State and Local Testing Strategies for Responding to Covid-19 Outbreaks in Communities

State and Local Testing Strategies for Responding to Covid-19 Outbreaks in Communities Cover Image

White Paper

State and Local Testing Strategies for Responding to Covid-19 Outbreaks in Communities

Published date

March 15, 2021

The purpose of this document is to support state and local leaders in developing equitable testing strategies to quickly identify, prevent, and respond to Covid-19 outbreaks in communities most impacted by the Covid-19 pandemic, including communities of color. Testing is and will continue to be a critical component of responding to outbreaks in the short term and managing the pandemic in the long term, in combination with vaccinations and other mitigation measures. Low income communities and communities of color face a disproportionate burden of Covid-19 cases, hospitalizations, deaths, and disability and yet have not received levels of testing that are commensurate to the disproportionate morbidity and mortality they experience.

To quickly identify and respond to outbreaks in communities, states and localities can follow the process depicted in Figure 1 and described in more detail throughout this paper. States and localities should identify accessible relevant data, and use that data to conduct a risk assessment to identify communities most at risk of an outbreak or high levels of severe disease and death from Covid-19 infection. Health officials can differentiate between areas that need additional access to more permanent diagnostic testing and areas that require an immediate, short term surge in screening testing to break the lines of disease transmission. As states and localities implement additional testing sites, attention to reducing barriers to testing may increase uptake and reduce inequities in who is being tested. Importantly, close coordination and engagement with communities is crucial at every step of this process.

Duke-Margolis Authors

Katie Huber

Katie Huber, MPH

Senior Policy Analyst

Andrea Thoumi headshot

Andrea Thoumi, MPP, MSc

Area Lead, Community Health and Equity
Faculty Director of Health Equity Educational Programming
Senior Team Member
Anti-Racism and Equity Committee Member
Core Faculty Member
Adjunct Assistant Professor
2020 Intern Mentor


Christina Silcox, PhD

Research Director, Digital Health
Adjunct Assistant Professor
Senior Team Member
Margolis Core Faculty

Mark McClellan

Mark McClellan, MD, PhD

Director of the Duke-Margolis Institute for Health Policy
Robert J. Margolis, MD, Professor of Business, Medicine and Policy
Margolis Executive Core Faculty