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Marion County reveals that it is partnering with the University of Oregon to validate an easier and cheaper test

COURTESY OF MARION COUNTY - Marion County Public Health Director Katrina Rothenberger apprises commissioners on COVID-19 saliva testing project on which the county is collaborating with University of Oregon researchers.Marion County revealed that it is collaborating with University of Oregon researchers on a project aimed at validating saliva testing for COVID-19.

If achieved, that validation could increase the rate of testing while driving down the cost for individual tests tremendously. It's part of the university's Monitoring and Assessment Program (MAP), which partners with a variety of local health authorities.

MAP is seeking to validate the efficacy of two self-collection methods for testing for COVID-19: saliva and anterior nares (the external portion of the nose), according to Saul Hubbard, UO's media and communications manager. If proven effective, both these testing methods would be easier to use and more affordable than the standard diagnostic test. MAP will use these two types of samples to validate both the collection method and the lab processes.

During the Marion County Board of Commissioners' meeting on July 1, Commissioner Kevin Cameron invited Marion County Public Health Director Katrina Rothenberger to share any information she could about the project.

The director said that materials used for current testing procedures, including reagents, cost about $25 per test. The saliva testing does not use reagents, which would trim material costs to just $1.

"What this would do is help drive down the price of testing supplies," Rothenberger said. "The reagents have been the major issue with the supply chain."

A subsequent increase in testing provides a substantial tool for combating the spread of the virus.

Marion County's role

The county's research input involves providing tests.

"What they need are 30 positive tests and 30 negative tests, so we are partnering with them to do testing in our community to try to validate their saliva test," Rothenberger said. "If they are successful, this would mean that their lab would be able to process 5,000 tests per day in Oregon."

Hubbard noted that the FDA requires at least 30 positive samples and 30 negative samples to be validated.

Another upshot is the saliva test is decidedly more comfortable, less invasive.

"It will be helpful, (because) people will probably want to be tested this way rather than getting a swab stuck up your nose all the way back to your (throat)," the director added.

"I've not been tested, but my daughter has been tested and she said it was not very comfortable," Cameron said.

The project would allow for more testing at a time when it is needed. Marion County's testing early on indicated about a 12% positive rate, while the more recent rates are closer to 7%. That difference is accounted for by the allowance of broader, asymptomatic testing; early tests were only administered to patients who exhibited symptoms.

"I'm really excited about this, and I think the whole state of Oregon should be really happy and excited that this research project is going on with the University of Oregon," Rothenberger said.

The objective is for this research to be universally beneficial.

"We are very grateful to Marion County for partnering with us on this endeavor," said Leslie Leve, a UO professor in prevention science and associate vice president for research. "We hope that the testing and lab processes validated through this study will provide lower cost, self-collection methods that ultimately increase the availability and accessibility of testing within communities across Oregon."

Positive tests surge

Commissioner Sam Brentano questioned Rothenberger about a perceived, general uneasiness over current COVID-19 upticks since reopening phases have unfolded — in Oregon and many other states.

That very day Oregon Health Authority reported a record 281 confirmed and presumptive cases in the state, eclipsing record highs set within the previous week. That record lasted one day as 375 cases were reported July 2.

"You watch the news now, and it feels like people are more nervous than they have been in the last month," Brentano said. "Is this a key time? Is this a junction where it could go either way?"

Rotheberger affirmed that hospitalizations and emergency-room visits are inching up in Oregon, as is the percentage of positive tests.

The county's dynamic COVID-19 dashboard on July 2 showed that the majority of positive tests occurred in people between the ages of 20 and 50. The 40 to 49 age group accounted for 19.1% of county positives while comprising only 12.1% of the population; ages 30 to 39 had 17.6% of the positives among 13.2% of the population; ages 20 to 29 numbers are 16.6% and 13.8% respectively.

"The younger folks, by far, as a percentage of our population are impacted by COVID more so than the people over the age of 50," Rothenberger said. "However, if we look at hospitalizations, and people who are dying, it is the older folks and the folks who are in these long-term care facilities settings; younger folks are experiencing COVID illness more, (while) the severity of the illness is impacting the older folks more."

Boon for care facilities

Long-term care facilities likely would welcome valid saliva testing.

Between June 25-29, the American Health Care Association and National Center for Assisted Living conducted a survey of 1,385 members on COVID-19 testing at such facilities and discovered that test-processing time was a predominant issue, followed by test costs. Some 87% said it took two days or longer to get results.

The survey noted that regular testing of nursing-home and assisted-living residents and staff is essential to stem spreading of the virus, and receiving timely test results is paramount to that end. Not only did most require at least two days, 1-in-4 said testing results were taking five days or more to receive.

"The amount of time it is taking to receive testing results is hurting the ability of long-term facilities to fight the virus," said AHCA/NCAL President Mark Parkinson. "Regular testing of nursing home and assisted living staff is a vital step in controlling the spread of COVID-19, but is not effective without obtaining timely test results.

"For nursing homes and assisted living communities to protect residents and staff, we need on-site testing with reliable and rapid results. With a recent uptick in COVID-19 cases among the general population, we are concerned labs will get overwhelmed and receiving results for long-term care residents and staff will take longer to obtain," he added.

Meanwhile, UO received an $800,000 contribution from PacificSource Health Plans to accelerate the saliva-testing research project.

"We are pleased to support this critical initiative and work," PacificSource President Ken Provencher told the university's publication Around the O. "This work, and additional collaborative efforts across the state of Oregon, serves as an important initial commitment to being part of the solution in addressing this health crisis."

Many of those collaborative efforts are ongoing and augmenting, such as Gov. Kate Brown issuing a statewide face-covering order at all indoor public places beginning July 1, expanding it from just a handful of counties.

"I think COVID is here to stay. We don't have a vaccine; we have few tools in our toolbox to help limit the spread," Rothenberger said. "So I think people should still be vigilant and careful when they are around others, in crowds, going into public spaces. Bringing their kids out in public, too, especially to grocery stores or other public venues, just still being more mindful — there is more COVID in our community today than there was when we shut everything down."

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