Abstract
The COVID-19 pandemic caused more than 30 million infections in the United States between March 2020 and April 2021. In response to systemic disparities in SARS-CoV2 testing and COVID-19 infections, health systems, city leaders and community stakeholders in Worcester, Massachusetts created a citywide Equity Task Force with a specific goal of making low-barrier testing available to individuals throughout our community. Within months, the state of Massachusetts announced the Stop the Spread campaign, a state-funded testing venture. With this funding, and through our community-based approach, our team tested more than 48,363 individuals between August 3, 2020 and February 28, 2021. Through multiple PDSA (Plan-Do-Study-Act) cycles, we optimized our process to test close to 300 individuals per hour. Our positivity rate ranged from 1.5% with our initial testing events to a high of 13.4% on January 6, 2021. During the challenges of providing traditional inpatient and ambulatory care during the pandemic, our health system, city leadership, and community advocacy groups united to broaden the scope of care to include widespread, population-based SARS-CoV2 testing. We anticipate that the lessons learned in conducting this testing campaign can be applied to further surges of SARS-CoV2, international environments, and future respiratory disease pandemics.
Highlights
The COVID-19 pandemic caused more than 30 million infections in the United States between March 2020 and April 2021 (1)
We subsequently identified potential testing venues in high-traffic areas in each target census tract
Our first nine-hour testing event was held on the evening of August 3, 2020, at the Community Development Corporation
Summary
The COVID-19 pandemic caused more than 30 million infections in the United States between March 2020 and April 2021 (1). Widespread testing remains one of the pillars of the COVID-19 pandemic public health response, as the probability of transmission can be limited by testing, quarantine and isolation (2–4). In the early months of the COVID-19 pandemic, testing availability in the United States was limited by availability of test kits, insurance/financial considerations, and the need for symptoms and access to a health care provider to obtain an order for testing. This set of barriers created a significant lack of equity in access to testing; even egalitarian testing resources undersampled lower socioeconomic status populations at highest risk for COVID-19 infection (6). In response to systemic disparities in SARS-CoV2 testing and COVID-19 infections, health systems, city leaders and community stakeholders in Worcester, Massachusetts created a citywide Equity Task Force with a specific goal of making low-barrier testing available to individuals
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