Oregon earned a notorious note of distinction last month when Dr. Deborah Birx, the White House coronavirus response coordinator, called the state out by name as being one of only a handful without sufficient testing capacity.

Running through a presentation that featured a color-coded nationwide map, Birx said Oregon, Maine and Montana “are the three states that we’re working on building capacity in.”

Exactly how Birx reached that conclusion remains a mystery.

The Oregonian/OregonLive asked the Oregon Health Authority, the U.S. Department of Health and Human Services and the White House to explain the underlying calculations that went into making the map that made Oregon look so bad.

None would.

In the absence of any explanation, The Oregonian/OregonLive used publicly available records to try to make sense of the situation. An answer remains elusive, but here’s what we can tell you:

Laboratory capacity

Birx’s comment about Oregon came during a lengthy public briefing at the White House on April 17. (Watch it here, or read the transcript here)

Brix preceded her words by first revealing a map listing the location of all laboratory machines capable of processing coronavirus tests nationwide. The testing machines, or platforms, are manufactured by the likes of Roche, Abbott and others.

A red dot on the map meant a machine could process many tests each day, a blue dot meant fewer. The map didn’t quantify the so-called throughput of the machines and neither did Birx.

“I want you to see how it’s distributed through the United States,” she explained of the machines. “So these are the current testing platforms available today throughout the United States for COVID-19.”

Monthly testing by state

Birx then moved to a new slide and suggested the information in it was based on the previous information about where machines were located.

“So then we’ve looked at all of the testing capacity from those platforms,” she said, “and this gives you an idea of what that capacity is.”

This next part is key. She said:

“The darkest red — you can see, like, in Texas and New York, those are — those are states that have lots of different platforms, as you saw on the prior slide, and the ability, if you just add up the platforms and the potential for test, of over a million tests per month.”

What’s most important from her comment: “if you just add up the platforms and the potential.” More on this later.

The map shows Oregon among about a dozen states with the lightest shading. According to the key, that meant Oregon had the ability to do less than 100,000 tests per month.

Birx then took a bit of a tangent.

New Orleans

Birx proceeded to focus not on testing capacity – the issue in her previous slides – but on actual testing.

She highlighted the testing completed in Louisiana and New Orleans which, at the time, was one of the nation’s hot spots for infections.

According to Birx, 27 out of every 1,000 residents there had been tested. It’s unclear if she was referring to residents only in New Orleans or in all of Louisiana.

“They’ve done, throughout the last month, 27 tests per 1,000 New Orleans and Louisianians,” she said. “So 27 per 1,000. So that is a good mark.”

Birx continued referencing New Orleans and that testing benchmark when the issue of Oregon came up. She rounded up to say that 30 tests per 1,000 residents would be an ideal monthly benchmark for other states.

Per capita testing

“So using that as a measure — next slide — we then looked across all the states of the United States of America, and looked for states that had 30 or more — ability to do 30 or more tests per 1,000 of their inhabitants in each state.”

The slide flashed on the screen, and there was Oregon, Maine and Montana, all with reportedly low testing abilities.

Birx named all three, but she overlooked the similarly shaded Oklahoma, as “the three states that we’re working on building capacity in.”

The title from Birx’s slide read: “Tests Per Month Per 1,000 People by State.” The key showed Oregon, Maine, Montana and Oklahoma as each having under 30 tests per 1,000 people per month.

The sources listed on that slide by the federal government: machine manufacturers Cepheid, Hologic, Abbott and Roche.

Birx suggested federal officials were going above and beyond to address testing nationwide.

“As we’ve described, we’ve measured every single platform and every single state,” she said. “We know exactly where they are, by geography, by address, by ZIP code, what their capacity is, what their cumulative capacity is, what their roadblocks are on non-ability to run all their full capacity.

“And we’re addressing those because each one of those is different and you have to address each of them one by one with the governors, with the state and local labs, and with all of the hospitals.”

Analysis

We knew Oregon ranked toward the bottom of states in actual testing per capita.

But bottom four? That really stood out, and we wanted to understand how federal officials reached that conclusion.

After all, the last time we’d crunched the numbers, using data from the day of Birx’s comments, not a single state had yet to hit 30 tests per 1,000 people total. New York, Rhode Island and Louisiana were each close.

Oregon ranked 20th from the bottom, at just 8.6 tests per 1,000 since the outbreak began. Oklahoma had tested 8.5; Montana stood at 9.6; and Maine was at 11.1 people tested per 1,000.

Clearly, the federal calculations couldn’t be based on actual testing.

We filed a public records request with Oregon Gov. Kate Brown’s office, which had a conference call with White House officials on April 20 to discuss testing.

Documents obtained from that request showed that Brown’s office received many of the same slide decks from Birx’s presentation as part of an email from Ella Campana, the deputy associate director of White House intergovernmental affairs.

Brown’s office received the same blue-and-red-dotted map showing the nationwide location of machines capable of analyzing coronavirus tests.

Brown’s office received the same national map showing monthly testing capacity, by state, in shades of red.

And Brown’s office received a nearly identical national map showing per capita testing, by state, in shades of blue. The machine manufactures were once again listed as the sources.

The one difference? The title was changed to “Test Capacity Per Month Per 1,000 People by State.” (“Tests” from Birx’s presentation had been changed to “Test Capacity.”)

We dug further into the documents that Brown’s office released. The final two pages seemed they may hold the answer.

Federal officials provided Brown’s office with details for every machine in the state. The list was preceded by a notice that read all “machine location information is confidential and proprietary to the manufacturers” and “reliance upon the contents is strictly prohibited” by anyone other than the intended recipient.

As Birx suggested, the list included not only each machine, but the lab name, city, address, manufacturer, model and whether it offered a low or high throughput.

Brown’s office also received information from the federal government listing the “Daily max tests” by machine type, assuming three shifts per day.

The Oregonian/OregonLive built a spreadsheet with this information, matching the description of each machine with its accompanying daily testing capacity, as listed by the feds.

We followed Birx’s guidance — “if you just add up the platforms and the potential” – to see what Oregon could do with the equipment on hand. We figured this would answer the question once and for all.

Instead, it only made things more unclear.

The machines, based on the daily capacity outlined by the federal government, suggested Oregon could process a whopping sum:

At least 87,000 tests. Not per month. Per day.

We were surprised. We thought perhaps three shifts per day was too many, as described by the feds. So we divided that sum by three, to get a more modest 29,000 tests per day.

That daily capacity over a month would produce roughly 870,000 tests. And that would equal more than 200 tests per 1,000 residents each month, far more than what the feds had said.

It’s unclear how that would rank nationally because we don’t have access to each state’s list of machines. Suffice it to say, however, Oregon’s testing capacity appears to be theoretically much higher than what was listed by the federal government.

We were perplexed. Was the federal government’s math based on the machine capacity, the actual testing, something else? If something else, what?

The response

The Oregon Health Authority, the state agency responsible for combatting the pandemic locally, expressed no desire to look into the math.

Instead, the agency issued a lengthy statement that didn’t address the factual basis for the ranking or how it was calculated.

“OHA has reviewed the White House’s testing report and we are not surprised by Oregon’s ranking on testing capacity, due to the difficulties our state has had receiving requested supplies from the federal government,” Philip Schmidt, an agency spokesman, wrote in part.

“Testing is a vital part of our strategy to contain the spread of the virus and protect Oregonians. We understand that the federal government has prioritized giving testing support to other states with far worse outbreaks,” he continued. “However, Oregon shouldn’t be denied the resources we need because the early and sustained social distancing sacrifices state residents have made has prevented COVID-19 infections and deaths from skyrocketing to rates other states have experienced.”

Asked again to address how the White House arrived at its calculation, or what efforts the state had taken to understand the calculation by contacting federal officials, Schmidt declined to answer.

“That statement is all we have to offer on this,” he wrote.

Similarly, the U.S. Department of Health and Human Services, which oversees the Centers for Disease Control and Prevention and has been helping states with testing, declined to comment.

“As the materials you received were leaked (they clearly state they are confidential) we don’t feel it appropriate to comment,” spokeswoman Tara Broido wrote in an email. “Also, these materials were provided by the White House, so I would refer you there for comment.”

The materials weren’t leaked, of course, and we told Broido they were obtained through a public records request. Broido would not address the calculations in the map that Birx presented, nor would she provide a White House contact.

Campana, the White House intergovernmental affairs official, didn’t respond to emails from the newsroom.

Anthony Cruz, the White House director of regional communications, didn’t respond to several emails, either.

Alas, the math behind the map that showed Oregon performing so poorly remained a mystery.

It was a rather unsatisfying answer.

Not only because government officials shared Birx’s map and comments publicly, during a White House briefing, potentially with millions of Americans.

But also because it’s such a basic question, one that should be easily addressed by government officials who are paid to provide information to the public.

Was the government singling out Oregon because it truly lacked enough machines to test a meaningful amount of people? Did Oregon have enough machines but other issues were holding it back?

Was Oregon really one of the fourth-worst states in the country, in whatever benchmark that map was supposed to convey?

Postscript

We decided to take one last crack.

On Friday, May 15, we reviewed the state-level testing tallies available from the COVID Tracking Project.

Four weeks after Birx’s comments, more than half the country had yet to complete 30 tests per 1,000 residents – since the beginning of the outbreak. Oregon, Maine, Montana and Oklahoma were all in that group, but so were 25 other states.

Oregon had the eighth-lowest testing per capita across America at about 21 per 1,000 residents, and 100,000 Oregonians had yet to be tested.

State officials now say the daily capacity among local labs is 3,150 a day, which would equal 94,500 tests per 30 days.

Meanwhile, other states such as Colorado and South Carolina have surpassed 100,000 residents tested. But their per capita rates are essentially equal to, or slightly less than, Oregon’s.

How does any of that that suggest Oregon is the fourth worst in the country, as the federal government claimed?

We don’t know. But we tried to figure it out.

David Cansler contributed to this report.

This article was originally published by the The Oregonian/OregonLive, one of more than a dozen news organizations throughout the state sharing their coverage of the novel coronavirus outbreak to help inform Oregonians about this evolving heath issue.