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Maryland to expand coronavirus testing to those without symptoms

A Maryland National Guardsman directs traffic coming in the the coronavirus testing at the Glen Burnie VEIP station.
A Maryland National Guardsman directs traffic coming in the the coronavirus testing at the Glen Burnie VEIP station. (Jerry Jackson)

More Marylanders will be able to get tested for the coronavirus under new guidance announced Tuesday by Gov. Larry Hogan.

The governor’s order allows people without symptoms but who may have been exposed to the virus to be tested without a doctor’s order at select state testing sites. It also calls on doctors to seek tests for such patients.

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The state also is opening two more testing sites in hard-hit Prince George’s County and allowing pharmacists to administer the tests.

Hogan said more than 200,000 tests have been administered in the state, representing 3.5% of the population, allowing testing to expand to people who may have been exposed to the virus but don’t have any symptoms.

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“This will help doctors diagnose and treat new cases more quickly, and it will further increase the safety of our citizens,” the Republican governor said in a statement Tuesday.

Public health experts have said that having widespread testing available is a crucial component to mitigating the spread of the coronavirus as restrictions on activities and gatherings are eased.

Identifying people who have the virus and isolating them, and tracing their contacts and testing and isolating them, can limit how many people get infected, experts say.

Through Tuesday, more than 41,000 Marylanders have tested positive for the coronavirus. Dozens of people are dying each day, with 1,963 confirmed coronavirus deaths so far and 118 deaths suspected to be due to the virus.

Until now, tests primarily have been given to those who show symptoms of COVID-19, the illness caused by the coronavirus, such as fever, coughing, shortness of breath, chills or a sudden loss of taste or smell. An effort has started to test all nursing home residents and staff as well as poultry plant workers to prevent further outbreaks in those settings.

Experts believe people infected with the coronavirus, but who are not feeling sick or having symptoms, can unwittingly pass the virus on to others.

“We want to expand our testing capacity to be able to test anyone who is symptomatic or anyone who’s deemed appropriate for testing. That includes asymptomatic folks who maybe have had exposures or who work on the front lines," said Dr. Letitia Dzirasa, Baltimore’s health commissioner.

The appointment-free testing at state-run sites will be rolled out gradually, starting Thursday with the site at the Maryland State Fairgrounds in Timonium, followed Friday by sites at the Vehicle Emission Inspection Program stations in Glen Burnie and Hyattsville and the VEIP station in Clinton next week.

The Hyattsville and Clinton sites are new in Prince George’s County, which has the highest rate of infection in the state.

The tests will be provided to anyone who suspects they’ve been exposed to the virus, with no need for a doctor’s order. The tests are done at no out-of-pocket cost to the resident. Depending on demand, the state could expand the symptom-free, no-appointment testing to other locations.

Hogan’s “Maryland Strong Roadmap to Recovery," issued in late April, lists testing as one of the four “building blocks” for relaxing restrictions. The plan, however, does not state a specific target for how many tests need to be on hand or administered.

Hogan has said he hopes to get the state to the point of administering 10,000 tests per day, which has not yet been reached. On Tuesday, for example, the state reported receiving 7,152 test results in the prior 24 hours. The state’s public health lab can process 1,000 tests per day, with the rest being done at private and university labs.

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The University of Maryland School of Medicine is using a $2.5 million state grant to retool a Baltimore research lab to eventually process up to 20,000 tests a day, largely from public testing sites. The lab needed to acquire equipment and other supplies such as swabs and agents used to transport and process the samples. The lab is currently processing 500 to 1,000 tests a day, said Jacques Ravel, associate director for the medical school’s Institute for Genome Sciences.

One data point that public health officials track is how many tests are coming back with positive results. The World Health Organization said that communities with extensive testing have positive rates between 3% and 12%.

When positive tests rates are higher than that, it means that likely only the sickest patients are being tested.

Maryland’s overall rate of positive tests is about 20% — and reached 25% for the day Tuesday when an influx of backlogged tests came back with a single-day high of newly confirmed cases. It is one of five states above the recommended rate of positive tests, according to Johns Hopkins researchers.

Maryland also is 22nd in the nation for the portion of residents tested, according to Johns Hopkins. Rhode Island has the most robust testing, with nearly 11% of its population tested.

Leaders of Maryland’s largest jurisdictions remain concerned about testing and other coronavirus-related issues.

The seven leaders — Baltimore Mayor Bernard C. “Jack” Young and the county executives of Anne Arundel, Baltimore, Frederick, Howard, Montgomery and Prince George’s counties — wrote Tuesday to Hogan to say the state isn’t conducting enough testing, pointing to the state’s high positive rate.

The local leaders also said they need the state’s help with such matters as monitoring nursing homes, fighting COVID-19 in minority communities and helping businesses and residents recover financially.

And they asked Hogan to use the state’s purchasing power to obtain more resources, saying “every one of the undersigned executives believes that we lack sufficient resources to achieve our shared goal of safely reopening our jurisdictions, without limitations.

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"While we all work furiously to implement comprehensive testing, increase contact tracing, and obtain more PPE for our residents, we need the State’s leadership to ensure that Maryland’s counties are not competing against one another on the open market,” they wrote.

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Young announced Tuesday that the city bought 18,000 tests and will receive 500 tests each week from the state, but he said that’s still not enough.

Even with those concerns, local leaders called Hogan’s announcement promising.

Baltimore County Executive Johnny Olszewski Jr., a Democrat, said in a statement that the expansion of testing to people without symptoms is “very welcome news.”

“As public health experts have consistently said, expanded testing is a critical component towards reopening,” Olszewski said. “This new step helps us move in the right direction.”

And Howard County Executive Calvin Ball, also a Democrat, praised Hogan’s announcement as a “needed, encouraging step to increase testing.”

Pharmacists are pleased to be granted authority under Hogan’s order to add coronavirus testing to the suite of diagnostic tests they can perform, said Dr. Richard DeBenedetto, president of the Maryland Pharmacists Association.

Many pharmacists already are trained in how to do the nasopharyngeal swabs to collect the sample, and others are training now, he said. A key factor in whether pharmacies will offer coronavirus tests will be whether they can get their hands on them.

“Pharmacists have been trying to get these tests and some have gotten tests already in preparation,” said DeBenedetto, who also is an assistant professor of pharmacy at the University of Maryland, Eastern Shore. “They’ve been wanting to do do this since tests started coming out.”

Because pharmacies are easily accessible, they could become a key component of a long-term testing strategy, said Dr. Cherokee Layson-Wolf, an associate professor at the University of Maryland School of Pharmacy.

“There are pharmacists found everywhere — urban areas, rural areas where there may not be as many resources,” Layson-Wolf said.

The other “building blocks” in Hogan’s reopening plan are increased supply of personal protective equipment, sufficient capacity at hospitals and establishment of a robust contact tracing system. Hogan has said progress has been made in each area.

Tuesday, the federal government announced an award of more than $205 million to Maryland for testing and contact tracing.

Hogan moved the state into the first phase of reopening last week, lifting a stay-at-home order and allowing retail stores, churches, barbers and hair salons to open at 50% capacity and allowing manufacturing to resume, all of it at the discretion of local officials.

Several jurisdictions have not adopted the steps in Hogan’s plan, including Baltimore City, where Young has kept a stay-at-home-order in place. Anne Arundel, Baltimore, Howard, Montgomery and Prince George’s counties also are not as permissive as the state.

In their letter to Hogan, the local leaders asked him to help remind residents to check city and county rules about pandemic restrictions.

“The biggest lesson that we have learned since Friday is how unclear the public is about your delegation of authority to local leaders,” they wrote. “Please continue to help us create greater clarity by repeating a refrain that the public should check with their local governing body for the rules that apply in their local subdivisions.”

Baltimore Sun reporters Colin Campbell and Meredith Cohn contributed to this report.

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