ALBANY — While vaccines may be the proverbial light at the end of the tunnel in the COVID-19 pandemic, testing remains critical to controlling the virus while we’re still in that tunnel.
Hundreds of thousands of tests are now being administered each week across New York, with the dual benefit of telling individuals if they’re infected and showing public health officials where the virus is most active.
The statewide cumulative test total since March 1 surpassed 27 million late last week.
State health officials are now seeking to expand one of the busiest testing regimes in the nation even further as they deal with a post-holiday onslaught of new infections and the arrival here of a more highly contagious variant of the virus.
As of Tuesday, some 26,333,682 tests had been performed on New York residents, or approximately 135 tests per 100 New Yorkers. (Not every New Yorker has been tested, but many have been tested repeatedly because they are at elevated risk or could potentially put others at risk.)
That’s compared with 76.7 tests per 100 citizens nationwide on the same day.
The number of COVID tests administered per-capita varies greatly from one county to the next. In and near the Capital Region, every county’s testing percentage is higher than the national total, but none is as high as the statewide total.
The population and per-capita testing rate in these counties are:
- Albany 305,526 114.8%
- Columbia 59,461 120.4%
- Delaware 44,135 104.4%
- Greene 47,188 94.4%
- Fulton 53,183 97.3%
- Hamilton 4,416 133.5%
- Herkimer 61,319 132.7%
- Montgomery 49,221 113.4%
- Otsego 59,493 105.8%
- Rensselaer 158,714 124.5%
- Saratoga 229,863 106.2%
- Schenectady 155,299 128.2%
- Schoharie 30,999 85%
- Warren 63,944 108.5%
- Washington 61,204 96.5%
- New York state 19.45M 135.3%
- United States 328.24M 76.7%
The numbers are drawn from a state Department of Health database except for the national figures, which come from the federal Centers for Disease Control.
There is no apparent pattern to the county percentages — they don’t move in sync with income levels or population or geographic proximity to each other, or urban/rural profile.
There are a variety of other factors that influence the numbers.
State Department of Health spokesman Jonah Bruno said via email:
“COVID-19 testing numbers often vary by county, with multiple factors accounting for the differences. Those can include people who are frequently tested in the county where they work, but live in a different county, as well as pop-up testing events to address localized outbreaks. With more than 26 million tests in New York to date, we continue to expand our statewide testing efforts, working with state and local partners to ensure tests are available for everyone who needs them.”
Tests are recorded by the person’s county of residence, Bruno added, not by the county where the swab was put in his or her nose.
Eli Rosenberg, a University at Albany associate professor of epidemiology who was embedded in the state Department of Health from early March through August, has returned to academic work but still sits on Gov. Andrew Cuomo’s COVID-19 Vaccine Distribution and Implementation Task Force.
“It’s funny how testing has fallen out of the headlines, but it’s an important tool. THE important tool,” he said. “Many places upstate are at an all-time high.”
Rosenberg said there’s not a single reason why the test rate for one county’s residents is much lower or higher than in a neighboring county.
“Different phases over the past year have seen changes in the testing being done,” he said.
The most basic reason: “Where the epidemic is surging, you’re going to see more testing.”
Other factors: Some colleges run many tests on students, and this can boost a county’s numbers; high-volume drive-thru test sites such as the one at UAlbany draw a lot of traffic; large health care facilities generate a lot of tests.
Meanwhile, hidden factors can make raw number comparisons uneven. Rosenberg has studied HIV rates in upstate counties, which are generally much lower than in downstate counties, except if the county has a state prison within its borders. HIV-positive state prison inmates are not considered county residents, but their infections are tallied as such. So here and there across the state one sees what appears to be an HIV cluster but actually isn’t.
Can county health officials do anything to boost the number of times their residents are tested? Should they?
Rosenberg said the question of whether to test is highly individual, based on a person’s circumstances, rather than a blanket policy for the whole community.
But counties should encourage them to be tested if they want or need to be, through public education efforts, especially since there’s no shortage of test supplies now unlike in the early days of the pandemic.
“I think a lot of it is around public information,” he said.
Three contiguous counties — Schoharie, Montgomery and Schenectady — have low, moderate and high testing rates among their residents, as compared with the rest of the region.
Schenectady County Administrator Rory Fluman last week said the county has maintained a vigorous testing program for many months, but he doesn’t think there’s anything it did or didn’t do that gave it one of the highest testing rates in the region.
It may come down to something beyond the county’s control — the number of nursing homes there.
“The only thing I can point to is people in nursing homes are tested more often,” he said. “We do have the six nursing homes in the county. If we have more residents working in nursing homes, they’ll be tested more.”
Another potential factor, Fluman said, is “just the fact that we still have a full-service health department.” Not every county does.
Through the spring and summer, Schenectady County public health officials operated mobile test sites to supplement the fixed test sites within county borders and did social media outreach to urge residents to use them.
Once it gained rapid testing ability, the county scaled back the mobile testing and focused the rapid testing on known clusters of COVID activity, so as to better identify infected people.
There’s now only one round of community testing per week — Thursday mornings at SUNY Schenectady County Community College — and that arrangement will continue even when warm weather continues, Fluman said.
“We are going to be so focused on vaccinations that we’re going to stay with our once-a-week physical site and our daily cluster testing,” he said.
Testing is still important, he said, and the waiting lines at pharmacies suggest tests are in high demand. But now, vaccination has to be the priority.
As of Tuesday, 128 tests had been administered for every 100 Schenectady County residents.
Montgomery County Executive Matthew Ossenfort said being a smaller, mostly rural county with budget constraints does create obstacles to building an effective testing regimen.
“I think certainly we’ve had our challenges,” he said. “I think we’ve really been proactive about urging people to be tested.”
However, being small and rural also is helpful in some ways: Neighbors are acquainted with and help one other, Ossenfort said.
“It’s one of the joys of being a small county executive: People know each other here.”
As of Tuesday, 113 tests had been administered for every 100 Montgomery County residents.
In Schoharie County, the problem is lack of testing sites and distance of residents from those sites, Public Health Director Amy Gildemeister said.
“I completely agree that our access to testing is inadequate in Schoharie County,” she said.
Many county residents would have to travel to Albany or Oneonta to be tested, and some people lack time, money or reliable transportation for such a trip, she said. This has the effect of blocking some vulnerable populations from being tested.
There are ripple effects, too: Schools want children with mild symptoms that may or may not be COVID kept out of the classroom until they test negative or until two weeks pass. Parents who can afford one get a rapid test kit that gets their child back in school quickly, while others must keep the young ones at home.
“That’s one of the big concerns I have with testing, is having it be more equitable,” Gildemeister said.
Another result: There is not a clear picture of how the COVID pandemic is affecting Schoharie County. It has one of the highest positive test rates of any county in the state — 12.6 percent for the week ended Tuesday — but that’s likely because it is trying to focus testing on those with symptoms or who are otherwise likely to be sick, she said.
When SUNY Cobleskill was in session, the county’s positive test rate was substantially lower because the students were healthy and being tested in large numbers. “It’ll go down again when SUNY Cobleskill comes back in session,” Gildemeister predicted.
One heartening metric: Schoharie County has had just five known COVID-related deaths, which is the second fewest of any county in the state after Hamilton County, and even lower per-capita than Hamilton, which has just one known death.
As of Tuesday, 85 COVID tests had been administered for every 100 Schoharie County residents.
Here are the number of tests administered from March 1 to Jan. 5 in the various counties, and the rate of positive tests during that period:
- Albany 350,848 3.7%
- Columbia 71,605 2.6%
- Delaware 46,093 1.7%
- Greene 44,548 3.6%
- Fulton 51,738 2.9%
- Hamilton 5,894 2.1%
- Herkimer 81,366 3.3%
- Montgomery 55,809 2.9%
- Otsego 62,929 2.1%
- Rensselaer 197,590 2.6%
- Saratoga 244,085 2.8%
- Schenectady 199,044 3.4%
- Schoharie 26,345 2.5%
- Warren 69,397 2.1%
- Washington 59,090 1.7%
- New York state 26,333,682 4.0%
- United States 251,797,935 8.3%