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Has Minnesota Figured Out Coronavirus Testing?

Has One State Figured Out Coronavirus Testing?

(Bloomberg Opinion) -- Last week, Vice President Mike Pence had an appointment at the Mayo Clinic to learn about how Minnesota plans to test 20,000 people per day for the coronavirus. Unfortunately, Pence's decision to decline a facemask while there overshadowed his purpose in dropping by one of the world's premier facilities for diagnosing illnesses — and some of the important lessons his visit should’ve highlighted.

After lagging other states in screening for the coronavirus, Minnesota is now leveraging Mayo's expertise to create a testing system that should help the state reopen its economy safely. In important respects, Minnesota is building precisely the model that the President Donald Trump’s administration envisages for other states.

When I visited Rochester a few days after Pence, my host was Dr. William Morice, a hematologist and president of the Mayo Clinic Laboratories. He started out by giving me a tour of the lab's loading docks, which receive 40,000 patient specimens each day from around the world via FedEx. Last year, the lab performed 25 million tests for more than 4 million patients, and generally reported results within 24 hours.

Diagnostic and logistical expertise of that kind "go together," Morice told me as we walked past a conveyor belt from which robotic arms were plucking patient specimens. And that combination is precisely what public-health experts are trying to replicate as states reopen their economies.

So far, it hasn't been easy. Shortages of critical materials, including nasal swabs and reagents, have led many states to limit testing to symptomatic patients and frontline workers. Meanwhile, some hospitals and health systems have contracts with testing labs that may not have sufficient capacity. Even when clinicians are able to reach outside their networks, they often struggle to provide patient information and samples to other labs and rarely receive prompt results.

This has led to some dismal consequences. In mid-March, Mayo had the capacity to process as many as 4,000 Covid-19 tests per day; a month later, Minnesota had a total capacity of around 8,000 per day. But on April 1, the Minnesota Department of Health's own lab reported just 176 tests completed, and external labs reported 1,235. Three weeks later, the numbers were worse: MDH reported 124 completed tests, and external labs 723.

Since then, however, the state has turned things around dramatically. On April 22, Governor Tim Walz announced a "moonshot" $36 million initiative to expand testing in partnership with Mayo and the University of Minnesota. The program will offer testing to anyone who is symptomatic, as well as to vulnerable populations in senior homes, prisons and tribal reservations. A virtual command center has been established to centralize the flow of critical materials in and out of labs. Where appropriate facilities don't exist — say, on reservations — the university will turn to its statewide network to get qualified personnel to meet the need. And as private and public institutions expand capacity, the state has guaranteed that it will provide the volume of testing to match, with an eventual goal of 20,000 a day.

Morice tells me that Mayo is ramping up not only for Minnesota, but to meet expanding demand from elsewhere. For now, few states have institutions with the diagnostic and logistical expertise of a Mayo Clinic, or a civic culture that enables public-private initiatives like Minnesota's. But even if they did, devices that run thousands of tests per day are relatively rare — Morice says it takes about four months to build one — and can require months of training for experienced lab technicians.

For Minnesota, at least, the prognosis is good. The state hopes to be processing 5,000 tests a day by the end of this week, and it's beginning to work with local governments to expand contact tracing. Once virus screening has been established, Minnesota's program will support serological antibody testing to gauge just how many people have already been infected with Covid-19 and — if safe — get them back to work. The partnership also plans to support longer-term research into therapeutics and new testing technologies.

That last phase may end up being the most consequential for states that lack Minnesota’s natural advantages. Some public-health experts argue that the U.S. will need to process as many as 30 million tests per day to safely reopen the economy. Doing so will require the development of new, more efficient technologies beyond what's available at Mayo, as well as better therapeutics. In the meantime, states could do worse than to try to emulate Minnesota’s modest but hopeful experiment.

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

Adam Minter is a Bloomberg Opinion columnist. He is the author of “Junkyard Planet: Travels in the Billion-Dollar Trash Trade” and "Secondhand: Travels in the New Global Garage Sale."

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