Despite delay in test results, Nez Perce community effort proves successful in slowing spread

The Nez Perce tribe reported good news about its efforts to control the spread of the coronavirus among its members this week, but the long wait raised concerns at Nimiipuu Health.

More than two weeks after mass testing nearly 400 Nimiipuu tribal members in late June and early July, only one test has come back positive, said Nimiipuu Health Medical Director Kim Hartwig.

But test results came in slowly and erratically. Seventeen days after the testing event in Lapwai, Idaho, the tribe was still waiting for results of eight tests, she said.

The outside lab where Nimiipuu Health sent its nasal swabs gave a three- to five-day time frame for results to return initially. The lab is now quoting a 13-day turn around for results.

Nimiipuu Health also offers rapid testing for symptomatic people that takes 3 to 15 minutes, though providers can only conduct 18 to 20 of those rapid tests per day.

Overall, including not only mass tests but also individual rapid tests of symptomatic people since May 1, Nimiipuu Health has tested 678 people and 24 have come back positive. Those positive cases have mostly been the consequence of travel and not community spread, Hartwig said.

That’s a reflection of the community’s diligent effort to slow the virus’ spread, she said.

“In retrospect it turned out to be fine. At the time, you certainly expect to get a result in two or three days as opposed to 16 or 17,” Hartwig said. “But we understand the delay is not purposeful. … We just appreciate that we’re getting the results that we are. Would we have preferred them in a shorter time frame? Of course.”

In this case, Hartwig sees value in tests that come back slowly because they can reassure the community that social distancing efforts are working. But if the community hadn’t quelled the spread already, the wait for test results could have had serious consequences.

One positive case can infect many people a day, which is why we see numbers climbing fast nationwide, Hartwig said.

“I describe people at risk kind of like a pebble in a pond,” Hartwig said. “When you drop a pebble, that’s a person that’s positive and then you get rings created beyond that pebble.”

That first ring is the biggest problem, Hartwig said, because from there the virus can start spreading fast.

And she had reason to worry. Three people tested positive for the virus shortly after they joined a congregation at the semi-annual General Council, Hartwig said.

Nimiipuu Health chose to test “aggressively” following those three cases because the tribe’s tests in May showed a significant number of asymptomatic people testing positive.

At the same time, Nimiipuu face more chronic diseases than the average population, which elevates risks involved with COVID-19, Hartwig said.

The delay in recent testing results is representative of a statewide trend as the number of people getting tested surges, Hartwig said.

The outside lab where Nimiipuu Health sent its nasal swabs, Quest Diagnostics, informed the tribe it had been receiving about 10,000 tests per day, Hartwig said. As a result of that surge, Hartwig said the lab sent Nimiipuu Health’s specimens “all over the United States.”

Those returning test results have not only come slowly, but in “no particular order,” according to a Nez Perce Tribe news release. Hartwig said the number of tests returning each day has been a “mismash,” with bulks of 60 tests some days and just a handful of results on other days.

If an outbreak were to happen that required more testing than Nimiipuu Health can conduct, access to a timely mass testing option would be critical.

But Hartwig has a plan for that scenario. She feels certain if she contacted Idaho Public Health for more tests, the agency would be quick to help.

“One of the things I’m thankful for and really proud of is that Nimiipuu Health has led our community,” Hartwig said. “We have an excellent team to help us achieve that.”