Even with vaccine doses rolling out, testing is still critical for tracing and containing the coronavirus. But throughout 2020, the White House Coronavirus Task Force consistently said that Montana wasn’t testing enough to contain the spread. Now, institutions statewide have set up their own testing, and are reporting the results to county health departments.
"So they’ll drive up to the teller window here and speak to one of our friendly staff."
Daniel Bierschwale is the executive director of the Big Sky Resort Area District, a group administrating a defined tax area streching into Gallatin and Madison counties. He was in front of an old bank in Big Sky. The building hasn't functioned as a bank in about a year, but it has found new use as a COVID test collection site.
"Doing your COVID test is as easy as making a bank deposit," Bierschwale said.
This is part of Big Sky Relief, a project the Big Sky Resort Area District launched at the end of last year to increase testing in the community. Locals can come for weekly tests even if they’re not showing symptoms.
Bierschwale said they chose this bank as a collection site because in the building’s banking past left it was perfectly outfitted for contactless deposits.
"You just come in here and drop your test off: open it up, close it, it spins the deposit into the bank."
Big Sky Relief has raised $4.5 million, all locally, for its testing efforts. It works with a private health insights company called LetsGetChecked that compiles the data and sends it to the county. It also conducts wastewater testing.
Private laboratories like this one have consistently conducted most COVID-19 tests in Montana since September. They now account for the lion’s share of them, although unlike Big Sky Relief, some are contracted by the state and receive state funds.
Private companies, hospitals and an American Indian research center with grant funding have added to statewide testing capacity, sometimes offering asymptomatic tests where counties aren’t able.
Other groups conducting testing include FYR Diagnostics, a Missoula biotech company that the state recently contracted to expand testing, and Billings Clinic, which announced on-site testing this month.
There is also the Center for American Indian and Rural Health Equity at MSU, which received a grant from the National Institutes of Health to study COVID-19 testing strategies among underserved populations.
Testing across the country has been limited since the beginning of the pandemic. Carrie Henning-Smith, associate professor at the University of Minnesota School of Public Health, says that is in part because of the lack of clear guidance from the federal government.
"Asymptomatic testing is really important because people who are not experiencing symptoms of COVID - and not displaying symptoms of COVID - can still spread COVID."
Researchers with the Centers for Disease Control and Prevention said in a recent report that they estimate 59 percent of COVID spread comes from asymptomatic transmission.
Henning-Smith said the lack of asymptomatic testing makes contact tracing and containment nearly impossible. Still, she says Montana’s recent testing rates are close to the median rate among states, and generally a little better than those in other rural states.
"There's room for growth, but it could be worse."
Montana COVID-19 Task Force Lead Matt Quinn said despite the White House assessment and low asymptomatic testing, he is not worried about the numbers. Montana’s capacity for testing has grown significantly over the course of the pandemic. Last summer, former Gov. Steve Bullock set a goal of 60,000 tests per month and now Montana conducts about half that weekly.
"Frankly, we're doing well on testing capacity."
He added that private groups are helping by taking some burden off the state’s public health lab and its limited resources. Still, he says it is important that those groups work well with local and state governments.
"I'm not 100% certain we're getting all of those results, but obviously the more that we can spread that wealth around the state of Montana, the better off we are."
Matt Kelley is the Gallatin County Health Officer. He worked with Big Sky Relief to fold the test drop-off site at the bank into the county’s testing plan without it becoming a drain to the county health department’s already limited resources.
He said that as groups like Big Sky Relief support the system, they also have to be mindful that they are not overwhelming it.
"The testing system overall has become more diverse, and with that diversity, it becomes more complex," Kelley said. "That's ok, we don't want things to be static. It makes it harder, it makes it more difficult to interpret some of our data, but that's ok."
There might be more federal dollars in the works to expand testing. Emergency funding to do just that factors into President Joe Biden’s $1.9 trillion plan to combat the virus.
The plan also calls for the Federal Emergency Management Agency to reimburse states for costs related to the pandemic, and for federal agencies to invoke the Defense Production Act to speed up production of testing supplies as well as other equipment.
Until that happens, private groups will continue making a large contribution to Montana’s testing efforts.
Diane Lund is program director for the University of Providence’s Masters of Science Program in Infection Prevention and Epidemiology. She said the university is conducting tests both on campus and in the community through a partnership with Alluvion Health in Great Falls. She said even with a vaccine rolling out, testing is as important as ever.
"It's just it's the right thing to do. If we can get them their results quicker, then we could hopefully then mitigate transmission."