As coronavirus cases emerged in Texas this spring, Montgomery County lacked free COVID-19 site testing for those without insurance, but on April 28 officials approved distributing about 12,000 free nasal swab tests through local sites for symptomatic residents.
Ideally, there should be a free coronavirus testing center in every quadrant of Montgomery County, said Misti Willingham, public information officer for the Montgomery County Public Health District. As of May 5, 662 residents had tested positive for the virus, including 240 in the six Montgomery County ZIP codes in The Woodlands area.
However, due to limited resources, Montgomery County—which has a population of more than 600,000 compared to Harris County’s 4.7 million, according to July 2019 estimates by the U.S. Census Bureau—had previously been unable to secure enough testing kits to launch a free testing site due to limited supplies and a backlog on orders for testing kits.
“Even though we have paid for them ... all of this activity is creating such a backlog ... that we’re still waiting and they get put off,” Montgomery County Judge Mark Keough said.
Testing availability
The new tests became available when the public health district voted April 28 to use grant funds to obtain 6,120 tests for symptomatic residents for use at four sites through a voucher system. Lone Star Family Clinic in Conroe and America’s ER Medical Center on FM 2978 in Magnolia were announced as two locations, but as of May 5, a starting date for the program had not been announced by the county.
Melissa Miller, the chief operating officer of the Montgomery County Hospital District, said in late April the Office of Emergency Management was in the process of confirming contracts for two other sites in east and west Montgomery County.
At the hospital district’s April 28 teleconference meeting, CEO Randy Johnson said an additional 6,120 nasal tests would be made available at the four free testing sites for both symptomatic and asymptomatic county residents, bringing the total to more than 12,000.He said the testing initiative was developed after the county experienced difficulty acquiring its own stock of nasal coronavirus tests.
“We haven’t been able to get any tests. ... All this stuff about, ‘There’s tests everywhere,’ that ain’t true. I’ve checked everywhere,” he said.
Through the county health organizations’ program, residents wishing to be tested may register through the county to receive a voucher for nasal swab testing at one of the four approved sites. Once residents receive their results, the county will reimburse the cost of the test, Johnson said.
The testing program was approved by hospital district board members at a cost of up to $314,000, funded through a $336,000 stimulus grant received through the Coronavirus Aid, Relief and Economic Security Act from the U.S. Department of Health and Human Services. The cost covers 6,120 tests at a cost of $51.31 each.
“I think [increased availability is] really going to be a big help in filling some more of the requests that we’ve gotten from local health departments or local governments that want to really step up the testing in their areas, and then we’re expecting additional shipments in the future,” said Chris Van Deusen, director of media relations for the Texas Department of State Health Services.
Strategies emerge
Before the new tests were made available, Willingham said the closest free testing site for Montgomery County residents was in Butler Stadium in southwest Houston, operated by the city of Houston. In addition to the city-led site, Harris County runs two drive-thru testing sites, which are free to anyone in the general public experiencing symptoms.
While Montgomery County has lagged on testing due to availability limitations, Harris County Judge Lina Hidalgo on April 28 unveiled a three-pronged approach to testing after Gov. Greg Abbott announced his plan to begin reopening Texas businesses May 1. The process of “Test, Trace, Treat” will ramp up Harris County’s testing capabilities as part of a COVID-19 containment plan. In The Woodlands, the village of Creekside Park is located in Harris County.
Umair Shah, executive director of Harris County Public Health, said April 27 the state of Texas had more than 25,000 confirmed coronavirus cases with Harris County accounting for 5,827 of those cases. Hidalgo said the county was averaging about 200 hospital admissions on a daily basis.
In early May, Montgomery County had more than 660 confirmed cases, but those numbers did not include suspected cases that had not been confirmed by testing. For example, as of April 27, there were seven suspected COVID-19 cases in Montgomery County intensive care unit beds and six confirmed, as well as 20 confirmed cases and 11 suspected cases in other hospital beds, according to Southeast Texas Regional Advisory Council, a coalition of regional health care providers.
Montgomery County has 159 operational ICU beds and 191 available during a surge—a federal mandate that facilities be able to increase their capacity by 20% in emergency situations, according to the SETRAC.
Willingham said the total number of tests conducted in the county could not be traced because health care providers are only required to submit positive results.
Although Montgomery County has a lower population and fewer confirmed cases, as of May 5 about 36% of the confirmed cases were in the six ZIP codes in The Woodlands area.
Challenges in getting tested
Although Montgomery County announced the planned free testing sites in late April, numerous private entities have opened testing sites in the county, including several drive-thru sites. America’s ER opened the county’s first drive-thru testing site at Stonebridge Church in The Woodlands on April 4, and Lone Star Clinic Family Clinic in Conroe opened its drive-up testing clinic April 13.
Self-pay swab tests are $150, and insurance is accepted at both facilities, according to the clinics’ websites.
Dr. Mark Feanny, president, CEO and owner of America’s ER, said because of the speed the virus spread, the funding, infrastructure and general bureaucracy were not in place. This prevented money from flowing quickly to allow for free and low-income testing, he said.
“I think people were caught off guard,” Feanny said.
America’s ER was testing between 130-140 people per day at its Stonebridge Church location in April, Feanny said.
“Until we receive subsidies of some form from any government agency, it will be challenging for us to open this test to the ... uninsured public,” Feanny said. “Somebody has to pay the check. And right now, we’re the one’s holding the bill.”
Dr. Joan Purcell, a physician at Step Pediatrics on Panther Creek Drive in The Woodlands said her facility has offered testing for patients on a limited basis, but like many private offices, it has faced a lack of availability for the swab tests it uses.
“As far as availability we’re on a countdown,” Purcell said April 27. “We started with 44 swabs for nasopharyngeal testing, and we’re down in our office to about 15.”
Another type of test offered at some area facilities, antibody tests, pose several challenges in accuracy and interpretation, she said.
“People are trying to use antibody tests to see if health care workers were exposed. The problem ... is that we don’t know how long it takes for the [test] to be positive,” she said.
Willingham said the new swab tests will help to track coronavirus numbers more accurately, but she said she could not predict how many tests will be needed in the county.
“We are hoping these tests provide some comfort to residents who need to be tested, and hopefully it will shed some light on the real impact of COVID-19 in our county,” she said.
Ben Thompson contributed to this report.
