Receiving a COVID-19 test in Tucson is now as simple as scheduling an appointment online, driving to a local center and taking 10 minutes to administer the test.

While the public conciousness is full of scary stories about the testing process, nasal swabs are pain free, and during a recent test, only resulted in some watery eyes and a tickle.

Pima County is expanding both its COVID testing and contact tracing as Arizona remains one of the nation's infection hotspots.

While the Pima County Health Department has increased its dedicated COVID-19 staff, these testing and tracing expansions come with the help of third party organizations.

The new testing center is at the Ellie Towne Flowing Wells Community Center, 1660 W. Ruthrauff Road. It will be facilitated by Arizona State University in partnership with the Arizona Department of Health Services.

Meanwhile, the new contact tracing effort will be operated by Maximus Health Services, which has a contract with PCHD.

Although Arizona's daily virus cases have gradually decreased for the past few weeks, Pima County is actively planning to establish a third testing center at Udall Park on the City of Tucson's east side as well as mobile testing in the near future.

"We have a ways to go, but we have ways to monitor the impact of the measures we're doing," said PCHD director Theresa Cullen. "This is not a rapid game. This is a long haul game. But the hope is that within a month, by the end of August, we'll see a significant impact."

Before the Ellie Towne testing center opened, the only county-run testing was nasal swabbing at the Kino Events Center. The Ellie Towne center instead tests saliva, which can be just as accurate and a more comfortable procedure. Since it opened in July, the Kino test center has consistently serviced between 400 and 600 patients per day.

"There's this concept of test saturation," Cullen said. "In Phoenix, they've seen this at a few sites; they set up test centers and the number of people who seek testing gradually goes down. We haven't seen that here, and some of it may be the strategic placement of the test centers."

While testing for COVID is the first step, contact tracing is equally critical. On July 6, PCHD announced a contract with Maximus Health Services to manage expanded contact tracing in our county. It's an "elastic contract" that can shift with the new case numbers in Pima County. According to PCHD, Maximus was flooded with applications for the new positions and hired more than 130 people as contact tracers, contact tracing supervisors and case investigators. Maximus is still accepting applications for the supervisor and case investigator jobs.

"Once you test positive, you get into what we call a traditional epidemiological response," Cullen said. "The first step is a case investigation. If you test positive, you're now a 'case' whether you feel ill or not. So we'll talk with you and obtain information about where you are, where you think you might have gotten the disease, who you might have contacted."

Contacts are those you've spent a lot of time around, the typical measurement being 15 minutes at less than six feet proximity. Contacts are then assessed for symptoms, and potentially asked to quarantine for anywhere between 10 and 14 days.

"This is the way we break the transmission," Cullen said. "The case already has the disease. So we'll make sure they're stable and have the resources they need. The contacts may or may not have the disease, and potentially be spreading it around the community... Many contacts don't become cases, but there's no way to predict. So that's why they have to isolate."

While the government is expanding local testing and tracing efforts, Cullen reminds the public that there are more than 50 test sites in Tucson, facilitated by businesses such as Walgreens and CVS, as well as various urgent care businesses.

"There are other ways for the public to get tested, they don't just have to go to the county sites. The difference is the county sites are free and we don't collect insurance information, but we do ask for an ID to make sure we know who you are when we call to deliver results," Cullen said.

On July 28, Arizona Public Health Association president Aimee Sitzler wrote an open letter to Gov. Doug Ducey detailing recommendations for improving the state's virus response. The first item on her list for how to isolate infected individuals and track the people they contacted is to achieve laboratory turn-around times of less than three days for COVID tests. According to PCHD, their turnaround time is currently three to five days, though this can vary.

In addition to establishing more test centers, PCHD is looking to extend testing in other ways, such as working with FEMA to support more rural testing and providing more testing for vulnerable populations. Expanding rural testing and increasing attention on at-risk populations are both mentioned in Sitzler's letter as crucial steps to reduce pandemic spread in-state.

"I have been reluctant to say we are on the downslope," Cullen said. "I think we are stabilizing, which in and of itself is really important and attributed to the community cooperating and masking and washing their hands. Obviously what we hope is that we're at the highest part of the wave and that we'll come down. I personally believe that by having more aggressive case investigation and contact tracing—assuming that the contacts are able to stay home and not infect others—we will be successful." ■

If you're interested in getting a test to determine if you've already had COVID-19, the UA has expanded a free COVID-19 antibody testing program to include 15 new categories of essential workers considered at high risk for exposure. The antibody test, developed by researchers at UA Health Sciences, determines who has been exposed to and developed an immune response against COVID-19. In addition to healthcare workers and first responders, the test program is now open to educators, childcare workers, agriculture, grocery and foodservice workers, hospitality employees, solid-waste collection workers, transportation services workers and members of the National Guard. More information and registration for the test is available at covid19antibodytesting.arizona.edu. Pima County is also one of several regions in the country where a new COVID-19 vaccine is being tested. The National Institutes of Health is conducting phase 3 trials on a vaccine co-developed by Moderna, Inc. and the National Insitute of Allergy and Infectious Diseases. If you're interested in volunteering, visit coronaviruspreventionnetwork.org or ClinicalTrials.gov and search identifier NCT04470427 to find a study center.