The Municipality of Anchorage is scaling back COVID-19 testing efforts, including reducing testing site hours and changing guidance on who should get tested, as the city continues grappling with a virus surge that’s recently driven cases in the city to pandemic highs.
The changes stem from a steep rise in the number of people seeking tests and a lack of funds to pay for those tests, a city health official said Thursday.
A note at the top of the testing locations website, anchoragecovidtest.org, said as of Thursday that testing locations run by city contractor Visit Healthcare “should only be used by people with COVID-19 symptoms or who are a close contact of a positive COVID-19 case.”
By Friday, the note was gone, but individual sites continued to note that they were for “only people with COVID-19 symptoms or close contacts of a COVID-19 case.”
Additionally, starting Friday, Visit Healthcare will scale back hours at several sites around the city by 108 hours each week, the company said.
Visit Healthcare runs many of the primary testing locations in the city, including those at the Loussac Library, Changepoint Church, Muldoon Community Assembly and the Eagle River site.
The decision to scale back hours and change the messaging has to do with a contract between the city and Visit Healthcare that expired over the summer and was extended for 90 days — through October — for roughly $7.5 million, Anchorage Health Department director Joe Gerace said Thursday afternoon. He was previously the director of operations at Visit Healthcare.
Given recent and significant increases in testing, the funding for tests is beginning to run out, Gerace said.
“That’s the straw that broke the camel’s back,” he said. “The volume has gone off the hook.”
Testing volume now is different from when the city extended the contract over the summer, Gerace said.
“Nobody foresaw the delta variant cranking testing numbers up to 1,500 a day,” he said. “So that has been what prompted this change.”
Anchorage, along with the rest of Alaska, has seen a major surge in new COVID-19 cases and hospitalizations since July. The city is the epicenter for health care in the state, and the three major Anchorage hospitals have activated crisis standards of care to provide flexibility and liability protection, as well as guidance for providers in case scarce resources require the prioritization of care for patients.
More cases have been identified as more tests have been conducted: In June, municipal testing sites were conducting between roughly 100 and 200 tests in total each day, but by August that number began eclipsing 1,000. In September, as Anchorage saw its highest-ever daily case counts, there were multiple days when more than 1,500 tests were performed, according to data from the city.
At current testing rates, Gerace said, the city would have run out of testing money on Oct. 18 and the soonest it could get a financial extension would have been Oct. 26 — meaning no city-run test sites would operate during the period in between.
Gerace said the city approached the vendor to ask for a price break on the tests, which cost $98 each, but they didn’t provide it.
Emily Oestreicher, chief development officer for Visit Healthcare, said in an email that the decision to scale back hours and change testing protocols was made by the city and wasn’t a result of shortages in testing resources.
Chelsea Ward-Waller, a spokeswoman for the health department, highlighted that the earlier note at the top of the testing website used the term “should.”
She said the department was not excluding anyone from those testing sites.
As positivity rates stay high, an effort to scale back testing
The changes come at a moment when, according to state and city data, Anchorage is seeing its highest percentages of tests returning positive results since the start of the pandemic.
In a memo to the Anchorage Assembly’s health policy committee last week, Anchorage Health Department chief medical officer Dr. Michael Savitt wrote that between Sept. 23 and 29, the city’s percent positivity was 9%. By Thursday, state data showed that number had risen to roughly 10% of tests returning positive results.
The percentage of tests coming back positive has long been cited by health officials as a way to gauge whether communities are doing enough testing.
“Percent positivity increasing above 3% indicates that we are missing cases because the community may not be accessing the available testing,” Savitt wrote in the Oct. 1 memo. “Increasing testing volume along with increased test percent positivity suggests that the increasing case counts are real and not just an artifact of testing.”
Ward-Waller said the Anchorage Health Department is focused on aligning with Centers for Disease Control and Prevention guidance — which, according to an early August update, recommends testing for those who have symptoms of the virus, people who have a known exposure of someone with a confirmed or suspected case of the virus and people not fully vaccinated who either are prioritized for community screening or have been asked to get tested by school, work or a health care provider.
“People that are fully vaccinated shouldn’t be getting tested just because someone in the office walked by,” Gerace said.
Fully vaccinated means people are two weeks past their final dose of the vaccine.
“So we do want to dissuade those people from taking the space and that precious commodity for the really sick people,” he said.
Gerace said that’s what the city was trying to get at with the initial messaging. He said the city will update its guidelines on the testing locations website to be clearer about who should and should not get tested.
“The piece that we really want to make sure is that the people that need the test have those services available to them,” Gerace said.
He also emphasized that there are several other places to get tested in the city.
Those other locations include a state-funded site at the Alaska Airlines Center, which doesn’t list any guidance on who should be tested there, and the site at Ted Stevens Anchorage International Airport, which is labeled as offering asymptomatic testing only. Both are operated by Capstone Clinic. Free testing is also available at Walgreens.
The sites operated by Visit Healthcare are the ones the city controls, Ward-Waller said, which is why other testing locations listed on the website don’t have the same disclaimer.
An upcoming request for more funding
Testing is reimbursable by the Federal Emergency Management Agency, but it has to be both fair and equitable and also comply with CDC guidelines, according to Gerace. Plus, the city has to foot the bill for as long as a year, Gerace said.
“Cutting hours doesn’t mean we’re cutting access for people. I’m actually ensuring that,” Gerace said. “Because if the money runs out, there’s no testing between (Oct.) 18 and 26.”
Corey Allen Young, spokesman for Anchorage Mayor Dave Bronson, said that the administration would be submitting a request for additional funding to the Anchorage Assembly “in the near future.”
“Until supplemental funding is secured, the Municipality of Anchorage is actively managing our current resources to continue testing through the end of the month,” Young said in an email.
The guidance from the city “absolutely, completely aligns with the state guidance,” the state’s chief medical officer, Dr. Anne Zink, said in a call with reporters Thursday. She also called state’s testing guidance “a little bit more extensive.”
The state’s guidelines for asymptomatic and unvaccinated people may include testing for routine screening as required by local communities, when admitted to health care facility, residents and staff in certain healthcare settings and workers in congregate settings.
The state also lists “limited testing of asymptomatic vaccinated persons,” and recommends that people who are fully vaccinated against the virus and who are not showing symptoms or had recent exposure be exempted from routine screening programs if possible.