July 10, 2020
HHS Releases May and June COVID-19 State Testing Plans
Today, the U.S. Department of Health and Human Services (HHS) made May and June COVID-19 Testing Plans from all states, territories, and localities publicly available on HHS.gov. The State Testing Plans serve as a roadmap for each state's 2019 testing strategy for SARS-CoV-2, the virus that causes COVID-19. The plans include details on response to surge cases and how to reach vulnerable populations including minorities, immunocompromised individuals and older adults.
"Overall, the plans submitted by the states were very good to excellent; and all will be improved by the ongoing collaboration of states with federal experts. Testing is not just about numbers – it is about targeting testing to the right people at the right time, and incorporation of testing into a comprehensive state plan for COVID-19," said Assistant Secretary for Health ADM Brett P. Giroir, M.D. "We are pleased at what nearly every state has achieved to date, and look forward to continuing to expand SARS-CoV-2 testing capacity in the U.S."
Each plan was required to include details of these and other critical parameters, including target numbers of tests per month, as outlined in Centers for Disease Control and Prevention's (CDC's) Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases guidance document.
Since early April, teams designated by the governor in each state have worked with subject matter experts from HHS and Federal Emergency Management Agency (FEMA) to develop testing plans that set specific targets for SARS-CoV-2 testing in each state. The plans build on these early discussions, including additional detail and specificity. The plans were submitted to CDC, and were individually reviewed by a multidisciplinary team from CDC and the HHS Office of the Assistant Secretary for Health (OASH).
Feedback was provided to each state, and that feedback will be incorporated for the July – December plans due to CDC on July 10.To meet the numeric testing targets of each state, the federal government will procure and distribute certain testing supplies that are in short supply – namely, swabs and transport media - to each state and territory. The federal government will also assist in matching laboratory reagents with the specific needs of each state, and is advising commercial suppliers on their allocation -- organizing and galvanizing the industry on an unprecedented scale. Finally, CDC staff in each state will provide technical assistance on all aspects of plan implementation, including flexible testing strategies and contact tracing. States are requested to detail how a minimum of 2% of the state's population will be tested each month beginning immediately; as well as plans to increase that number by the fall of 2020. States are requested to include a list of laboratories that will be testing in their state, along with each laboratory's available platforms and throughput. The overall goals for each state were determined in a federal state collaboration considering multiple factors, including the current rate of new cases, plans for mitigation, percent positivity, and other factors.
In May, CDC awarded a total of $10.25 billion to states, territories, and localities to be used to implement the goals of each jurisdiction's testing plan. States, territories, and localities will be expected to use these funds to purchase tests and related supplies, as necessary.
Each state plan must establish a robust testing program that ensures adequacy of SARS-CoV-2 testing, including tests for contact tracing, and surveillance of asymptomatic persons to determine community spread. In general, state participants included a representative from the Office of the Governor, the state public health laboratory, the state health official, and the state epidemiologist – or their equivalents.
In each month's state plans, states must assure provisions are in place to meet future surge capacity testing needs including point-of-care (POC) or other rapid result testing for local outbreaks. States should also include plans for testing at non-traditional sites (e.g., retail sites, community centers, residential medical facilities, or pharmacies); testing of at-risk and vulnerable populations including older adults, the disabled, those in congregate living facilities such as prisons, and racial and ethnic minorities and other groups at-risk due to high frequency of occupational or non-occupational contacts; testing of individuals engaged in critical infrastructure sectors, such as food and agriculture and healthcare workers, and will address any essential partnerships with academic, commercial, and hospital laboratories to successfully meet testing demand.
Once submitted, a multidisciplinary team of experts from HHS thoroughly review each state's plan to ensure that the testing plan is sufficient to mitigate the spread of the virus, protect vulnerable groups, and account for enough testing supplies and reagents to cover all groups including underserved populations.
The review panel, chaired by the HHS Assistant Secretary for Health, includes subject matter experts that span the required disciplines, including membership from the Laboratory and Diagnostics Task Force within the OASH, the National Institutes of Health (NIH), CDC, and other subject matter experts. The panel also reviews state testing progress, needs assessment, and plans on a monthly basis to determine if modifications to the plan are required, or additional assistance is needed. Modifications to the state plans may be necessary if patterns of virus transmission change or are projected to change, increased case rates are observed, and/or additional types of testing and inventory become available through the Rapid Acceleration of Diagnostics (RADx) program at NIH or other sources.