“Mask down, chin up — this is going to be uncomfortable,” said the man behind the clear, plastic face shield and full-length medical gown.
The white Q-tip-like swab in his hand looked much longer than I expected as he quickly eased it up my nose.
“There we go,” he said as it hit the top of my nostril, raising me upward in the seat of my pickup.
So went a reporter’s COVID-19 test as administered inside a huge, white tent set up in the parking lot of Omaha’s sports arena, the CHI Health Center.
It was quick and, yes, quite uncomfortable. But I felt it was important to know if the mild symptoms I had — scratchy throat and tiredness — were the result of seasonal allergies and a rise-before-dawn puppy or COVID-19.
But why, I wondered, had I been picked for a coronavirus test, and not someone else who had serious symptoms of the infection, or was at higher risk for catching it?
* * *
That’s a question more than one person has asked after being selected for a test through Nebraska’s $27 million testing program called TestNebraska.
And the question is just one of several raised about the program, the result of a no-bid contract signed a month ago with four Utah high-tech firms.
Gov. Pete Ricketts, whose administration signed the contract, has insisted more than once that he’s satisfied with the performance of TestNebraska, even though it has, so far, fallen far short of its stated numerical goals for COVID-19 tests — an average of 500 tests per day, per mobile testing site. Another goal: ramp up to 3,000 tests per day at six mobile test sites.
On Thursday, four TestNebraska sites swabbed 1,155 tests, or fewer than 300 tests per day at the four sites. That is about the number of daily tests the Ricketts administration has been reporting over the past two weeks.
“We knew it was going to take time to ramp this,” Ricketts said Friday, comparing TestNebraska — which began administering testing on May 4 — to a “startup business.”
“You find out things you can improve upon, and that’s what we’ve been doing. When we find something we can do a better job on, we fix it,” he said.
“The fact of the matter is we are testing more people because of TestNebraska.com,” the Republican governor said. “You cannot dispute that at all. We’re doing more testing, which is a good thing. People should be happy about that.”
As of Friday, nearly 148,000 Nebraskans have signed up for testing, and about 21,000 have received tests through TestNebraska. It has allowed the state to double the rate of testing during May, according to the governor.
Both publicly and privately, however, some state lawmakers, readers and medical professionals question whether TestNebraska can deliver its ambitious goal of delivering 540,000 COVID-19 tests within a year. Others wonder about the quality and accuracy of the tests delivered by the Utah group, and whether enough information about the program is being shared.
So The World-Herald posed several questions to the Governor’s Office. Not all elicited immediate answers — such as how many tests per day have been done every day by TestNebraska, how many showed “positive” for the virus and how many were inconclusive — though most did receive responses (unless otherwise indicated, the answers below are from the governor’s spokesman, Taylor Gage).
What will it take for TestNebraska to reach its goal? More lab workers? Better lab performance? More people signing up? More personnel at the test sites?
“Yes, to all of those things,” said the governor, who has made “process improvement” a major theme of his administration.
More people need to sign up so they can be processed, and six testing teams need to be organized. “No shows” have been a problem, with between 10% and 20% of those scheduled for testings not showing up.
Personnel is not an issue (CHI Health employees administer the tests at Omaha and Lincoln, with National Guard medics and nurses pulling that duty elsewhere). But more people are being scheduled to address the no-show problem.
Will the program meet its goal of 3,000 tests per day by the end of the month?
The key word here is “goal.” We are working tirelessly and aggressively to do that. We are proud that we were able to set up a certified lab in less than a week. That can take months. And the state got 200,000 test kits well ahead of schedule.
The test site in Omaha has consistently tested 500 to 600 since May 11, but it’s hard to get 500 people at a test site per day in a rural area. But we need to test there, too.
How accurate are these tests?
The tests, developed by Co-Diagnostics and the medical device company ATL Technologies, have a sensitivity rate of 95%, which means that 5% of those tested got a false “negative” result, when they really had the virus. (The accepted standard is 95%). The specificity rate (which describes how accurate a test is at avoiding false “positive” test results) is 94%.
(The Governor’s Office did not provide the actual validation test documents, as requested, but offered to allow a reporter a later interview with CHI Health officials, who run the lab, and officials at the Nebraska Public Health Lab, who have been consulting with TestNebraska to ensure that they meet lab standards for testing.)
Have any test samples, which must be kept cool in transit, spoiled or been rendered useless?
Only 10 so far. Patients were promptly informed to take another test.
Why test someone who has mild symptoms and is younger than 65 years old when others might need a test more?
The priority for testing is those who have COVID-19 symptoms or have been in close contact with someone who is positive, as well as those who are in high-risk groups (age 65 and over) or work in health care, law enforcement or meatpacking or are first responders.
Anyone who meets those qualifications can get tested, if test slots are available. People must sign up at TestNebraska.com and fill out emailed assessments asking about symptoms.
Why not send TestNebraska to hot spots, like hard-hit nursing homes and meatpacking plants? Several people were turned away at South Omaha’s One World public health clinic on May 17, for instance, after test kits ran out at 300.
The Nebraska Public Health Lab has been deployed to such hot spots, according to Dr. Peter Iwen, the director of that lab, which is under the wing of the University of Nebraska Medical Center.
The public lab can return results within 24 hours, and has a capacity to do 300 to 400 tests a day. TestNebraska, by comparison, has a stated turnaround time of 72 hours, though the governor said recently that tests were coming back in under 48 hours.
The Public Health Lab, which recently increased from four to five employees, has been working seven days a week, sometimes 12 to 14 hours a day, to keep up, Iwen said.
Ricketts said Friday that TestNebraska sites have been set up at hard-hit meatpacking towns, such as Grand Island and Schuyler. TestNebraska is able to do a higher volume of tests because patients sign up beforehand. Testing at One World was first-come, first-serve.
The governor said the goal is to provide more than one option for testing, because people aren’t always comfortable with a certain testing procedure or site.
Has anyone been tested twice?
Yes, 108 people have received more than one test as of Friday. They were selected on the criteria of showing symptoms.
What, exactly, has been learned?
TestNebraska has helped dramatically expand access to testing, and is allowing the testing of some asymptomatic people who may be carrying the virus.
* * *
How was my experience with TestNebraska?
I gotta say, it was overall a good one, though I’ve heard from many people who’ve had test results delayed or who wonder why they got picked for testing instead of someone in more serious need.
I even talked to one physician who sees COVID-19 patients who was initially, and wrongly, denied a test. A software problem was fixed, and she was later able to be tested.
In my case, I honestly answered the emailed assessment that yes, I had some symptoms. But the quiz didn’t ask if I thought they were linked to COVID-19 or to a new puppy that gets me up before sunrise or to seasonal allergies.
Still, as a reporter, I wanted to see firsthand how the testing was done, and if results could be returned within 48 hours, which was the initially stated goal.
I was tested on Saturday, May 9, arriving about 15 minutes early for my appointment, which was the first slot available that morning. Checking in and being tested took only a couple of minutes — less than the “5 minutes” the governor has mentioned.
Two and a half days later, on the night of May 11, an email told me my results were in. “Negative,” the email said.
That provided some peace of mind that I wasn’t spreading the disease unknowingly, and helped me understand the medical meaning of the term “uncomfortable.”
But that relief is only temporary. It only showed I was negative at that moment — the virus is still out there, and ready to hitch a ride in my nose and lungs.
So my masks and hand sanitizer aren’t going away any time soon.