Tim Steller's opinion: Limited testing, tracing are holding us back from reopening

Ask any expert about how to handle an epidemic like COVID-19, and they’ll mention the same two concepts: testing and tracing.

You need to test widely in order to know who has or has had the disease. And you need to trace who they’ve been in contact with so those people can get tested or quarantine themselves.

Those are keys at the outset to try to isolate the clusters in an outbreak. But they remain crucial in moments like this when we are looking for a way to gradually re-open the economy without having unmanageable spikes in disease.

Testing and tracing — the concepts sound simple, but Arizona and America are showing they aren’t easy for us.

Dr. Anthony Fauci, the government’s top expert in infectious diseases, said Tuesday that we don’t have an adequate system for either testing or tracing to be able to re-open the economy. “We have to have something in place that is efficient and that we can rely on, and we’re not there yet,” Fauci said in an interview with The Associated Press.

Former Arizona health director Will Humble, who is now the executive director of the Arizona Public Health Association, explained we need a “quick diagnostic test with a fast turnaround time. You need to be able to find everybody who’s asymptomatic and sick, so they can go into isolation. They only can do that if they can get a quick test, and it’s diagnostic, fast and convenient.”

That’s not happening any time soon. Since March 25, Arizona’s health department has been discouraging medical providers from testing for COVID-19.

The guidance says, “The current reality in Arizona and the rest of the country is that there are not enough available supplies to meet testing demand. Clinicians should consider removing this diagnostic ‘tool’ from their toolbox and managing patients with respiratory conditions as if they have COVID-19.”

The situation is only slowly changing today, three weeks later. States and medical institutions are scrambling for testing materials, as private labs move toward offering more tests for the disease.

The drive-thru testing center at Banner- University Medical Center is often empty — not because there is no demand, but because people have to meet narrow criteria in order to be scheduled for a test. Medical personnel, first responders, vulnerable people and those with specific symptoms may get tests. Others will not.

Gov. Doug Ducey and state Health Director Dr. Cara Christ offered a few hopeful words about testing for the coronavirus at their news conference Tuesday. Walgreens will open two testing sites in Arizona, and the state is working with CVS to do the same. Also, Abbott has sent the state 15 rapid-testing units that will give results within 15 minutes.

But each of those will be limited, at least for a time, by the availability of swabs and other testing materials. We haven’t found a way out of the testing shortage yet.

Then there is testing for antibodies — the evidence that a person has had COVID-19, perhaps even with mild or no symptoms, and has recovered. This is crucial because the likelihood is that people with antibodies will be immune to being infected again for a decent period.

Dr. Robert Robbins, the University of Arizona president, noted at the news conference Tuesday that antibodies in recent epidemics have been shown to give immunity from reinfection for one to three years.

Robbins was there to announce a big push in the direction of antibody testing: The UA is seeking FDA permission to produce a new antibody test, and is aiming to make 250,000 tests available in Arizona. The university also wants to make them available to all employees and students. Some private labs are already offering antibody testing.

These tests are key to letting some portion of the population get back to a more normal routine, Humble said.

“We need a widespread antibody test that’s easy, convenient and fast, so that people know if they were exposed,” he said. “There are millions of people in this country right now who can do whatever they want. They just don’t know it.”

What’s glaringly missing, though, is contact tracing. As my colleagues Justin Sayers and Jasmine Demers showed in Sunday’s paper, Pima County’s health department has done a spotty job of alerting people who have been in the presence of infected people.

Even when I broke the news last month that the coronavirus was apparently circulating at a large bridge tournament in Tucson in early March, the health department deemed it too labor intensive to track down the players. The bridge-playing community did that work.

I asked Ducey and Christ about contact-tracing as a component of re-opening the economy during Tuesday’s news conference. They didn’t have much to offer.

“We continue to explore how to increase testing,” Christ said. “We are continuing to explore contact tracing as well.”

One possibility is technological: Apple and Google are working on an app that would use Bluetooth technology to alert people when they have come in contact with infected people. It would be a voluntary system, though, meaning its reach would be limited.

If we want to open this state back up, we need to put more energy into mobilizing and training employees or volunteers who could make the calls and let people know they’ve been in contact with an infected person.

With that and vastly ramped up testing, we could take some first steps back toward normal.