States struggle to meet COVID-19 testing targets while private institutions make testing easy

by Chris Butler

The week before Thanksgiving, Boston resident Michelle Monti, 24, was hoping to get tested for COVID-19 before she would head to her parents house to celebrate the holiday. She found a testing site in Framingham, where she and her boyfriend waited in a line of cars for three hours before pulling up to the window to receive their tests.

“In Framingham, the line went to the exit of the highway,” she said.

Many times during their wait, the couple contemplated turning around and going home. But they ultimately decided to wait it out. Luckily, after paying a small fee and waiting two days, Monti’s test came back negative and she was able to spend time with her family.

Monti’s experience reflects an issue seen across the nation: COVID-19 tests are becoming harder and harder to find. COVID tests have become a limited resource that many communities are struggling to access. While some populations have the luxury to get tested on a regular basis, most Americans have to spend hours waiting in line and are sometimes turned away.

Despite Monti’s tedious testing experience, Massachusetts has been one of the most efficient states when it comes to COVID-19 testing protocols, providing just over 1,000 tests for every 100,000 state residents. The state has reached 159 percent of its COVID-19 testing target set by health experts. Many other states, however, are well below their recommended targets.

Harvard Global Health Institute has worked to create these suggested COVID-19 testing targets for each state, which is based on a variety of factors including population size and infection rates. According to data from the COVID tracking project, 37 states are performing well below these set targets.

Data from https://www.nytimes.com/interactive/2020/us/coronavirus-testing.html

South Dakota for example, has only reached 8 percent of its target, testing only 251 residents for every 100,000. Iowa has reached 10 percent of its target, testing 146 residents per 100,000.

Even though the country as a whole has ramped up its testing capacity, the majority of states are underperforming and struggling to keep up with the influx of rising cases. Since cases are on the incline, the demand for testing has increased and labs are overwhelmed, leading to a backlog of test results and a shortage of testing supplies.

Data from https://www.nytimes.com/interactive/2020/us/coronavirus-testing.html

Many of the states that are the furthest from their targets also see a high percentage of positive cases. South Dakota, the state furthest from its target, also has the highest percentage of positive cases at 45 percent. While these states struggle to keep up with testing guidelines, many testing sites only take in residents who are showing symptoms or who can prove they have been exposed to the virus, meaning many residents are turned away.

Cases are projected to skyrocket following Thanksgiving weekend when many Americans traveled out-of-state to celebrate with their families. As many states combat their limited testing capabilities, a larger spike in cases may complicate those efforts.

How states are spending their relief funding

In March, the government passed the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act, which provided $2.2. Trillion in funding to help combat the virus. $150 billion was delegated directly to state governments depending on each state’s needs, with a minimum of $1.25 billion per state. How the state spends the money is entirely up to that state’s government.

While a portion of the funding in many states went toward COVID-19 testing, some went toward other initiatives, like providing reliable Wifi in schools or aiding small businesses.

The majority of states have less than half of their funding, even though the spending deadline is December 31. Alabama, for example, was granted $1.7 billion and still had $900 million to spend as of November. The state’s government spent $6 million on testing. Before the state can officially delegate the funding to provide resources, it must get approval from the Department of the Treasury, slowing the process down.

Many of the states that are well below their testing targets have also spent the smallest amount of their delegated funding. Data from August presented by the COVID Money Tracking project showed that only 25 percent of the total fund across America had been spent as of August — five months after the CARES Act was passed.

Seven of the 10 states furthest from their testing targets spent less than 10 percent of their funding as of August, showing a connection between the amount of funding spent and the state’s testing capacity. While these states hold onto the money, testing sites are struggling. Kansas, which now meets just 13 percent of its target, had spent only 1.5 percent of its funding by August. South Dakota, meeting only 8 percent of its target, had only spent 6 percent of its funding.

Conversely, California spent 74.5 percent of its funding by August: the most of any state. Now, California is getting closer to reaching their testing target, currently meeting 84 percent of it.

Private institutions juxtapose public testing sites

While Monti and many other Americans wait in hour-long lines to get tested, college students and staff can get tested on a regular basis. Steven Perzigian is a fourth-year student at Northeastern University, where students and staff on campus are required to get tested every three days. The school has their own campus testing site.

“It’s pretty seamless,” Perzigian said. “I don’t think I’ve been there where there’s any delays.”

Perzigian said the whole process takes no more than five minutes. But it’s a different story for his family in his hometown of Pearl River, New York.

“My family members have gotten the test, but back home it’s a bit tougher,” he said. “You actually got to go find a place.”

Northeastern’s testing policy mirrors what many other colleges across Boston and across the country are doing. Private institutions, like universities, are able to partner with private laboratories to bypass the state’s tedious testing process.

The Broad Institute has processed over 1 million COVID-19 tests since March. The company, who processes a portion of Northeastern’s tests, began working with many universities across New England in May to test their students and faculty. They have now completed over 400,000 tests for these universities, charging the school $25 a test.

According to Northeastern’s COVID-19 dashboard, the school has completed roughly 475,000 tests since the start of the school year. Testing anywhere from 1,500 to 7,000 people per day, the school spends roughly $50,000 on tests processed by The Broad Institute in a single day. Northeastern has reportedly spent a total of $50 million on COVID-19-related expenses for this year.

Similarly, Emerson College has spent an estimated $1 million to $2 million on COVID-19 testing for the fall semester, according to reporting from The Berkeley Beacon.

Universities, like those who partner with The Broad Institute, are able to use their own funding to privately test their own communities, while state governments can only pull from the federal funding delegated to them. This difference enables a large disparity between how easily the testing process is for college students like Perzigian compared to the general public.

Data from October showed the disparity between testing within Boston universities and their surrounding neighborhoods. Even though the populations of the neighboring communities were significantly higher than the school’s population, the schools provided a higher amount of tests than the public testing sites could provide.

Testing has become an integral part of combating the pandemic. But while the majority of states struggle to keep up with their testing targets, local governments have refrained from spending their delegated COVID-19 relief fund — causing longer wait times and limited access to tests. Meanwhile, private institutions are able to fund their own COVID-19 expenses and provide their communities with reliable testing.

Luckily, The Broad Institute also provides tests for the communities surrounding Boston in addition to the tests they process for universities. Institutions can aid state governments by working with them to get adequate testing to their residents — something the public will need even more as cases are bound to increase nation-wide.