The Wisconsin Department of Health Services (DHS) is ramping up a statewide sweep of nursing homes this month, aiming to test every longterm facility resident for the virus that causes COVID-19 by the end of May, officials said Monday.
Nursing homes, along with factories, especially meatpacking plants, as well as prisons and jails have been hotspots in the state and across the country for the virus.
“The story of the number of cases we’ve had in workplaces and nursing homes is very, very concerning,” said Dr. Ryan Westergaard, chief medical officer for the DHS Bureau of Communicable Diseases, speaking at a media briefing on the state’s COVID-19 fight on Monday. “It tells us that the virus spreads when people don’t do physical distancing.”
Of 187 COVID-19 outbreak investigations in Wisconsin, 93 — almost half — have been in longterm care facilities, according to DHS Secretary-designee Andrea Palm. Nursing home infections trigger an outbreak investigation even when there’s just a single positive test from a resident or a staff member in a facility, because of the risk for rapid spread, she added.
With that in mind, DHS has set a goal of testing about 10,000 nursing home residents and staff members a week in May, Palm said. The state has 373 nursing homes.
The fire isn’t put out yet
Local public health authorities, assisted by 25 Wisconsin National Guard units, are also carrying out testing for all employees and their families at workplaces in the state that have been the site of outbreaks, according to DHS.
“The signal that we’re getting now, two months into this, is that we’re still having outbreaks,” Westergaard said. “That’s because the virus is still here. The wildfire is smoldering.”
Caution is essential, he advised.
“What we need to be prepared to prevent is that, when more people come together and are not doing physical distancing, that it doesn’t flare up in a very large way, because that’s what the virus tends to do,” Westergaard said. “That’s what it’s going to do unless we are very careful with physical distancing, until we have a strategy to contain and know exactly where it is and put out those local fires.”
The outbreaks illustrate the danger of casually relaxing the rules aimed at avoiding close contact that can spread the illness.
“If people went back to normal and were in normal contact with each other that would happen at a scale much larger than it is now,” said Westergaard. “Right now it’s focused in places where people have to be in close proximity to each other.”
Drive-through testing ramping up
In addition, the state is setting up more pop-up, drive-through testing programs for people in communities where testing has been in short supply. Anyone with COVID-19 symptoms or “any symptom that could be suggestive of COVID-19” can and should seek a test, he said.
Sites announced Monday included ones established for residents of Milwaukee, Brown, Burnett, Barron and Polk counties, along with the St. Croix Chippewa Indian tribe
“We want every Wisconsin resident who needs a test to get a test,” emphasized Palm. While people are encouraged to ask their health care providers for COVID-19 tests, the drive-through sites do not require a doctor’s referral and provide tests free of charge, she added.
Gov. Tony Evers said the state is already “one of the top states” in the country with respect to COVID-19 testing capacity, with 51 labs around the state now able to provide up to 11,347 tests a day, “and our goal is to ensure that we are one of the top states in actual testing per-capita.”
As of mid-afternoon Monday, the total number of COVID-19 infections reported by DHS reached 8,236, with 340 deaths.
“We’re trying to use our public health strategies and testing widely, so we know the best way to contain [outbreaks] when these things flare up,” Westergaard said.
Palm told the Wisconsin Examiner that one reason access has been limited in rural parts of the state is that they haven’t had easy access to the laboratories equipped to conduct the testing. Drive-through sites have helped bring capacity to such areas.
In addition, she said, DHS has been working with local healthcare providers to “make a shift from a clinical, diagnostic mindset to a public-health mindset.” Clinicians value tests more when there are vaccines or treatments for a condition, Palm explained, but now increased testing is needed as a tool to help understand the spread and prevalence of the disease.
At the same time, Westergaard said, the testing capacity isn’t yet large enough to allow people with no symptoms to be tested unless they have been exposed to people with symptoms or those who have tested positive for COVID-19.
The role of antibody testing
Westergaard also said antibody testing doesn’t help for diagnosing people with active symptoms. Instead, it’s for assessing what percentage of the people have been infected in the past.
With COVID-19, it’s still not clear whether people who have had the illness and recovered have long-term immunity, so the significance of antibodies to the virus isn’t known. “You don’t want to assume people are safe when they’re not,” he said.
With the number of tests increasing, the state is also working to increase contact tracing — identifying everyone who has been exposed to someone with a confirmed infection, so they can take steps to isolate themselves and be monitored for the disease. Palm said DHS has hired 250 contact tracing employees so far, about 25% of its goal of 1,000, initially deploying them to follow up on workplace and nursing home outbreaks.
A major need that the state still has is for more personal protective equipment (PPE) to be used by healthcare workers, said Palm. Evers renewed his call for federal help in obtaining PPE.
In the meantime, Evers said, the state has gotten access to technological solutions to sterilize used N-95 masks so they can be returned to their users and safely worn again. One such service has been established in Madison through the help of the Federal Emergency Management Agency (FEMA), and an ultraviolet decontamination unit has been deployed in Sawyer County capable of decontaminating more than 45,000 respirators a month, according to state officials.