U-M study explores ways to increase COVID-19 testing in Michigan

FILE - In this Oct. 23, 2020, file photo, University of Washington research coordinator Rhoshni Prabhu holds up a swab after testing a passenger at a free COVID testing site in Seattle. Deaths per day from the coronavirus in the U.S. are on the rise again, just as health experts had feared, and cases are climbing in nearly every single state. (AP Photo/Elaine Thompson) (Elaine Thompson, Copyright 2020 The Associated Press. All rights reserved)

ANN ARBOR – As COVID-19 cases continue to rise in Michigan, experts say the need for efficient and rapid testing remains critical.

According to a new University of Michigan study, promoting incentives to quicken turnaround, having public health officials monitor testing operations in real-time and coordinate testing across state lines could prevent more deaths.

Although diagnostic testing has increased in Michigan, many experts say that compulsory testing capacity and turnaround times to keep the spread at bay is lacking.

The study’s lead author, Ravi Anupindi, said that although Michigan outperforms many states in testing, more needs to be done.

“Michigan has made good progress but needs to do more for life to begin to return to a (new) normal,” Anupindi, a professor of operations research and management at U-M’s Ross School of Business, said in a statement.

"Researchers at Harvard University have called for scaling to ‘suppression-level testing,’ whereby a state or community is able to quickly find and isolate new cases before they lead to a wider outbreak, with an aim of keeping new case levels at near zero. To achieve this goal, Michigan needs to scale up its testing to about 2.4 times the current level.”

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He said Michigan currently meets “mitigation-level testing” which helps decrease the level of spread.

More than doubling testing would require better coordination among clinical labs, manufacturers, collection points and others, according to the study.

Anupindi and his colleagues acknowledged the progress Michigan has made in opening new lines of communications with state officials and bringing labs together to expedite processes. Michigan has also signed a compact with five other states to ramp up testing.

For the study, researchers interviewed more than 20 public health experts, state leaders, epidemiologists and laboratory directors. They also analyzed issues with supply chain, government and overall process and studied corporate responses to previous crises such as the 2011 earthquake and tsunami in Japan and the H1N1 virus.

They also suggest the following measures moving forward:

  • Offer incentives, such as paying labs more for faster testing.
  • Continue to expand testing capacity beyond strictly symptomatic people through increasing the availability of different kinds of diagnostic tests.
  • Develop an architecture to orchestrate design, planning and execution of response that includes internal dashboards, or visual management, to track testing capacity, supply availability and turnaround time by lab and sample collection point.

Although the study focused on Michigan, researchers said the situation is similar in many U.S. states.

“Well-meaning efforts have been underway in states as well at the federal level, but it has been akin to building a plane as it is flying,” Anupindi said in a statement.

“The challenges of COVID-19 response management have exposed some underlying issues in the health care ecosystem that need to be addressed long term but cannot be fully accomplished during a crisis situation in the short term. Fragmentation, lack of lab networks, lack of technology integration—these go beyond COVID-testing specific issues, yet underlying issues must be addressed.”

Though it falls outside the study, Anupindi also hailed the establishment of the state’s Coronavirus Task Force on Racial Disparities which was seen more testing sites set up within vulnerable populations that have been disproportionately affected by the pandemic like African Americans and other minority groups.

The U-M Institute for Healthcare Policy and Innovation funded the team’s work. The co-author’s include Lee Schroeder of U-M’s Department of Pathology; Rajan Dewar, formerly of the Department of Pathology and now with Michigan State University’s Institute for Quantitative Health Sciences and Engineering; Emily Edkins, a Ross MBA student; and Surabhi Rajaram, a U-M master of public health graduate now with the Bill & Melinda Gates Foundation.

To read the full study, click here.