Colorado’s new school COVID-19 testing program isn’t yet up and running as hundreds of thousands of students — many of them unvaccinated — return to class amid a surge in cases and hospitalizations caused by the delta variant.
The Colorado Department of Public Health and Environment is running weeks behind schedule when it comes to signing contracts with companies to help implement the expanded testing initiative. The program, backed by $173 million in federal funding, is intended to offer weekly rapid COVID-19 tests to students, teachers and staff at all schools across the state, public and private.
Under the health department’s original timeline, contracts were supposed to be signed by Aug. 2. The department issued a notice of intent to award contracts to four companies Aug. 5, but the state hasn’t actually inked any deals yet, and doesn’t expect to until Aug. 20 at the earliest.
State officials say they’re still on track for the program to be “operational” by their scheduled date of Sept. 7, but did not elaborate on why they think they can meet that deadline in light of the delay.
Meanwhile, school started this week in Douglas County School District, Colorado’s third largest district. Most students in Aurora Public Schools, the state’s fifth largest district, are set to start classes Thursday. Jefferson County Public Schools, the state’s second largest district, and Cherry Creek School District, the state’s fourth largest, are scheduled to start next week. And the state’s largest school district, Denver Public Schools, is scheduled to start Monday, Aug. 23.
That means hundreds of thousands of students will return to school without the state’s new testing strategy already in place.
State officials did not explain why they set a Sept. 7 deadline to get the project up and running when so many students are going back to school weeks before that.
In the meantime, they say they’re supplying rapid tests to any school that needs them, providing rapid response testing teams to respond to outbreaks and linking schools to community testing sites as they ramp up the new school testing program.
Gov. Jared Polis downplayed the significance of the start date for the expanded testing initiative in an interview Wednesday with The Colorado Sun. He noted that the state already has a school testing program in place, though that mostly involves sending tests to schools to use rather than the sort of turnkey testing operation for schools that the state has envisioned.
“There’s no shortage of testing or money for testing,” Polis said. “Even if this program started in October or November, we have plenty of testing today to be able to meet the needs of school districts that request it.”
Polis said the problem is with demand, that schools generally aren’t that interested in doing the type of broad surveillance testing laid out in the state’s request for proposals.
“We hope that school districts include surveillance testing as part of their back to school plans in August and September,” he said. “We’re able to support it today. We’re able to support it in September. Regardless of when these contractors go live, we have both the tests and the ability for processing the tests.”
Glen Mays, chair of the Department of Health Systems, Management and Policy in the Colorado School of Public Health, said he thinks “the sooner the better for having this kind of testing capacity as schools move back to in-person learning.”
Funding announced in March
The state first found out about the federal funding to pay for the testing back in March as part of the American Rescue Plan. The federal Centers for Disease Control and Prevention awarded Colorado the money April 8.
But the state didn’t start requesting proposals from companies until June 25. The deadline to submit a proposal was July 16, three weeks later. Three weeks after that, on Aug. 5 — three days after the estimated date for contracts to be signed — CDPHE picked four finalists to negotiate with. But they still don’t plan to sign any contracts until Aug. 20-24.
In response to questions about why the state is behind schedule, Brian Spencer, a spokesman for the state’s Joint Information Center, wrote in an email to The Colorado Sun that the state needed to give companies at least 30 days to submit proposals, and that the department must wait another 14 days for a protest period after giving notice of their intent to award contracts to certain companies before they’re allowed to sign contracts.
Contrary to Spencer’s claims, the length of time to accept proposals can be shortened from 30 days, and the bid was actually open for 21 days.
State procurement regulations also don’t bar agencies from signing contracts with companies for any period of time after a notice of intent to award contracts, though companies do have 10 business days to file a protest after whatever situation gives rise to the protest, which could be a notice of intent to award contracts to other companies.
Making the cut
Out of nearly two dozen companies that submitted proposals, the four firms the state is considering signing agreements with are HealthQuest Esoterics based in Irvine, California; Mako Medical Laboratories, based in Raleigh, North Carolina; Mobile Health based in New York City; and Novir, based in Milwaukee, Wisconsin.
Mako Medical Laboratories, which state evaluators actually scored seventh, has drawn attention in the past for problems with their testing in Colorado and other states.
In August 2020, more than 350 people who were tested by Mako Medical in Colorado Springs were asked to return after state health officials found problems with how their samples had been handled.
The state called Mako Medical, which runs 16 testing sites around the state, “a good testing partner for the state for over a year,” and said the Colorado Springs situation was “an isolated incident.”
Mako also wants to charge the state the most of any of the four companies. Under the “full service” model, in which companies provide testing supplies and staff to actually perform the tests, Mako proposed charging $66 to cover the price and administration of each test.
Meanwhile, Novir proposed charging $39-$44 per test, Mobile Health proposed charging $35.50 and HealthQuest proposed charging $16.50.
Delta variant sows chaos
When the state first started requesting proposals for this project, Colorado’s COVID numbers had been on the downswing after the rollout of vaccines. But as the new school year is starting, the more transmissible delta variant has caused a surge in cases and hospitalizations around the state and across the country, especially among the unvaccinated.
“We expect it to get worse before it gets better,” Polis said during a news conference earlier this month at the governor’s mansion in downtown Denver.
Despite the surge and recommendations from pediatricians that everyone in schools wear masks, regardless of whether they’re vaccinated, districts are all over the place when it comes to masking requirements.
Mays said that between variations in mask requirements among districts, the rise of the delta variant and the fact that large groups of children who are too young to be vaccinated will be interacting in schools, there’s good reason for concern about the risk of transmission.
“Being able to detect that transmission as quickly as possible is critical in being able to interrupt further chains of transmission,” Mays said. He added that a delay in implementing testing capabilities means schools “should really carefully consider doubling down on the other strategies that work during that period of time,” like vaccinations and mask wearing.
Mays said schools that maximize vaccinations and mask wearing while also using regular rapid tests are much more likely to have less transmission.
But without a robust testing system in place, Mays said schools will have to rely more on noticing symptoms, which he said isn’t a great way to identify the risk for infections.
“The real benefit of testing is being able to identify early people who are infectious,” he said.
Still, there’s the question of whether schools and students will even opt in to the testing program.
Spencer said state officials are “skeptical we would see uptake for these tests without incentives and have been talking with the CDC about ways to incentivize.”
CDPHE asked companies to include proposals for implementing a gift card incentive program that would be available to students for each week they participate in testing.
Spencer said “many schools” turned down free testing resources from the state last year, “citing that the public did not want to test children.”
He said state officials “hope that more schools take advantage of the free testing from the state this fall,” and encouraged parents who want to see this testing program at their kids’ schools to contact district and school officials to ask for it.