Mass. Taking Steps to Prepare for Second Coronavirus Surge

The state continues to ramp up its testing capacity to ensure that it will be ready should COVID-19 cases start to spike again

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Even as the state works to ramp up its testing capacity with a goal of being able to test as many as 45,000 people a day by the end of July, the actual number of tests for COVID-19 being conducted daily in Massachusetts has been declining for weeks.

Gov. Charlie Baker on Tuesday said that trend can be attributed to the decrease in the infection rate as people have stayed home and worn masks in public to control the spread of the virus. But he also expects it to change as more proactive testing becomes part of the state's routine.

"I do think some of the issue with respect to testing generally is driven by demand," Baker said on Tuesday from Lawrence, after touring the New Balance factory, where operations have been converted to produce personal protective equipment.

The administration at the end of May submitted a plan to the federal government to build its testing capacity from 30,000 a day currently to 45,000 by the end of next month, and has received $374 million from the Trump administration to put toward testing.

Testing also has been singled out as a key part of the administration's strategy to prevent future outbreaks and a second surge by quickly identifying infected patients and geographic hotspots to isolate those with the virus and control the spread.

The state testing regimen, however, has never approached its full capacity.

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During the week of May 11 to May 17, when it appears from public data the state hit its high-water mark for testing, the Department of Public Health reported an average of 11,109 tests being conducted per day, totaling 77,768 for the week and a daily high of 13,864 on May 13.

Instead of continuing to climb, the ensuring weeks saw fewer tests being conducted with only 48,461 tests reported last week for an average of 6,923 a day between June 1 and June 7. The most tests reported on any given day last week was 9,409.

DPH spokeswoman Ann Scales told the News Service earlier this week that the decline in testing volume had to do with a reduction in transmissions that has led to fewer people with symptoms needing testing, and fewer close contacts of positive cases to test.

"The overall effect is to reduce the demand for testing. However, as we continue to move carefully through the reopening process, we anticipate an increasing demand for testing as the potential for exposures increases," Scales said.

"The Commonwealth's goal is to have sufficient testing capacity should we experience another surge," she said.

Because there are so many people with COVID who are asymptomatic, Dr. Jon Santiago said that efforts should also include antibody testing to get a better sense of how widespread the virus is throughout the state.

A month ago, Baker said 13 percent of all tests being done were coming back positive for the coronavirus, but as infections and the spread of the virus have slowed, that positive test rate has fallen to under 5 percent.

The federal government has recommended that states put in place a plan to immediately be able to test at least 2 percent of its population each month, and to increase that capacity by the fall. With over 650,000 tests conducted so far, the administration reported in its testing plan to the federal government that it is currently testing roughly 4.4 percent of the population every month.

"The goal here, once we get the go-ahead from the feds, will be to test everybody's who's symptomatic, everybody's whose asymptomatic and a close contact, everybody who works in the health care space, everybody who works with vulnerable populations, and to continue to expand the number of testing sites that are available for testing," Baker said on Tuesday.

The governor said the state is currently in the process of adding 20 more sites for testing in areas the administration considers "underserved."

"So I certainly believe that the number of tests and our testing capacity are both going to go up over time," Baker said.

Boston Hope, the coronavirus field hospital in the Boston Convention Center, discharged its last patients Tuesday.

In additional to molecular tests for the presence of the virus, the governor said he also anticipates that over time, as serology testing for antibodies becomes more reliable, the state will be doing more of that type of testing as well to identify people who may have had the virus but either didn't have symptoms or didn't find their way into the health care system.

A top World Health Organization expert on Monday said that new research had shown the transmission of the deadly virus by asymptomatic individuals was "very rare," which if true would dramatically change the public's understanding of the virus and the protocols in place to prevent its spread.

But that official, Dr. Maria Van Kerkhove, walked back her statements on Tuesday and said there had been a "misunderstanding."

Baker, who talks repeatedly about the risk of asymptomatic transmission as the reason people should take precautions like wearing facial coverings, had not read the research that Van Kerkhove cited, but believed it to be based on a very small sample size. The governor said he was on a call with health care professionals Tuesday morning, all of whom were "enormously skeptical of that conclusion for a whole bunch of reasons, and so am I."

"I continue to believe that based on the advice that we're getting from the health experts here that people who are asymptomatic who become symptomatic are absolutely capable of spreading the infection and so are many of the asymptomatic people who never show symptoms at all, and I would urge people to follow the feedback and the pushback that's going to come from that broad declaration yesterday from a lot of other people who spent a lot of time trying to figure this virus out."

Last week, as Baker prepared to make a decision about entering Massachusetts into the second phase of his economic reopening strategy, a coalition of public health and community organization urged Baker to wait until the state had better data collection, worker protections and testing capabilities in place.

The group said the state should be testing 32,000 people a day to remain on track to reach its testing goals, and Helena DaSilva Hughes, of the Immigrant’s Assistance Center in New Bedford, said testing, including for asymptomatic people, must be available "without people having to go through flaming hoops."

"You can't clean fish from home and you can't be a personal care attendant without being close to the client, so many more people need to be tested, starting with our essential workers," Hughes said.

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