We're about to hear more about positivity rates and prevalence testing here in Ohio

Posted at 6:03 PM, Apr 30, 2020
and last updated 2020-04-30 18:03:39-04

COLUMBUS, Ohio — Ohio Department of Health Director Dr. Amy Acton said during a news conference on Thursday that the state will start prevalence testing next week while monitoring positivity rate to help determine how many people have been infected with COVID-19 but may be asymptomatic.

So, yeah.

What does all that mean?

Prevalence testing
Acton said a team of researchers led by a group from Ohio State will head into communities to do tests that will help doctors understand how prevalent the virus is across the state.

Acton said the state will start with 1,000 tests and conduct serological testing, which measures the amount of antibodies or proteins present in the blood when the body is responding to a specific infection, like COVID-19. It will take about two weeks before scientists are able to analyze the data.

“We're actually going to use a blood test, which is unique about Ohio. We're going to actually test the accuracy of the antibody tests, and also that type of antibody we're doing,” Acton said. “Looking at neutralizing antibodies— it's a lot of geeky science which I love getting into. It's the same thing we're testing in hospitals on people who have recovered and are donating their antibodies for convalescent plasma.”

The state is also going through emergency room data and its existing surveillance on flu-like illnesses, death rates and other data to develop a deeper and better understanding on how the virus works.

As an example, right now, in some prisons, the state is finding that in some cases, people who have the virus are 80-90% asymptomatic.

According to Acton, “You could cohort people and separate out the at-risk people from the knot, but our asymptomatic rates are so high that you really almost have to treat everyone as if they're potentially positive.”

The testing is expected to roll out on Monday.

Positivity rates
It won't be until we get into May that Ohio will really be able to increase testing. Currently, the state analyzes around 3,700 test kits a day. That number is expected to increase to 15,000 by May 6, and then to 18,800 a day by May 13. By May 27, Ohio plans to test around 22,000 kits a day.

"Numbers we will be looking at are some that we always have, the cases, and the case numbers, and of course with increased testing you're going to see more cases," Acton said.

That's where the positivity rate comes in.

"You have to look for trend and another number that's very helpful that we're looking at now," Acton said. "It's called a positivity rate, and that lets you look at the amount of positive tests, versus all the tests you did and the tests that were negative."

The idea behind looking at positivity rate is that it will help the state correct for the fact that it's conducting more testing.

"Positivity rates will be a very important number, but we have all sorts of things we're watching. We're watching hospitalizations — ICU for COVID specific. We're looking for influenza-like illnesses, to another mechanism through emergency department visits, and maybe even people who aren't hospitalized," Acton said.

The state is also looking at deaths and working with coroner's departments and medical examiner's offices to gather more information and additional reporting about individual causes of death since the death certificate might list something like a stroke if the person wasn't tested for COVID-19, according to Acton.

"There's a series of about 20 different measures that we've been building the ability to track, and those will all be things we watch," Acton said.

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