal, state and local government agencies across the nation. Learn more about NIC at www.egov.com.

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Recently acquired by Tyler Technologies, NIC is a leader in digital government solutions and payments, partnering with government to deliver user-friendly digital services that make it easier and more efficient to interact with government. NIC and Tyler are united in their mission to empower public sector entities to operate more efficiently and connect more transparently with their constituents and with each other. Tyler has more than 27,000 successful installations across more than 11,000 sites, with clients in all 50 states, Canada, the Caribbean, Australia, and other international locations.