More on Duke’s testing program

Update: I confess to being shocked at how well Duke’s COVID19 mitigation strategy is going as evidenced by the very small number of positive tests. We had and have a robust testing program, but so do other Universities that have still had outbreaks, and that still could happen at Duke. Here are the latest results for the period September 5-11, 2020–1 contact-traced case among 87 faculty or staff who were potentially exposed, and 7 in precautionary quarantine; 0 of 416 faculty and staff positive in surveillance tested (surveyed below). For students, 3 cases identified from 100 with symptoms or possibly exposed, and all of them in precautionary quarantine, and 2 of 6,969.

Duke needs to lay out in detail exactly what we are doing to get such good results so that others can learn from our experience. Duke also needs to release information on how many people were asked to undergo survey testing, and how many had the test.

Duke has what seems to be among the most successful COVID19 testing programs, based on the small number of positive tests as shown on Duke’s testing dashboard (cases updated each Monday). As I noted last week, it is difficult to know what the surveillance or survey testing means, since students have reported to me being selected for such testing and not getting the test done. At a minimum, Duke should make clear how many persons were selected for surveillance testing and how many actually received a test.

Below is an email that a colleague received today (name redacted by me).

From: <>
Sent: Sunday, September 13, 2020 10:33 AM
To:  [Redacted by me]

Subject: Message from Duke United Testing

As part of helping to ensure your safety and the safety of our community, Duke is expanding its COVID-19 testing to include asymptomatic faculty and staff working on campus and off-campus students taking classes remotely.

You have been recommended for a surveillance test this week. While this test is not required, we encourage you get tested to help us identify and respond to the asymptomatic spread of the virus and limit the potential for local outbreaks.

Please visit any of the many locations on East or West campus to complete this test, which should take no more than 5 minutes. Testing will be conducted from 9 a.m. to 4 p.m. Monday through Friday.

You will only be contacted afterward if you test positive, at which point you will receive further medical guidance and support.

You can find more information about the process, testing locations and answers to frequently asked questions on the Duke United website.

At a minimum, Duke needs to provide information regarding how many persons have been “recommended” for testing, and how many actually receive the test. The rate of compliance with such a clearly voluntary testing program would be of interest, and any selection bias that may be present is important.

All my questions about what the data provided in the dashboard mean remain, and the continued lack of transparency by Universities not having an agreed upon set of data to track cases harms our ability to produce evidence that is useful and very much needed.

About Don Taylor
Professor of Public Policy (with appointments in Business, Nursing, Community and Family Medicine, and the Duke Clinical Research Institute), and Chair of the Academic Council at Duke University . I am one of the founding faculty of the Margolis Center for Health Policy. My research focuses on improving care for persons who are dying, and I am co-PI of a CMMI award in Community Based Palliative Care. I teach both undergrads and grad students at Duke. On twitter @donaldhtaylorjr

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