HUNTINGTON — When it comes to a system to measure COVID-19, West Virginia health officials have decided one that encourages testing, even if people attempt to take advantage, is better than no testing at all.
West Virginia developed its county color-coded COVID-19 measuring system using a model developed by Harvard researchers, and tweaked that plan after officials determined it encouraged communities to not get tested for fear of negatively impacting the metric, thus keeping children out of school.
Now, media outlets have reported communities have tried to influence the system by getting tested multiple times a day, mainly to get counties into football-playing territory. Gov. Jim Justice last week reported 13 incidences of this were found and the cases were thrown out. He instructed the director of the WVSSAC to come up with guidelines for testing players and punishments if coaches are found encouraging players to get tested multiple times a day. Those plans have not been released yet.
While it seems a handful of West Virginians have tried to "game the system," state coronavirus czar Dr. Clay Marsh said it would take a large, organized effort to really impact the metric, especially in larger counties. Smaller counties might be able to nudge their numbers in this way, but it would still take some effort.
There have been no reports of anyone attempting to influence the numbers in Cabell County, said Dr. Michael Kilkenny, chief health officer of the Cabell-Huntington Health Department.
Still, Kilkenny encouraged everyone not to try and test multiple times a day, mainly because it is a waste of resources. He said a person would likely be turned away at the health department if they were caught returning in the same day for another test.
"We would discourage that," Kilkenny said. "No. 1, it potentially wastes resources, but it won't help them any."
Kilkenny also expressed doubt there was a widespread enough effort to manipulate the data.
"There are rules that govern the processing and management of this data," Kilkenny said. "There are definite mechanism by which it's analyzed. They are set, known... Those who still trust the government to help them should rest easier knowing we take these numbers seriously. We want you to know about them as quickly as possible."
Both the state and the county monitor for duplicate tests.
Locally, Kilkenny said most times duplicates are the result of human error or from case transfers from county to county.
At the state level, Marsh said they are discussing how to better catch duplicates, but they have to be done manually, which makes it difficult.
Marsh said he also believes there are good reasons for duplicates. For example, someone may be tested after being in close contact with a positive case. The first test may be negative, but a few days later, the person starts to feel sick, so they get tested again. That second test should be counted, Marsh said.
Another example is the three times a week tests of the state's college football players, including Marshall.
But Marsh said they want to find a better way to catch other types of duplicates, such as someone who went twice in one day.
"This is my first real experience working with the state government at this intensity level, but I am blown away by the dedication of the people here," Marsh said. "I have no pony in the race when I say the people work really hard. The complexity they deal with is substantial. And the systems we have to work with are not as sophisticated at our state level, or any state level probably, but I see people trying really hard to find a way to approach these complex issues. It's all a work in progress."
The state's metrics continue to be critiqued, including by the state's teachers.
Even one of the nation's leading coronavirus experts Tomás Pueyo - whose work is frequently cited by Marsh - said the use of two different criteria to monitor schools was "stupid," according to reporting by Mountain State Spotlight. He said you need to use both prevalence and positivity rate.
Marsh stands by his metric system, saying more testing will drive the number of positives up but eventually, the percent positive will drop. He also reiterated the system is not for getting back in school, but to reduce spread of the virus in communities. Reducing spread is how students stay in school safely.
"The people who spread, more like 75% are spreading to 80% of other cases, and having no symptoms," Marsh said. "One of the problems, people are using old thought patterns for new things. Our group is trying to look at things differently. If we see our death rate below 3%, do contract tracing and do things right, it will affirm that for our state it is working. And if something doesn't work and we see things going in the opposite direction, we can shift. We have to find the line between constantly tweaking things so people feel like it never settles and trying to create a learning system. As you see flaws and benefits you are constantly adjusting."
What will remain constant is health officials push to increase testing and encourage broad testing now that it is available.
Friday, Justice announced Walgreens and Fruth Pharmacy will be offering free drive-thru COVID-19 testing in several counties, including Cabell and Putnam. Anyone in any county can get free testing at these locations. The tests are paid for by the Department of Health and Human Resources.
DHHR Secretary Bill Crouch said the goal was to set up every pharmacy in the state with the ability to provide free COVID-19 tests.
Free testing is available at the health department all weekend, including Sunday. The health department also provides tests Tuesday and Thursdays.