JOHN DAY — A state change in counting COVID-19 tests will benefit rural Oregon — once the state figures out how to accurately account for all the tests.

Previously, the state was not counting multiple tests taken by a single person, which failed to account for many negative tests taken weekly or monthly by health and long-term care workers. However, as the Oregon Health Authority is switching its system, rural county health officials say many of the results from the rapid tests they are using, which are reported differently, are not yet being counted at all.

Grant County Health Department Clinic Manager Jessica Winegar said, like other rural counties, most of its testing is with the rapid tests. She said Grant County sent many more than the 393 rapid tests the state recently reported.

“I am 100% sure,” she said.

However, she said they cannot recount them after they go to OHA.

Harney County Public Health Administrator Nic Calvin said, as a county that is primarily testing via the rapid and antigen tests, the county’s test results are not accurate.

In the first week of November, the state reported two positives and 79 negatives. In reality, Calvin said, Harney County had between 10 and 20 positive rapid test results that week.

State health officials did not immediately respond to the Blue Mountain Eagle‘s request for comment. Eastern Oregon health officials said the state is aware of the problem, but has not provided a time frame in which they expect to fix it.

The problem

Umatilla County Public Health Director Joe Fiumara said rapid tests, which account for a majority of the types of tests administered in rural counties, will not be counted for the next couple of weeks.

OHA said laboratory tests comprise the majority of tests given in Oregon and as such are the bigger priority, he said.

Fiumara said, not only does the delay in counting the test results impact the severity of county lockdown measures, which are based in part on the positivity rate, it also gives county health officials no way to track, isolate and respond to positive cases.

“If (rapid tests are) the only testing happening in a county, you can have positive cases with a zero percent positive rate,” he said.

According to OHA’s data, Grant County had a total of 31 positive cases last month when the county saw roughly 95% of its 142 infections.

Sarah Poe, Malheur County’s public health administrator and public health information officer, said most health care providers in rural counties do not have access to in-house labs and send out for them when someone is sick.

Poe said rural Oregonians lacked accessible testing options, and the purpose of bringing rapid tests to the county was to make it easier for people to test.

“Early on, we’re given a rapid test machine,” she said. “Most of our clinics around here, including the hospital, all have rapid test machines, and none of those tests are being counted.”

Poe said, previously, she and her staff had manually converted the formatting so antigen and rapid test results could be submitted to the state’s database with the other results. However, she said the state is now purging the negative rapid test results from its electronic system, which was bogged down with so much data, so those negative tests can no longer be tracked.

She said there were about 600 test results with a 10% positivity rate from drive-thru tests in November that would not be counted under the current setup.

The impact

Poe said the problem is Malheur County’s positivity rate is 20%, and the county is conducting drive-thru tests en masse using rapid tests with nowhere to send the test results — a large number of negative tests that would reduce the rate will not be counted.

“We’ve been fighting an issue with public perceptions since the beginning of this, and items like this don’t help,” Fiumara said.

Poe said ramping up testing amid an outbreak of positive cases is the right thing to do, but it’s difficult when many residents are skeptical of the virus to begin with.

“I have guaranteed my constituents because they are working really closely with us to expand testing, and we’ve had to do a lot of relationship-building in a very conservative county even to get people on board to test,” she said. “I am losing all of the buy-in and the trust that went into increasing testing.”

The positives

The health administrators agreed the change to count all tests, and not just tests from new patients, will eventually benefit rural counties.

Fiumara said, if someone tested negative in May, but then returned for another test in September and was negative, that second test would not have been counted as part of that September daily number of tests administered.

Not counting “serial testers,” such as health care workers, increases the positivity rate of counties, he said.

The positivity rate is important, he said, because it is used to determine when to open schools or when and how to limit businesses.