Missouri will roll large-scale coronavirus saliva testing by the end of September, speeding results and more than doubling the state’s daily test capacity, the state health director said Friday.
In a session with reporters after speaking to a Columbia Chamber of Commerce Lunch with a Leader meeting on Zoom, Director Randall Williams said he couldn’t give much information but expects the tests will allow 20,000 results per day to be generated.
During the meeting, he defended his recommendations against a statewide mask mandate and described the priorities for any vaccine that may become available. Speaking to reporters, he said he would not recommend statewide adoption of the plan used by Columbia Public Schools that triggers changes from in-person to online learning based on COVID-19 case counts within the district.
The Columbia Board of Education will meet Monday afternoon to consider whether the recent surge in cases locally means it should implement the plan to go online when case numbers reach 50 per 10,000 residents over two weeks. The rate reached 52.1 on Thursday and stood at 61.5 on Saturday.
"I am not as much of a believer in that because I think those triggers are not granular enough," Williams said. "Just looking at positivity rate, or case rate, I don’t think gives you the specificity to make those kinds of draconian decisions."
On Wednesday, the Food and Drug Administration granted Washington University in St. Louis an emergency use authorization for the saliva test it developed. Missouri will have an edge in access to that test, Williams said, but he said the state is also looking at other tests.
"Looking at the universe of saliva testing, including Wash U, I am confident we will have saliva testing the way I just described it by the end of the month," Williams said.
If Williams is correct, Missouri will not be the first to use such tests. The University of Illinois was ready when students arrived with a saliva test for 50,000 students and 10,000 staff and faculty.
Missouri’s peak of testing came in mid-July, when the state was averaging a little more than 15,000 tests per day. In the week ending Aug. 22, that rate was down to about 12,000 tests per day.
A saliva test can return results within 24 hours and labs can process about 20,000 samples per day, Williams said.
As he spoke about the Columbia schools’ plan to use case thresholds, his feelings on a state mask mandate and the decision Friday by Columbia-Boone County Health Director Stephanie Browning to order bars closed at 10 p.m., Williams stressed that the state supports all local decisions to control COVID-19.
If a community like Columbia wants to have an ordinance requiring masks, he said, he supports it.
"If other communities think they are creating more problems in doing that, and we really need to stress messaging and education, we support that," Williams said.
During the lunch meeting, Williams described the state’s experience with the coronavirus as fortunate and less severe than other states. Missouri is in the lower half of states, 34th, in total cases per capita and deaths.
And while the state ranks in the upper third of states for cases since July 1, the death rate in that period is 34th in the nation.
"We have a lot more young people getting the disease who don't die," Williams said to reporters. "And so our numbers are going up but thank goodness our hospitalizations, our mortality are not going up."
Of the cases reported statewide in the week ending Saturday, 43 percent have been among people under 30.
The key to ending the surge in cases is responsible behavior, Williams said, and ending the pandemic will take a vaccine.
"For a disease that doesn't have a vaccine, that doesn’t have antivirals, you are really dependent on the people," Williams said.
A vaccine will be made available first to health care workers, first responders and people at high risk of severe disease or death from COVID-19, Williams said. Then it would be made available generally.
But the key to success, he added, is that people will take the vaccine in large enough numbers that those who won’t are protected.
It will take education, a message delivered by the right messenger, and enough vaccine that when a person seeks it, it will be available, he said.