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Pool testing aims to save resources, money as North Dakota prepares to ramp up testing for college restart

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UND athletes are tested for COVID-19 during a testing event Wednesday at the High Performance Center on campus. Photo by Eric Hylden/Grand Forks Herald

Coronavirus pool testing could be an effective way to save supplies and money as testing across North Dakota ramps up in anticipation of students returning to college campuses this month.

Though not currently being done in North Dakota, Dr. Christie Massen, director of the North Dakota Public Health laboratory, said pool testing is a tool that could be utilized by the state, especially as it prepares to meet a steep demand in testing when the North Dakota University System begins its plan to conduct 34 testing events over the next three weeks.

“Right now, our (positive) population is relatively low (in North Dakota) and we've got a big demand for testing. It's just something that we're looking at possibly using,” she said.

What is pool testing?

Sample pooling allows multiple people to be tested at once.

Samples would be taken from four to five people on different swabs. Those swabs are then collected and tested in a pool or “batch” using one test, rather than running each individual sample as its own test.

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If the pool comes back as positive, it means at least one of the individuals tested is infected. At that time, each individual sample is tested on its own.

As an example, Massen said her family of four -- herself, her husband and her two children -- could each be swabbed on individual swabs. Those swabs could then be combined into one test, thus using just one testing agent.

“Now, instead of wasting the money and the time and the resources associated to complete four tests, the lab only has to do one test, and it got four results,” she said.

Why do it?

This type of testing strategy is most efficient in areas with low prevalence, or meaning most results are expected to be negative, Massen said.

“It's a really great tool for saving money, conserving resources and just really efficiently addressing a testing demand that we don't have the resources to meet,” she said.

North Dakota has been fortunate to get the supplies and equipment it needs to carry out testing thus far, Massen said. Some states have struggled to get the equipment and reagent solution needed to conduct tests in a timely manner.

Massen said the state lab has been doing from 500 to 5,000 tests a day, but other states are only doing about 400 tests each day because they could not get access to materials. Gov. Doug Burgum aims to have the state performing 8,000 tests per day over the next two months.

If North Dakota were to do pool testing, Massen said it would be done on low-risk populations or in areas with a lower prevalence.

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“We’re not going to put any additional risk on symptomatic people or vulnerable populations or high risk people because it doesn't make sense,” she said. “But, communities and areas or testing events where it's low risk, low population. We can do a lot, we get a bigger bang for our buck."

Pool testing has been successful in other states, Massen said.

Dr. Joshua Wynne, dean of the UND medical school who is also heading up the university system’s “smart restart” task force, said it’s a concept that could work with mass testing, such as when students return to campus.

So long as it is done correctly, Wynne said there is little to no downside on pool testing and it would be an upside for communities, such as Grand Forks or Fargo, as more tests will be conducted in the coming weeks.

“If it expands the ability to test people, that is a good thing, particularly on a college campus with a lot of young people coming back together from different parts of the state and the country,” he said.

Massen notes that there could be some drawbacks to pool testing if laboratory issues were to arise, but she said it would be important for there to be policies and procedures in place to make sure everything was working correctly. The health department is running its own studies and research to figure out what may be the best method for pool testing.

The FDA said while there is a concern that combining samples may make it more difficult to detect positives, since pooling in the laboratory dilutes any viral material present in the samples, there is data that demonstrates it does work.

Wynne, who also is serving as the state’s health strategist, said, as long as the number of specimens is low -- between four to five swabs -- “the results are excellent” as far as he’s seen.

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“I think it has some real potential,” he said.

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UND football players arrive at the High Performance Center on campus for UND's COVID-19 testing event Wednesday. Photo by Eric Hylden/Grand Forks Herald

Sydney Mook has been the news editor at the Post Bulletin since June 2023. In her role she edits and assigns stories and helps reporters develop their work for readers.

Mook was previously with the Grand Forks Herald from May 2018 to June 2023. She served as the Herald's managing editor, as well as the higher education reporter.

For story pitches contact her at smook@postbulletin.com or call her at 507-285-7771.

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