Montgomery County is working on significantly expanding its testing capacity to provide more than 2,000 tests a day through a new partnership.
Dr. Travis Gayles, the county’s health officer, told the Montgomery County Council on Thursday that the health department expects to announce details about the increased testing capacity soon, which will add to a “buffet of testing options” the department is pulling together.
He said the county would “launch it shortly.” Gayles did not give any other details, including who the partner is and whether it is currently doing any testing.
Dr. Earl Stoddard, executive director of the county’s Office of Emergency Management and Homeland Security, said the contract, which is being finalized, would allow for more than 2,000 tests to be administered a day in several additional testing sites. He did not name the sites.
“That will be a game changer and be able to expand the scope of test availability,” Gayles said. “I want to say we are able to move on these partnerships because we are working and taking advantage of the expertise locally. We’ve been able to identify some companies to help move through the process in terms of their capacity. It’s an example of the richness of the resources that we do have locally.”
Stoddard said the new tests will not be collected with a nasal swab, which requires certain expertise, time, and personal protective equipment.
“We are looking at how we can leverage simpler test collection kits, particularly self-collection kits that would make the test process a lot simpler, easier, faster,” Gayles said.
Mary Anderson, a spokeswoman for the county’s health department, told Bethesda Beat she would look into which company would be helping to expand testing, but had not responded by Thursday evening.
County officials have looked at several potential testing sites and plan to visit them soon, Stoddard said.
The county is currently testing by appointment only at the Wheaton Library and Community Recreation Center and the Upcounty Regional Services Center in Germantown. It is also providing appointment-only, drive-thru testing with the state at the Vehicle Emissions Inspection Program site in White Oak.
The three testing sites can provide about 500 tests a week.
Gayles said the new tests will allow the county to administer tests to all employees and residents of nursing homes and senior living facilities, something Gov. Larry Hogan has ordered statewide.
It will also expand testing with group homes and vulnerable communities.
The state’s goal is for 2% of its residents to be tested before loosening social distancing restrictions. Gayles said 2.3% of the county’s population has been tested so far.
“It’s not high enough for me,” he said. “We want to test as many people as possible.”
The state reported that more than 6,000 county residents had tested positive as of Thursday morning. Up to 2,500 have tested negative, Gayles said.
To get a true sense of the virus’s presence in the community, people would have to be tested multiple times, Gayles said.
“We’re thinking through what that looks like, as well,” he said.
In addition to the new contract, the county is also expecting to start a mobile testing unit early next week. It is finalizing details with a volunteer agency that will help coordinate the testing in hotspot areas or facilities, or areas with older and vulnerable populations.
The county’s hotline for residents to connect to medical providers who can order tests is expected to start running early next week.
“We had some glitches from a liability perspective, but we got that taken care of and we’re able to move forward,” Gayles said.
In addition to the county’s efforts, the state has sent two teams to the county to help with homeless services and prevention, and provide in-home testing to vulnerable families.
Gayles said there was an uptick in the number of hospital beds being used at the beginning of last week, but no hospitals were at full capacity.
Some had high numbers in intensive care needs, but those numbers are dropping in the number of beds used, as well as the percentage of those requiring intensive care management, he said.
As of Thursday evening, the county is on a “blue alert” for hospitals, indicating a shortage of critical-care beds. Patients might not be directed to the nearest hospital, depending on which were busier.
“We will continue to monitor those trends and continue to keep you all updated. … We’ve got to look at trends over more time before it’s a safe point to, for example, start doing elective procedures in facilities.” he said, adding that those would take away from needed resources in the hospitals and the ability to handle a case surge.
Hogan said on Wednesday that the state was allowing elective surgery starting Thursday.
Gayles said the county continues to send teams into nursing homes and senior living facilities to provide support where necessary. The state has also sent state inspection control specialists to several nursing homes in the county.
County and state officials have visited about 12 facilities.
There have been 1,512 cases and 217 deaths in congregate facility settings, such as nursing homes and senior living communities, according to the Maryland Department of Health. Residents account for 1,000 of the cases and 215 of the deaths.
Gayles said the causes of the cases were most likely asymptomatic staff members working in several nursing homes.
During that window of when the spread happened, the guidance from the Centers for Disease Control and Prevention was that if you did not have symptoms, you couldn’t transmit the COVID-19. The CDC later discovered that transmission of the coronavirus was possible even for someone not displaying symptoms.
The county is keeping a running list of nursing homes where outbreaks, which are considered to be at least one case in those facilities, have been resolved. Sixty facilities in the county have had outbreaks — seven of which have been cleared, which means they have not had any new cases in at least two weeks.
The first facility was cleared on April 21 and the most recent clearance was on Thursday.
Stoddard said the county is continuing to deliver personal protective equipment to nursing homes and senior living facilities on a weekly basis. It is also providing supplies to group homes.
In addition, the county is considering creating a position to be a liaison to nursing homes to address questions or concerns.
Gayles said the county is pushing nursing homes to be transparent with family members of residents about the number of cases in the facilities and procedures for containing it.
Council Member Gabe Albornoz said he has received concerns from residents who have said that nursing home staff members aren’t providing information to them.
“There are a set of options that we can take if facilities don’t comply in doing what they’re supposed to do from a medical and legal standpoint,” Gayles said. “We do have that bag of actions to take.”
Getting the expanded testing in place should help with anxiety among residents and family members, he said.
Albornoz said Hogan’s orders for all residents and employees of nursing homes was important, but there was not enough test kits or staff members to be able to meet that policy, creating a “dire situation.”
“[County teams are] not able to meet the demands that are out there for the outbreaks that are recorded, let alone test the facilities that have not had an outbreak yet,” he said.
Albornoz said the county is relying on nursing homes to share information, but it’s a problem that some aren’t being transparent.
Gayles said staff members are working with nursing home administrators to increase people’s access to relatives in the facilities, including by coordinating video calls, and providing daily photos and updates on residents.
Council Member Evan Glass said he was glad a new mobile testing unit would go into hotspot and vulnerable communities, but residents need more information, so they’re aware of the opportunity.
Council Member Craig Rice said he was concerned that when society begins to open up again, businesses such as hair salons, nail salons and barbershops will be told to open first. Those are owned by many minorities in the county, Rice said.
Since there’s already a disparity in cases and deaths among minorities, it’s a concern to use those businesses as test subjects, he said.
Gayles agreed that there was a race and class component that is a concern.
“I am hopeful, and I can attest to here on a local level, that equity and concerns about race will be factored into those conversations,” he said.
Gayles said county health officials met with representatives from hospitals, transportation services, planning, and Montgomery County Public Schools on Monday to discuss disparities and social determinants in addressing the needs of certain populations.
They also discussed the racial death rates from the virus, which show that black residents have the highest rate in the county, but more white residents have died. The partners are looking at ways to have community conversations around the topics, Gayles said.
Stoddard said the county is in better shape with supplies of personal protective equipment than it was three weeks ago.
It currently has 750,000 N95 masks. The only item the county has had a problem buying is surgical gowns because of supply chain limitations, he said.
Emergency management employees have made 600 deliveries of personal protective equipment to hospitals and facilities in the last month.
Stoddard said there are 10- to 12-week order delays on shelf-stable foods, such as peanut butter, to distribute to vulnerable communities.
“We need to be aggressive early to try and build up stores knowing that the problem is likely to get worse,” he said.
County employees are distributing cleaning supplies to 198 day cares that are serving essential employees.
Stoddard said the county will continue to be aggressive in purchasing personal protective equipment and cleaning supplies. After restrictions are loosened, there might be a greater need for them, he said.
Briana Adhikusuma can be reached at email@example.com.