Testing those most impacted by COVID-19

Testing those most impacted by COVID-19
Three residents enter the Alexandria Health Department testing site at the Cora Kelly School for Math, Science and Technology on Monday to be tested for COVID-19. The tests were antigen, meaning they were testing for current cases of COVID-19. (Photo/Denise Dunbar)

By Denise Dunbar | ddunbar@alextimes.com

Two groups of people in Alexandria have been hit hardest by COVID-19: older residents and the city’s Hispanic/Latino population.

Because the disease is causing great harm in those communities, the Alexandria Health Department and city leaders are making a concerted effort to test more widely for COVID-19 in the two groups. This is being done by making point-in-time testing available at community testing sites, and by working with the Virginia National Guard to test at the city’s long-term care facilities.

The AHD and the City of Alexandria offered free testing for up to 3,000 people on Memorial Day, with temporary testing sites set up at Landmark Mall and Cora Kelly School for Math, Science and Technology. The Landmark site had drive-through and walk-up testing, while only walk-up testing was offered at Cora Kelly. Testing was open to all Alexandrians regardless of race or ethnicity, though residents with the means were encouraged to obtain testing through their own health care providers.

A resident is tested for COVID-19 inside the Alexandria Health Department tent at Cora Kelly School for Math, Science and Technology on Monday. A second testing site was held at Landmark Mall, and included both walk-up and drive-through testing. Almost 3,000 people were tested in all. (Photo/Denise Dunbar)

All but 20 of the 3,000 available tests were used, according to Craig Fifer, Alexandria’s director of communications and public information. The Cora Kelly site had 976 walk-up participants, while the Landmark site had 637 walk-ups and 1,367 cars drive through. There was particularly high demand for the drive-through option, and the city issued a news release at 1 p.m. saying all drive-through slots had been claimed.

Both Dr. Stephen Haering, director of the Alexandria Health Department and Sarah Taylor, Alexandria’s legislative director who handled media relations at the Monday testing event, said the locations were chosen deliberately to be accessible to the city’s low-income residents.

“Our purpose is really to make this available for people who otherwise have not been tested and might have barriers to access,” Haering said. “Those barriers to access can be multiple: They can be lack of awareness of where they can get testing for free, concern about their documentation status and [worry] that if they go somewhere and they have to register, they might be tracked by the federal government.”

The Memorial Day community testing came on the heels of a community testing day in the Arlandria neighborhood on May 16, which was conducted by Neighborhood Health, a nonprofit that provides primary care medical services to low-income residents.

The effort to test more widely in the Hispanic/Latino community stems from data that shows those residents have been hit particularly hard by COVID-19.

Sixty percent of the COVID-19 cases in Alexandria for which ethnicity is known are Hispanic or Latino residents, who make up only about 17 percent of Alexandria’s population. In addition, 44 percent of Alexandria’s hospitalizations have been Hispanic or Latino residents, according to May 26 demographic data on the Virginia Department of Health website.

The testing on Memorial Day and on May 16 were both point-in-time testing for antigens, to see if the person currently is infected with COVID-19. The testing will not reveal whether the person was previously infected by COVID-19 or whether they have antibodies for or immunity to the disease.

Point-in-time testing of both symptomatic and asymptomatic people helps the AHD control the spread of COVID-19 by identifying people who need to quarantine, and educating them on steps they need to take, key elements in controlling community spread.

“We’re giving them information about where they can get further, free testing and free care,” Haering said.

One of the responsibilities that goes with being in a leadership role is deciding how to best make use of the resources at your disposal, Haering said.

“I look at where are the cases, the positives, where are the hospitalizations and where are the deaths,” Haering said.

While the cases and hospitalizations have disproportionately been Hispanic or Latino residents, the deaths have overwhelmingly been older Alexandrians, of varying races and ethnicities.

As of Tuesday, 41 Alexandrians had died from COVID-19, and 32 of them had been residents age 70 and older. Residents age 70 and over account for 78 percent of the COVID deaths in Alexandria, though they account for only 9 percent of the total cases in the city.

Haering has steered resources toward testing older Alexandrians, particularly residents of long-term care facilities. He said that out of nine LTCFs in Alexandria, point prevalence surveys have either already been completed or are scheduled at seven of them.

“Our resources have really been focused on congregate living facilities, skilled nursing facilities, assisted living facilities,” Haering said. “What I want to do is actually do even more testing with those facilities. … We’ve been very aggressive about using the National Guard, using the Virginia Department of Health State Public Lab, as well as the Fairfax County Public Health Lab, to make that available for the long-term care facilities.”

Mayor Justin Wilson said there are multiple benefits to thorough testing in longterm care facilities, starting with helping contain current cases of COVID-19.

“There’s a couple of ways that’s beneficial to us. First of all, it allows the facilities to manage where the patients are and where the staff are,” Wilson said. “It’s not a situation where they’re generally kicking people out, but they’re creating floors where folks are positive and floors where people are not and trying to isolate it within the building. The point prevalence surveys allow them to do that.”

Wilson said testing information is also helpful to families and workers at the facilities in their decision-making regarding risk, and more broadly benefits the community.

“There’s a scientific piece to it too, where … it gives you a sense of how the spread is occurring in some of these facilities, and that’s useful information,” Wilson said.

While the point prevalence tests are important tools to identify sick residents and control community spread, Haering cautioned people whose tests come back negative to avoid behaving as if they are in the clear.

“The one thing that people need to know is this is a point in time,” Haering said. “So somebody can get swabbed, have a negative test, and yet this afternoon catch [the virus]. So it can give people a false sense of security. But for people who are symptomatic or for people who are asymptomatic and concerned about exposure and worried they might be one of those asymptomatic carriers, then it’s very useful.”

(Read more: Alexandria prepares to reopen