University of Wisconsin–Madison Medical College of Wisconsin

Community-Based Testing for COVID-19 in a Low-Prevalence, Rural Area: Documentation of Logistics and Practical Aspects of Testing

Mari Freiberg, MPH; Mary F. Henningfield, PhD; Paul H. Hunter, MD; Elizabeth Bade, MD

WMJ. 2021;120(2):100-105.

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Introduction: Testing and mitigation strategies for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection often focus on high-prevalence, urban communities, leaving low-prevalence rural areas without specific strategies to maintain the health and safety of their populations. We evaluated a cost-effective strategy for SARS-CoV-2 testing to determine point prevalence in a rural community with a generally low prevalence of infection.

Methods: We voluntarily tested asymptomatic clinic employees and conducted 2 community SARS-CoV-2 testing events in Cashton, Wisconsin, that included testing for asymptomatic persons. We also partnered with local clinics and public health departments to conduct weekly drive-up clinics for asymptomatic, high-risk persons identified through enhanced contact tracing. This was possible as testing capacity in Wisconsin never reached its maximum, and we continued symptomatic testing through our clinic.

Results: We tested 61 employees, 268 individuals at 2 community events, 36 high-risk asymptomatic people at drive-up clinic events, and 128 symptomatic people within our clinic. We observed 1 positive result in asymptomatic people and 5 positive results in symptomatic patients, confirming the low prevalence in our area.

Conclusions: Our testing events confirmed a low prevalence of SARS-CoV-2 infection, providing prevalence information to local businesses and schools. We reinforced our partnership with local public health departments to facilitate enhanced contact tracing and test asymptomatic persons, and we provided a service to asymptomatic persons requiring testing for travel, school, or work. Local businesses and community members appreciated the services and expressed relief for point-in-time testing results during a period of stress and uncertainty.

Author Affiliations: Scenic Bluffs Community Health Centers, Cashton, Wisconsin (Frieberg, Bade); Wisconsin Research and Education Network, Madison, Wisconsin (Henningfield, Hunter).
Corresponding Author: Elizabeth Bade, MD, Medical Director, Scenic Bluffs Community Health Centers, 238 Front St, Cashton, WI 54619, phone 608.654.5100; email
Acknowledgements: The authors would like to thank Parker Garman, Health Information and Quality Specialist at the Wisconsin Primary Health Care Association, for support in the development of this project.
Funding/Support: This research was funded by Scenic Bluffs Community Health Centers through funding from both the center’s general budget and funding from the US Department of Health and Human Services.
Financial Disclosures: Dr Hunter reports receiving support from City of Milwaukee Health Department, outside of the submitted work.
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