Stopping the Spread: Community Testing Uncovers Asymptomatic COVID-19 Carriers

As a nonprofit agency dedicated to public health, Heart to Heart International (HHI) knew from the outset it would play a role in fighting COVID-19.

“Our mission is to improve health access and strengthen communities,” said Tena Tiruneh, director of the lab program at HHI. “So when COVID hit, we asked ourselves, ‘Where can we do the most good?’”

With a deep background in both domestic and international health emergencies, Tiruneh and his fellow staff members looked carefully for cracks in the evolving public health policies in their home state of Kansas. As stay-at-home orders came down from the governor, they realized many workers were required to work in public versus remotely and that many of those workers could be unwitting carriers of the virus.

“We decided to focus on those who were asymptomatic because they could be the main factor in the spread of the virus and didn’t even know it,” Tiruneh said.

Tena Tiruneh, director of the lab program at Heart to Heart International

With that focus on asymptomatic patients in the Kansas City metro area, particularly among essential workers and in marginalized communities, HHI needed funding for their project quickly. Having partnered with the CDC Foundation years earlier on a project to combat opioid addiction, Tiruneh knew where to turn. He approached the CDC Foundation for help in securing 5,000 COVID-19 test kits, as well as the funding needed to process the samples and promote community testing events. With the support of the CDC Foundation, HHI got immediately to work.

Working with community groups, county health departments and other nonprofits, HHI set up 74 drive-through testing sites around Kansas City’s metro area over the next few months, providing quick and ready access to administer the tests. Of the 4,639 total tests the organization conducted by late October, 254 came back positive—a rate of 5.5 percent. More telling, Tiruneh said, was the rate of asymptomatic patients tested who turned out to be positive.

“From our positives, we learned that very close to 50 percent of them were asymptomatic,” Tiruneh said. “That tells you that if we didn’t focus on finding asymptomatic cases, we would be missing 50 percent of the positives, and that’s a big deal.”

By pre-registering participants before testing events, the organization was able to gather critical information about patient behavior before the tests were given, speeding up the testing process on-site while also feeding an important database on community health practices and psychological stress. This data played an increasingly critical function for county health officials as the pandemic wore on, alerting them to rising hot spots and also confirming areas of success. In one three-day testing event in Lawrence, Kansas, for example, HHI found an infection rate of only 1.5 percent—very low for the peak of the pandemic in the area.

If we didn’t focus on finding asymptomatic cases, we would be missing 50 percent of the positives, and that’s a big deal.

“When we gave the county the data, they did a press release for the community to let them know that measures they had taken, such as closing bars and restaurants, had been paying off,” Tiruneh said.

The COVID-19 pandemic continues to unfold nationwide. To meet the challenge, HHI teamed up with other privately funded groups seeking to expand testing in at-risk communities to as many as 1,000 tests per day, which some projections say will be needed to keep pace with future surges. Those partnerships, Tiruneh said, will pay dividends for the Kansas City metro area, as testing reaches further in the most marginalized communities.

“This has brought us into contact with other community-based groups and organizations also working to reduce the spread of the disease and help those in need. None of this would have happened without the CDC Foundation helping with funding, no doubt about it.”


Display Date