COVID-19 infections ease, but they’re still too high

State health officials continue to urge more testing to understand how widespread the virus is

Wisconsin National Guard members collect COVID-19 testing specimens in July. (Wisconsin National Guard photo via Flickr)

Wisconsin’s rate for confirmed COVID-19 infections has maintained a steady pace over the last two weeks: an improvement over July, but not yet where state health officials want to see it.

Meanwhile, the number of people getting tested for the virus has continued to lag well behind the lab capacity that Wisconsin has to analyze tests.

“I think it’s very safe to say that we’re not doing enough tests,” Dr. Ryan Westergaard, chief medical officer in the state’s Bureau of Communicable Diseases, said at a media briefing on Thursday. “We can do more tests.”

Widespread testing is important for several reasons as health officials seek to understand just how the virus responsible for the COVID-19 pandemic is spreading.

On the one hand, if too few people are tested, the percentage of positive tests could end up being artificially high.  But there’s also the opposite risk: that the infection will get overlooked in many people.

The state Department of Health Services (DHS) wants people to get tested if they have symptoms of  COVID-19. But the agency is also adhering to recommendations that  people who have simply been exposed to someone with the illness also should get tested — whether they’ve got symptoms or not.

“The most recent estimate is that 40% of the cases of COVID-19 have no symptoms, and that about 50% of infections are likely the result of transmission from those asymptomatic people,” Westergaard told the Wisconsin Examiner. “So just testing symptomatic people is not going to detect and allow us to intervene in the ways we need to in order to prevent chains of transmission.”

On Thursday, DHS announced plans to expand access to a test registration app that people can use at free community testing sites around Wisconsin. The agency is rolling out a Spanish-language version of the app. A Hmong-language edition is next, and more languages are planned.

“It’s imperative that we all work together to box in the virus,” said DHS Secretary-designee Andrea Palm. “To do that, we need to continue to build our testing and tracing capacity, making sure everyone who needs a test can get one.

Weekly shifts in COVID-19 tests

The number of people getting COVID-19 tests in Wisconsin rose through July, but it's been falling since then.
Week EndingTotal Number of People Tested
July 4, 2020
100,875
July 11, 2020107,376

July 18, 2020135,432
July 25, 2020135,801
Aug. 1, 2020125,925
Aug. 8, 2020120,004
Aug. 15, 2020111,879
Aug. 22, 2020104,025
Aug. 29, 2020107,837

Declining tests

In July, over successive seven-day periods from Sunday to Saturday, the number of people getting COVID-19 tests rose each week. The week ending July 25 broke a record, with 135,801 people getting tested. Since then, however, the number of people getting tests has been falling, reaching a low of 104,025 for the week ending Aug. 22.

Last week, the number of people rose for the first time in more than a month. It’s not clear whether this week will maintain the pace, though.

While the number of COVID-19 cases confirmed each day varies widely, the 7-day average number, represented by the blue line, has been steady over the last two weeks. (Graphic courtesy of Wisconsin Department of Health Services)

Because the number of tests, and the number of positive tests, on any given day can fluctuate widely for reasons that have nothing to do with how prevalent the disease actually is,  public health analysts calculate each day’s average number and percentage of positive tests over the previous seven days.

“We typically ask people to look at the seven-day average in the number of new cases reported — and other summary measures — rather than focusing on just one day’s numbers to understand the full picture of COVID-19 in Wisconsin,” says Elizabeth Goodsitt, a DHS spokeswoman.

Over the last two weeks, the average percentage of confirmed COVID-19 cases has held fairly steady, at about 8%.

That’s something of a Good News, Bad News story.

The number of test results, and the percentage of positive tests, fluctuate widely from day to day. But a seven-day average of the percent positive cases (pale blue line) has hovered around 8% over the last two weeks. (Graphic courtesy of Wisconsin Department of Health Services)

The Good News is that overall, the average number of new infections per day has fallen over the last six weeks.

As of Thursday, “Our seven-day average of new confirmed cases is 674 — compared to a seven-day average of 930 new cases in late July,” said Palm. That, she told reporters, is evidence that the statewide mask requirement that took effect Aug. 1, as part of Gov. Tony Evers second executive order declaring a health emergency, is working.

“Since the face-covering order has been in place here in Wisconsin, we have seen a decrease in our COVID-19 case activity levels and in our daily trends,” Palm said.

The mask mandate is now the subject of a lawsuit claiming that Evers had no right to institute a second COVID-19 health emergency. On Thursday, the governor lumped the claim with previous actions by Republican legislators that blocked his last-minute effort to delay the April election as well as his Safer at Home order in May.

“Republicans have been dedicated to taking our efforts to keep people healthy and safe to court, and this one’s no different,” Evers said. “Public health should not be a partisan issue. Science should not be a partisan issue.”

A June 16 article in the journal Health Affairs further bolsters the case, Palm said. The study found that in 15 states and the District of Columbia that all imposed mask mandates anytime from early April to mid-May saw their daily growth rate of COVID-19 drop by up to 2 percentage points compared to the rest of the states that had no mandate.

The longer a mandate was in place, according to the University of Iowa researchers who conducted the study, the more effective it became.

That’s no reason for complacency, however, Palm warned — especially with the Labor Day weekend ahead. DHS has a web page to reinforce safe choices that people can make to avoid COVID-19 exposure.

“We’re moving in the right direction,” she said. But the coming three-day weekend, “it’s not the time to take our foot off the gas — gatherings can easily spread COVID-19.”

Continued community spread

The Bad News is that the state’s current rate of positive tests is still too high.

“We certainly want to see a percent-positive rate below 5%,” Palm said. “It is better, but a rate of 7 or 8% week over week certainly indicates to us that there is more community spread than we want to see.”

In its public presentation of data, DHS will start displaying  the age breakdown of COVID-19 cases more prominently.

“The highest number of confirmed cases are in the 18 to 34 year old age group,” Palm observed — over time since the pandemic started, as well as in the measure of new cases each week.

Wisconsin is not alone in its lower rate of testing. “We have seen nationally, not just here in Wisconsin, a reduction in the demand for testing over the last several weeks,” said Palm. “But we absolutely want to continue to encourage people who need tests to get tests. It is an important part of our strategy to stop the spread.”

In making sure that even asymptomatic people who have been exposed to someone with COVID-19 get tested, the state is taking a more aggressive approach than the Centers for Disease Control and Prevention (CDC). Last week — to the consternation of many public health officials around the country, the federal government relaxed its testing guidelines, suggesting that close contacts of people who are confirmed to have COVID-19 don’t necessarily need to be tested themselves.

Westergaard said that advice might be appropriate “if there’s a critical shortage of tests,” but in Wisconsin, there are “more than enough tests” to go around. 

“Our position in Wisconsin remains that all people with symptoms, and all people who have been in close contact with a [confirmed COVID-19] case, should get tested,” he said. “And we have at this time plenty of tests to do that.”

Erik Gunn
Senior Reporter Erik Gunn reports and writes on work and the economy, along with related subjects, for the Wisconsin Examiner. He spent 24 years as a freelance writer for Milwaukee Magazine, Isthmus, The Progressive, BNA Inc., and other publications, winning awards for investigative reporting, feature writing, beat coverage, business writing, and commentary. An East Coast native, he previously covered labor for The Milwaukee Journal after reporting for newspapers in upstate New York and northern Illinois. He's a graduate of Beloit College (English Comp.) and the Columbia School of Journalism. Off hours he is the Examiner's resident Springsteen and Jackson Browne fanboy and model railroad nerd.