As Montana scales up COVID-19 testing while preparing to enter phase two of the state's economic reopening plan, mass surveillance drive-thru testing sites popped up in Crow Agency and Hardin this week.
The testing site at the Little Bighorn Casino in Crow Agency saw a steady stream of cars Wednesday.
Drivers stopped at the first tent station to give their contact information to nurses with Indian Health Service and county and tribal public health.
"And how are you feeling?" a masked nurse asked through the car window. "No shortness of breath, no fever? Fabulous. And any exposures that you know of? Okay, good deal, let’s keep it that way."
Then the cars were directed to the second station, where nurses and Montana National Guard members draped in gowns, masks and face shields gave drivers and passengers the test using a long nasal swab.
"So put your head back on that—there you go, perfect, you’ve got it. Deep slow breath open that mouth, take a big, deep slow breath. Alright, that was it."
A quick touch to the very back of the nose and then the sample was sent off for analysis.
583 people were tested Wednesday alone.
"We are moving into the more proactive stage of sentinel testing as opposed to the reactive stage where we were just dealing with people who were sick," said Esther Wynne, Big Horn County public health nurse.
Without symptoms, the test is sent off to a private lab out-of-state and results are given over the phone within one to two weeks. The tests of those with symptoms is sent to the state public health lab in Helena, where results are available between 24 and 48 hours.
Wynne says when a test comes back positive, Indian Health Service and county public health workers call the infected person and ask for a list of everyone they’ve spent time with back to two days before they had symptoms, so officials can begin contact tracing.
"We try to contact the close contacts within 24 hours," Wynne said. "If we get a call at five o'clock, we will stay in the office until as many initial phone calls can be made as possible. For the most part, each person has had 15 to 20 people. That's manageable. part of that is because people have been sheltering at home for the most part. That could be changing as the state opens up, contact tracing could be more difficult."
As Montana enters phase two of reopening, officials warn that cases are likely to increase. According to Wynne, testing is a way to see how drastically the modified guidelines impact virus transmission after June 1.
"You know, Montana’s going to open up to out-of-stater’s June 1. And so I’m thinking June 15, the latter half of June, we’re gonna see some more cases, and so it’ll be helpful to be able to figure out what changed," she said. "Have a baseline now and then we’ll compare it in the future."
Previous mass testing events in Lodge Grass and Pryor have already identified three COVID-19 patients who weren’t showing symptoms. The Fort Belknap and Blackfeet tribes have hosted similar events.
In Crow Agency, Gov. Steve Bullock reiterated the statewide plan to increase testing to 60,000 tests a month.
"Right now we're in the process trying to test everyone in our long-term care facilities and the workers. We want to make sure to really amp up the tests in our tribal communities, both with multigenerational living and health risks, that the sooner that we actually find positive cases, the better off we are," Bullock said.
The state on May 15 entered into a contract with Quest Diagnostics to increase testing capacity. The contract, which could run up to $6.1 million using some federal funds, means Quest will supply future testing materials and fly tests out of state for analysis. Bullock says the Quest contract covers up to 1,500 tests a day.
While statewide Montana is preparing to move into Phase 2 of reopening on June 1, the Crow tribe on May 13 extended a stay-at-home order until June 15.
Chairman AJ Not Afraid says it will be important now to get a snapshot of how the virus is moving through the community as the state reopens.
"I believe if we can identify the baseline, we can surely contain or identify the influx of this virus, whether it’s primarily coming from the outside, or did it start here? Because really we feel it started out there, right? And if we can identify that traffic, I think that could be one of the solutions to tapering that off, if you will," Not Afraid said.
State Rep. Sharon Stewart-Peregoy, a Crow tribal member, was one of several tribal, county and state leaders who recommitted to working collaboratively against the virus.
"As the Crow Nation, one of the solid bounds that we have is when the creator gave us the clan system and he told us that we would be interknitted and coming together so that any force could not pull us apart. And the COVID is a force. I'd like to just say to my Crow people: Stay diligent, take care of each other, and love each other and help each other, because that's how we're going to be able to flatten the curve, not only on the Crow Reservation, but across Montana."
The Chippewa Cree and Little Shell tribes will hold similar testing events May 28.
Kaitlyn Nicholas is Yellowstone Public Radio's Report For America tribal affairs reporter.