Question: At the beginning of March, New York State was conducting 40–50 COVID-19 tests a day. By the beginning of April, NYS was conducting 20,000+ tests a day (see bar chart below). How did it manage to increase testing by such an enormous magnitude?
Answer: New York State has conducted the most tests per capita of any U.S. State and even more than South Korea. This success is attributable to the following factors:
- Existing Capacity: New York State has strong laboratory capacity with 28 labs the New York Department of Health can call upon.
- Leadership: New York State’s leaders were quick to recognize that testing would be a key component of the pandemic response and made strong calls for testing capacity early on in the epidemic.
- Regulatory Approval: On 13 March, FDA authorized New York’s Department of Health to process thousands of coronavirus tests per day by contracting with private labs. This allowed the NY Department of Health to authorize its 28 labs to conduct tests without need to engage with FDA or get an Emergency Use Authorization. That same day, FDA also authorized automated testing.
- Public-Private Collaboration: Meanwhile, the State of New York had been working on public-private partnerships with labs like BioReference with the aim of establishing drive-thru testing sites and increasing lab capacity. Once FDA approval was received, New York was able to quickly implement its plans.
- Existing Capacity/Regulatory Approval/Innovation: Additionally, New York’s larger labs had the financial and technical capabilities to purchase and use automated testing equipment as it was approved by FDA. For example, Northwell adopted Hologic testing once it received FDA approval on 16 March, allowing it to test 1,150 tests/day.
- Innovation: Finally, on 29 March, New York State’s Wadsworth Lab announced its new, less intrusive test for COVID-19, which allows testing to be done through a saliva sample and a self-administered short nasal swab in the presence of a health care professional, thereby reducing risk of exposure while increasing testing availability.
To curb the pandemic, testing must be wide-scale and population-based. New York’s testing began after community transmission had taken hold. Testing has thus far focused on identifying infection among those who exhibit illness. With 40% of New York’s tests coming back positive, more testing is needed to ensure that asymptomatic and pre-symptomatic infections are identified so that these individuals can self-quarantine, their contacts can be traced, and infection spread can be minimized.
