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As national experts sound the alarm that the nation needs to dramatically increase coronavirus testing, Pennsylvania officials said Friday that they will aim to conduct a modest 8,500 tests per day as they begin loosening restrictions across large swathes of the state.
The Department of Health’s plan sets a target for testing 2% of Pennsylvania’s population — or 256,000 people — each month. Health Secretary Rachel Levine said the state will continue to restrict testing to only those people who are showing coronavirus symptoms.
“We will continually remain flexible in our testing strategy as the disease changes and progresses,” Levine said during a news briefing.
Krys Johnson, assistant professor of epidemiology and biostatistics at Temple University, said she was disappointed by the administration’s goal.
“I was really hoping to see something more aspirational,” Johnson said. “Not something that we have previously achieved.”
The Wolf administration’s daily testing target is about 2,000 more than the roughly 6,000 tests currently being conducted each day in Pennsylvania. But it’s only about 500 tests more than the state’s peak of 7,915 new tests reported April 4. Also, it’s significantly less than benchmarks proposed by most national researchers who say that dramatically expanded testing and contact tracing is needed to prevent future coronavirus outbreaks.
Researchers at Harvard University, for instance, have proposed that the nation should be conducting a daily minimum of 152 tests per 100,000 people. That works out as about 19,000 Pennsylvanians per day — or more than twice the rate of the Wolf administration’s plan.
Because so many people can be infected with the virus without showing symptoms, Johnson said, it’s impossible to fully gauge its spread without broader testing.
The Wolf administration’s new goal is also not enough to greatly expand testing for particularly vulnerable populations, such as all inmates and correctional officers in the state prison system, a step recently announced in New Jersey. Despite a large number of cases and deaths, Pennsylvania is also not planning to enhance testing for residents and staff at nursing homes, a step recently taken in Maryland.
Overall, the state’s current testing capacity remains difficult to gauge.
Robert Shipp, vice president of quality and population health for the Hospital and Healthsystem Association of Pennsylvania, said that while some hospital systems need more testing kits, many now have enough supplies to test all patients who have symptoms.
Shipp said while it might be intuitive to assume that shortages are most pronounced in areas like Philadelphia, where coronavirus rates have been highest, that wasn’t necessarily the case.
“From what I’m hearing and what we have gathered in speaking with hospitals, it’s not any one specific area,” Shipp said. “I think there’s a lot of variability.”
Based on interviews with hospital system officials over the past week, Spotlight PA found a number of them are testing at only about 30% to 50% of their overall per day capacity. Many said they weren’t testing asymptomatic cases.
The Allegheny Health Network, which has 12 hospitals in western Pennsylvania, said last week it had the capacity to test about 1,000 patients per day but was only testing about 300.
Dr. Brian Parker, chief quality and learning officer, said that the system was following guidelines from the Centers for Disease Control and Prevention, and only testing patients with coronavirus-like symptoms.
As of Tuesday, he said, he saw no immediate need to expand testing to asymptomatic patients.
“Based on what we are seeing in the western PA region relative to COVID incidence, we believe there is no reason to move beyond what we are doing at this time,” Parker wrote in an email.
Penn Medicine, the University of Pennsylvania’s health system, which has five hospitals across eastern Pennsylvania, told Spotlight PA last week it had the capacity to administer and analyze 1,500 tests per day but was performing only about 700 to 800 tests per day.
Like other systems, Penn Medicine has primarily been testing patients with coronavirus symptoms. But Mike Feldman, professor and vice chair of pathology for the University of Pennsylvania, said the system was beginning to test asymptomatic patients, like those coming in for hospital procedures.
“We have enough capacity on test kits and swabs and will be using 100% of our capacity in short order,” Feldman said in an email.
Geisinger Health, which largely serves central Pennsylvania, said it is has the capacity to test roughly 700 patients per day but is only testing roughly 300 per day because, like other systems, it’s only testing symptomatic patients
Donna Wolk, the system’s director of clinical and molecular microbiology, said the system was both trying to adhere to CDC guidelines about testing and, more generally, to not overuse testing supplies at a time when they’re scarce nationally.
“Even though we can test more, we understand there are facilities that may have a need so we are not indiscriminately testing,” Wolk said.
But some researchers say that health systems should be wary of following the CDC’s guidelines too rigidly and should consider expanding testing — preferably in coordination with state governments.
Jen Kates, director of global health and HIV policy for the Kaiser Family Foundation, said the CDC has been woefully slow over the past three months in encouraging adequate testing. Even now, despite recent updates, Kates said the guidelines still appeared to be too strict given the number of researchers and public health officials who are encouraging broader testing.
“It’s not clear that the guidelines have caught up yet,” Kates said.
Johnson, the Temple University professor, said she agreed that the guidelines were too strict.
“I think agencies that have the capacity to test at a higher rate than they are should be more generous in conducting that testing,” she said.
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