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Missoula health officials launch “sentinel testing,” screening for vital workers most as risk

Missoula Drive Thru COVID-19 Testing
Cindy Farr
COVID 19 Social Distancing
Posted at 12:20 PM, Jun 19, 2020
and last updated 2020-06-19 14:26:55-04

MISSOULA — In an effort to get ahead of an anticipated resurgence of COVID-19, health officials in Missoula plan to launch surveillance testing and extend it to asymptomatic workers in various fields.

Missoula-City County Health Officials announced the new approach on Friday, making good on a state directive asking local health departments to screen certain sectors of the population that may be at greater risk of contracting and spreading the virus.

“It’s a surveillance system where we look at specific groups of people who we feel are at high risk for either getting the disease or spreading the disease,” said Pam Boyd, a public health nurse who came out of retirement to lead the effort. “We’ve identified high-risk groups and we’ll test those groups and analyze the data that we get from those groups to look for trends happening in Missoula County so we can step in and do some early intervention.”

The number of confirmed COVID-19 cases in Montana has jumped this past week, including 25 cases on Thursday and another 11 cases reported early Friday.

Missoula County also has seen its numbers tick up, including six new cases this week. Contact tracing has linked those six cases to three modes of transmission including travel, contact with a known case, and community spread.

Early in the pandemic, local health officials struggled to stockpile testing supplies and the personal protective equipment needed to keep frontline workers safe. But such challenges have been overcome and testing has increased over the past few weeks.

Missoula County opened its drive-thru testing site on April 11 and has tested 752 people so far, not counting those who arrived on Friday. Those tests have been reserved for symptomatic patients, meaning they were showing viral symptoms and were referred by a health professional.

But the new surveillance testing, or sentinel testing, will expand that approach.

Cindy Farr
Cindy Farr, head of the pandemic response in Missoula County, discusses the role sentinel testing will play in identifying COVID-19 cases in asymptomatic patients and intervening early.

“We’re updating all our protocols here so we can begin testing asymptomatic individuals as part of our sentinel testing plan,” said Cindy Farr, who’s leading the local pandemic response. “It will include healthcare workers, grocery store clerks, service industry workers, daycare and preschool workers, camp staff and counselors, and people experiencing homelessness, along with county residents returning home to Montana.”

Gov. Steve Bullock moved the state’s economic reopening to Phase 2 in early June, permitting bars and restaurants to increase capacity. Missoula County followed suit, allowing crowd sizes to grow with certain precautions. The mandatory 14-day quarantine of visitors and residents arriving in the state was lifted.

The easing of restrictions, along with more social mixing, led health experts to predict a resurgence of COVID cases. That prediction came to fruition this week, with numbers trending back to where they were in March.

As more testing takes place, health officials expect to see those numbers continue to climb, though they’re better positioned to deal with it now than earlier in the outbreak.

“As we know from past outbreaks, if we’re looking for cases, we’re going to find them,” said Farr. “We definitely expect that as testing continues to increase, we are likely going to see an increase in our case numbers. At this point, we have enough trained people who are able to do contact tracing, so we don’t have any concern for that right now.”

In an effort to mitigate spread without putting economic restrictions back in place, the Missoula health department intends to widen its screening efforts by targeting asymptomatic residents most at risk of contracting and spreading the disease.

“We know tourism is increasing and we’re starting to see a lot more people come into our county from other parts of the country,” said Farr. “Our front line workers are people who work at the grocery stores and in our restaurants that are going to be serving those people.

“It’s important that we’re targeting those populations so we can really try to pick up on these cases before they’re symptomatic and spreading it to a lot of people and get them isolated, find out who their contacts are, get those people into quarantine, and continue that contact tracing.”

COVID 19 Social Distancing
City officials and healthcare workers gather to discuss the new sentinel testing announced Friday by the Missoula City-County Health Department.

The Missoula health department on Friday also issued another call for healthcare workers willing to staff the testing facility. While they’re currently testing around 30 people a day on average, they’d like to increase that number to 70, though that will require more nurses.

And while some states are putting restrictions back in place to combat further spread, Missoula health officials said they’ll continue watching the trends and analyzing the data before making such decisions.

They’re also holding back on making face coverings mandatory in public, as is now the case in California.

“I don’t know that we’re going to move into requiring it at this point, but that could certainly change as we move forward,” said Farr. “We had seen a dramatic decrease in the number of people wearing masks but I can tell you that just this week with numbers going up, we’re seeing more people put those face coverings on.”

Click here for more information on Missoula County's COVID-19 Sentinel Testing plan (pdf).