For months, the city of Memphis has been piloting its broad-scale COVID-19 testing capacity, including in schools, for people who do not have symptoms.

Thursday, Nov. 5, it publicly rolled out Test to Protect to businesses in general, citing at least 20 restaurants that have already signed on.

“By doing this, we are able to quickly determine where a potential hot spot may be and stop it before it spreads,” Mayor Jim Strickland said. “We are now ready to take this program to the next level by opening it up to businesses and restaurants who want to take the extra precautions of getting their employees tested on a regular basis.”

Test to Protect will work by allowing businesses to test their own employees with PCR nose-swab kits they can use at work or in their homes. Through a series of local laboratories here, the tests will be processed in small pools, which means a group of samples will be analyzed for the virus as one sample, reducing the cost per test from $100 to as a little as $5.

If the test comes back positive, the samples from that pool will be run separately to pinpoint the positive cases. Test results are to be returned in 12 hours.

For information about the program and how to sign up, go here. 

Tsunami owner Ben Smith is one of the restaurateurs who have signed up.

“We’ve tried to stay proactive throughout this, and always the safety of my staff and customers has been at the top of my mind. This is just the next level. Knowing and being sure of our health status is real important,” said Smith, who has been driving once a week to Atoka for a rapid test that is read while he waits.

The drive has been an hour each way, “which really takes a chunk out of my day,” Smith said.

“I tested yesterday, and other members of the staff, especially in the front of the house are testing on regular basis as well.”

But it hasn’t been weekly, because it has been too hard to schedule employees not yet working regular shifts.

“This will be self-administered. We can do it at work. We don’t have to take time out of the schedule to do it and be around other people in the process,” Smith said. “We can be safe in our bubble of people we have been working around since all this started.”

Participating businesses will be asked to test weekly or biweekly. The cost per test will range from $5 to $15. They will receive a sign they can display to let others know they are taking part in assurance testing.

There is no financial incentive from the city for businesses to participate.

“The pricing and frequency really depends on what the positivity rate is,” said Jim Sweeney, head of Poplar Healthcare.

“And so each restaurant, each work setting has to look at what their positivity rate is and discuss it with some of the health experts, and then they can better decide with the laboratory which method is best for them for doing pooling.” 

Memphis is one of the first cities to build capacity for large-scale testing for asymptomatic people in the nation. Several of its laboratories received FDA approval over the summer to run pool testing, which is the linchpin of the program because it cuts the cost dramatically.

“Many businesses are doing it, including my office for the past month,” said Dr. Manoj Jain, an infectious disease expert who has been advising the city on its pandemic response since March.

“Everyone in our staff has been tested at a regular basis every week. Churches have been taking great interest. Scott Morris (CEO of Church Health) had a long conversation with me, and we have multiple churches who are interested in this program,” Jain said.

Testing capacity in the city now is running at 3,000 to 4,000 tests a day. Test to Protect, if widely used, could ramp it up to 30,000 tests a day.

The pilot testing system, which started in early June with city employees, was built with CARES Act funding. The widespread use now will be footed by businesses for their employee tests.

It is designed for people who do not have symptoms and have not knowingly been exposed to a positive case.

“We embarked on this journey six months ago, trying to get ahead of the supply chain constraints that we were having,” Sweeney said during COVID task force briefing Thursday. 

“As many of you know, there were many issues getting testing done in a timely manner. And instead of the labs competing against each other, we began working with each other.”

Poplar Healthcare did the sample analysis for the pilot and has continued through this fall with testing for schools. To provide the 12-hour turnaround, other labs, including AEL, Compass and University of Tennessee Health Science Center, will also be running the tests.

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The PCR test is the gold standard for COVID-19 testing and requires a swabbing of both nostrils. The employee will put the swab in a vial with solution and it will be collected by the employer for testing.

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“We’re not talking about the antigen or any of the rapid tests. It’s the test that ultimately needs to be done in order to diagnose the virus,” Sweeney said.

Poplar Healthcare can now run 4,000 samples a day, up from 2,000 in early summer. With pool testing, which is effective when the positivity rate is 1o% or less, Poplar Healthcare has capacity to run 20,000 to 25,000 tests a day.

The other lab partners have similar capacity.

Pool testing for large groups of asymptomatic people is called assurance testing. It is critical to the region’s ability to move forward, said Alisa Haushalter, director of the Shelby County Health Department.

“We really want to commend Mayor Strickland and Dr. Jain as well all of the labs for focusing locally and building our capacity to be able to do assurance testing locally,” she said. “Again, this has not been done in many places in the United States, and it’s a testament to the commitment within Memphis and Shelby County to serve the constituents here.”

Assurance testing in workplaces builds in a safety net for catching people who have COVID but may not have symptoms. In some samples, this population has been as large as 40%.

“But the critical piece of that is it allows us then to isolate and quarantine those individuals who may pose a risk to the rest of the public,” Haushalter said.

As of Thursday morning, 2,709 people have active cases of COVID-19 in Shelby County. With another 8,100 in quarantine because they have been exposed, the county has more than 10,000 people sidelined due to the virus.

“Assurance testing allows any business, school or organization that’s participating to know quickly who needs to be excluded from the workplace to reduce ongoing transmission,” she said.

Ongoing transmission is a serious issue in Shelby County, although it was not on the White House list of 64 counties in Tennessee in the red zone for disease spread.

But several neighboring counties are. Residents come to Shelby County to work, shop and for medical care, particularly if they need high-level hospital care. 

“So, when there’s transmission in those surrounding communities, it’s going to impact us greatly,” Haushalter said. “It’s going to impact our systems. But it’s also going to impact our ability to contain the virus within our own community.”

She noted that many of the surrounding counties and communities are not masking; “either they don’t have a mandatory mask, either an ordinance or order, or they’ve chosen not to enforce it.”

While there is no way to force other governmental jurisdictions to adopt masking, Haushalter says local elected officials are having those conversations at higher levels.

“All of our mayors have had conversations at the state level as well as have reached out to their counterparts in rural counties, encouraging them to at a minimum move forward with mandatory masking,” she said.

“So, we’re doing everything that we can to influence others. I think we also serve as a role model here in Shelby County of how we can come together.”

Restaurants that have signed up to participate in Test to Protect are The Majestic Grille, Cocozza American Italian, Restaurant Iris, Second Line, Fino’s, Tsunami, River Oaks, Rendezvous, Sweet Grass, Sunrise Memphis, 117 Prime, Central BBQ (all locations) McEwen’s on Monroe, Felicia Suzanne’s Restaurant, Andrew Michael’s, Catherine & Mary’s, Gray Canary, Bishop, Acre, Bari, Erling Jensen the Restaurant, The Beauty Shop, Hazel’s Lucky Dice Delicatessen and Back Do at Mi Yard.