In Detroit, which has been ravaged by COVID-19, Mayor Mike Duggan has made mass testing the centerpiece of his administration’s response.
“The way we beat this is through testing, and knowing who’s infected and who’s not, so we can separate," Duggan has said.
Some may wonder what benefits mass testing provides at this stage in the pandemic. After all, we know it’s here and that it’s spreading. And testing may not change any individual patient’s treatment.
But experts say widespread testing is crucial for public health — and can be vital for patients as well.
Testing at the Michigan State Fairgrounds
The drive-thru testing site at the former Michigan State Fairgrounds in Detroit has been up and running for less than two weeks.
At first, it only tested a few hundred people a day. But Mayor Mike Duggan said it’s now approaching more like 1,000.
“The city of Detroit has dramatically increased this state’s overall testing capacity with what we’ve done,” Duggan said this week.
Duggan has repeatedly said that every single Detroiter who needs a test should be able to get one. On Wednesday, the city reported 5,834 COVID-19 cases. As of Wednesday afternoon, the state reported that 251 Detroiters have died.
The state fairgrounds testing is open to residents of Wayne, Oakland, and Macomb counties, the epicenter of Michigan’s COVID-19 outbreak. It’s free, but you do need a doctor’s prescription and an appointment.
JeDonna Dinges was tested there last week. Dinges said she’s had some COVID-19 symptoms, such as fatigue, chest tightness, and shortness of breath.
She said the whole process was relatively seamless, and getting tested took about 15 minutes from start to finish.
“Everybody was very professional, they were very friendly. As friendly as you can be talking to somebody through your car window,” Dinges said.
Dinges is 56. She lives in Grosse Pointe Park, and owns a small store in Ferndale.
Dinges has a car; but when you’re talking about testing at the state fairgrounds, transportation can be a barrier, particularly for Detroiters. That’s why the city of Detroit has contracted with transportation companies to pick up patients who couldn’t make it to the fairgrounds otherwise.
Many Detroiters also don’t have a doctor, or health insurance. The city has put together a list of physicians and clinics that will take new patients, even if you don’t have insurance or money. They’re listed on the city’s website.
Dinges does have a doctor, but said she still had a hard time getting a prescription. She has an autoimmune disease called sarcoidosis that can mimic some symptoms of COVID-19, but also put her at greater risk if she does have it.
Dinges said she just had to get a definitive answer. “I think there’s so many people that got to the point where they were in dire straits before they got to the hospital,” she said. “Because things can turn on a dime with this thing.”
Testing can boost patients’ chances, inform policy, and help mitigate the “second wave”
Helping people avoid those dire straits is one benefit of expanded testing. That’s according to Dr. Teena Chopra, the medical director of hospital epidemiology and infection prevention at the Detroit Medical Center.
Chopra said that ideally, she would like to test everybody for COVID-19. “Because the more you test, the more you are going to find these milder cases, and even asymptomatic cases, who are shedding the virus and spreading the disease,” she said.
Like most southeast Michigan hospitals, Chopra said the DMC has been overrun with COVID-19 patients. And many of them come in at a point when the disease is already shutting down their lungs.
Chopra said it’s true that knowing you have COVID-19 doesn’t necessarily change your treatment.
But “I’ll tell you what it will do,” Chopra said. “It’ll tell people that you have COVID. And people will take it seriously. And people, if they have symptoms, and their symptoms progress from mild to moderate, they will come to the hospital.”
"The more you test, the more you are going to find these milder cases, and even asymptomatic cases, who are shedding the virus and spreading the disease." --Dr. Teena Chopra, medical director of hospital epidemiology and infection prevention, Detroit Medical Center.
Chopra said the hospital has had some success treating COVID patients with the anti-malarial drug hydroxychloroquine. In less severe cases, steroids have been effective.
“We want to see patients in milder forms so we can treat them, because now we have a drug that is working for us,” Chopra said.
There’s also the question of how testing can shape our larger COVID-19 policies.
Jon Zelner is an epidemiologist at the University of Michigan’s School of Public Health. He said right now, we’re relying on strict social distancing measures to prevent the disease from spreading. But that can’t last forever.
Zelner said it’s inevitable that a second wave of the disease will emerge. “It’s not really a question of will that happen, it will happen,” he said. “I don’t know how it will play out.”
But Zelner said testing will help us figure out when we should start easing up, and how quickly. And once we do, testing will help us identify the sick and use contract tracing to find and isolate their contacts — hopefully mitigating the second wave.
“The tests are also going to be really important in the community, just to go out and do a survey, and get a sense of, how much disease is circulating here?” Zelner said.
“They don’t want condolences. They want me.”
JeDonna Dinges got her test results back. She’s negative.
But Dinges said if you really feel like you need a test, you should push to get one. That’s what she did, when an assistant at her doctor’s office balked at her request.
“And I said, 'Well, the reality of the situation is, if I become ill and I pass away, the only thing you can offer my family is condolences,'” Dinges said. “They don’t want condolences, they want me.”
Duggan said on Tuesday that despite the ongoing shortage of tests nationwide, the state fairgrounds is well-stocked and expanding capacity every day.
Duggan said initial test results from the state fairgrounds consistently show around 43% of people testing positive for COVID-19. He called that that number “scary.”
