Glacier County has performed the highest rate of testing in the state since COVID-19 was first detected in Montana on March 11, according to a recent epidemiology report and other testing data from Montana Department of Public Health and Human Services.

The report provides a broad overview of COVID-19’s presence in the state, as well as testing insights from early March through Aug. 7, when Montana had experienced a total of the 4,888 positive cases. And a separate dataset compiled by the health department, which also spans that time-frame, shows weekly testing data by county. The data represents individual tests, not individual people, and includes results from the state lab in Helena and those from all private and reference labs used for Montana.

One example of private and reference labs include those used by Kalispell Regional Healthcare. According to spokesperson Mellody Sharpton, while the hospital has sent more than 5,000 tests to the state laboratory as of Wednesday, the facility has also sent more than 3,600 to a Mayo Clinic laboratory and has performed more than 2,700 tests in-house at Kalispell Regional Medical Center. These tests and subsequent results are included in the testing data, as well as hospitals and other lab reports to the state and federal health departments.

As of early August, the state’s information shows Glacier County, which is home to an estimated 14,000 people, had the highest testing rate in the state at about 631 residents per 1,000. Toole County, an area of the state that was hit hard early on in the pandemic after COVID-19 spread through an assisted-living facility, is testing about 302 individuals per 1,000 residents.

Overall, the average testing rate in Montana among all 56 counties is 176 individuals for every 1,000 residents. Other counties with testing rates higher than the state average include Rosebud, Park, Big Horn, Blaine, Hill, Lincoln and Lake.

As for why Glacier has such a high COVID-19 testing rate, state health department spokesperson Jon Ebelt said the numbers “were from large community testing events held on American Indian reservations,” which includes the Blackfeet Reservation located in Glacier County. More than 2,000 individuals were tested on the Blackfeet Reservation in early July, which is reflected in the data. In Glacier County, testing climbed in July to more than 1,000 per week and hit nearly 1,800 during the week that ended on July 18, which was around the time testing on the reservation concluded.

Similar pushes for testing can explain Lake County’s spike in testing as well, when in late June, the Confederated Salish Kootenai Tribes held a widespread, multi-day testing event. The results of these efforts are also reflected in the numbers, which show 330 tests were performed for Lake County during the week that ended on June 20, but that shot up to 1,843 tests one week later, soon after the testing event was over.

HIGH TESTING rates aside, the information provides other insights into Montana’s COVID-19 outbreak, including which areas have higher positivity rates, transmission characteristics of cases and more.

While laboratories had conducted nearly 8,700 tests for Glacier County by early August — again, the most in the state per 1,000 residents — only a little more than 1% of those turned out to be positive. To break that down further, labs will run about 90 tests for Glacier County to get one positive.

Overall, about 3% of tests performed for Montana, as of Aug. 7, have come back positive.

However, this number is slightly skewed by outliers such as Judith Basin and Phillips counties. Only eight tests have been performed in Judith Basin, for example, and two of those have come back positive. That means 25% of tests have resulted in positives — a far cry from Glacier’s 1%.

About half of the state’s counties, which range greatly in size and population, are experiencing a 1.5 to 4.5% positivity rate in tests performed.

As one example, 14,671 tests were conducted for Flathead County during the report’s time-frame, with about 3% of those resulting in positive cases. Therefore, according to the data, 32 tests must be performed in Flathead County before one positive is detected.

On the subject of how many tests come back positive, Flathead County falls in the middle of the larger counties, with Yellowstone, Gallatin, Missoula, Cascade and Lewis and Clark counties seeing between 1.4 and 5.1% of tests come back positive.

Each of these areas, according to the epidemiology report, have experienced various “routes of transmission” for the virus as well. These case characteristics are broken into six categories: cluster outbreak, community spread, contact, household contact, travel associated and health-care associated infection.

Among some of the most populous counties, contacts account for more than 40% of new cases in Flathead, Big Horn and Cascade counties, and more than one-third in Gallatin, Missoula and Yellowstone counties. Gallatin and Yellowstone have the most cases attributed to community-acquired transmission, at around 27% to 30%, whereas about one-in-five cases in Flathead, Lake and Lewis and Clark are community-acquired.

In Flathead County, about 26% of new cases are travel-associated, which is defined as “case traveled out-of-state during the incubation period.”

THE EPIDEMIOLOGY report was released at a time in the pandemic when testing capabilities in Montana have become strained, as is the case with much of the United States.

The state announced it would be switching testing companies after turnaround times had climbed to about 14 days, give or take. It was mid-July when Gov. Steve Bullock reported the challenges and said there was a backlog in testing with Quest Lab, the company Montana was utilizing.

According to Ebelt, as part of the initial agreement with the state, Quest had agreed to perform 1,500 tests per day for Montana and anticipated results for those would arrive within two to three days. But toward the end of the state’s time with Quest, the average turnaround time was 11 days, Ebelt said.

In early July, capacity was stretched when Montana as a whole surpassed 60,000 tests per month — a testing goal that was set by Bullock in late April. At that time, all labs were performing 14,000 tests per week by July 4 and that number peaked to more than 21,000 per week by early August.

The backlog that ensued prompted many health-care facilities across the state to halt asymptomatic testing. The state also adjusted its testing priorities to move asymptomatic individuals down the list.

But according to Ebelt, the backlog has “been taken care of.”

The state is no longer working with Quest and now has a contract with Lab Mako in North Carolina, which has performed 13,000 tests to date with a two- to three-day turnaround time since the first sample arrived at the facility.

Ebelt said Montana State University has also begun testing and has the capacity to run 500 tests a day, but is “hoping to increase that capacity further.”

Reporter Kianna Gardner may be reached at 758-4407 or kgardner@dailyinterlake.com.