On Monday, Georgia Department of Public Health Commissioner Dr. Kathleen Toomey privately told local department leaders about an ambitious statewide goal of conducting 100,000 tests in 10 days.

On Tuesday, a public announcement by Gov. Brian Kemp’s office made that goal seem within reach. Nearly 13,000 tests were conducted that day alone, and DPH will continue to work to push these numbers upwards, Toomey said.

“In the end, my goal is to have everybody who wants to be tested get tested,” Toomey said. A pledge Thursday by federal authorities to deliver some 210,000 additional tests during May will mean that capacity will continue to grow, she said.

The developments could mark a turnaround for a state that until recently tested a smaller share of its residents than almost any other in the nation.

Now across metro Atlanta, local health departments are rolling out their welcome mats. The question is whether people will show up. Several sites are testing half of the people they could be if they were fully stocked with tests, protective equipment and staff, according to figures the agencies provided.

Core workers used grabbing tools to exchange materials with patients to be tested on Thursday, April 30, 2020 at the Home Depot Backyard. Los Angeles-based CORE Response and the Arthur M. Blank Family Foundation on Thursday opened a coronavirus testing site at Mercedes-Benz Stadium. The testing center is at the Home Depot Backyard adjacent to the stadium, offered free tests to people with appointments from 10 a.m. to 4 p.m. The site will operate Monday-Friday for at least the next several weeks. David Boden, a volunteer with CORE, said the nonprofit, founded by actor Sean Penn, has operated about a half-dozen sites in southern California. The center will offer both drive-through and walk-up service. Tests are self-administered via an oral swab and those tested will be contacted by the testing company with results. State Rep. Mark Newton, R-Augusta, a physician who helped arrange the testing site, said it will serve people with COVID-19 symptoms, health workers, first responders as well as asymptomatic food service workers. Workers who are sick are not permitted to return to work, under the new restaurant rules, but it’s also known that asymptomatic people carry the virus. Newton said that this center will help food workers know if they have the virus, even if they show no signs, offering assurance to their employers, co-workers and patrons. JOHN SPINK / JSPINK@AJC.COM

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While some departments have done so to manage limited supplies, local leaders agree that tests kits are easier to find. In fact, some sites have more tests than they do patients. In Clayton County, the number of tests conducted has gone down in recent days, the head of its local emergency management department said, even though loosening state and federal guidelines mean that far more people are now eligible. Health care workers, first responders, and long-term care facility and staff can now get tested even if they show no symptoms.

These signs of improving capacity make leaders of metro health departments and emergency response efforts cautiously optimistic that they will be able to get to the Toomey’s testing goal of 100,000.

"We have plenty of space, enough capacity and enough people," said DeKalb County Health Director Dr. Sandra Ford. "We're ready and we're here.

‘Virtually everyone’

Now that Kemp has announced he will lift the statewide shelter-in-place for more Georgians, experts agree that the state's ability to reopen without causing needless illnesses or deaths rests on building a testing infrastructure unlike anything it has tried before.

“I think 10,000 a day is a good goal,” said Dr. Harry J. Heiman an associate professor at Georgia State University School of Public Health and a critic of the state’s pandemic response. “But we could do 10,000 a day and fail in our ability to test the people we need to be testing and putting in the other infrastructure we need for containment.”

Toomey said the 100,000 short-term testing surge goal came about during a weekend conversation with U.S. Surgeon General Dr. Jerome Adams. It is ambitious, but can be reached now that more tests are available, and the Centers For Disease Control and Prevention issued a broader list of COVID symptoms that make people with headaches, sore throats, or muscle pain eligible, she said.

“If you look at what the CDC said were symptoms — virtually everyone probably meets the criteria,” Toomey said.

» Complete coverage: Coronavirus in Georgia 

Los Angeles-based CORE Response and the Arthur M. Blank Family Foundation on Thursday, April 30, 2020 opened a coronavirus testing site at Mercedes-Benz Stadium. The testing center is at the Home Depot Backyard adjacent to the stadium, offered free tests to people with appointments from 10 a.m. to 4 p.m. The site will operate Monday-Friday for at least the next several weeks. David Boden, a volunteer with CORE, said the nonprofit, founded by actor Sean Penn, has operated about a half-dozen sites in southern California. The center will offer both drive-through and walk-up service. Tests are self-administered via an oral swab and those tested will be contacted by the testing company with results. State Rep. Mark Newton, R-Augusta, a physician who helped arrange the testing site, said it will serve people with COVID-19 symptoms, health workers, first responders as well as asymptomatic food service workers. Workers who are sick are not permitted to return to work, under the new restaurant rules, but it’s also known that asymptomatic people carry the virus. Newton said that this center will help food workers know if they have the virus, even if they show no signs, offering assurance to their employers, co-workers and patrons. JOHN SPINK / JSPINK@AJC.COM

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Notable change

A loosening supply of diagnostic tests marks a notable change for Georgia. Health departments had enough to identify only a fraction of those who contracted COVID-19.

In the pandemic’s early weeks, strict Georgia criteria required that patients get a referral from a physician to receive a test, throwing up barriers to those with no insurance or money for a doctor. Local health departments kept the street addresses of their testing sites under wraps to avoid being overwhelmed by crowds. Fulton had the capacity to test only about 70 of its 1 million residents per day at its single county-run site, while DeKalb could test about 120 for a population of 760,000.

DPH began a rapid expansion of testing sites April 15 that increased their number by about one third in a week, yet local health departments noted that supplies of tests and protective equipment such as masks and gowns remained unsteady.

Now daily average testing sits at about 7,000 statewide, and free drive-thru testing sites are beginning to spring up across metro Atlanta.

Four sites operated by Augusta University, the Georgia National Guard and other collaborators that can run as many as 260 tests per hour. Kennesaw State University, Georgia State University, Greenbriar Mall and Morrow sites have tested more than 1,260 since last Friday.

Fulton county opened new drive-thrus in Alpharetta and South Fulton that can test 50 people each day. Clayton county’s emergency management agency operates one that can test 100.

Los Angeles-based CORE Response and the Arthur M. Blank Family Foundation on Thursday, April 30, 2020 opened a coronavirus testing site at Mercedes-Benz Stadium. The testing center is at the Home Depot Backyard adjacent to the stadium, offered free tests to people with appointments from 10 a.m. to 4 p.m. The site will operate Monday-Friday for at least the next several weeks. David Boden, a volunteer with CORE, said the nonprofit, founded by actor Sean Penn, has operated about a half-dozen sites in southern California. The center will offer both drive-through and walk-up service. Tests are self-administered via an oral swab and those tested will be contacted by the testing company with results. State Rep. Mark Newton, R-Augusta, a physician who helped arrange the testing site, said it will serve people with COVID-19 symptoms, health workers, first responders as well as asymptomatic food service workers. Workers who are sick are not permitted to return to work, under the new restaurant rules, but it’s also known that asymptomatic people carry the virus. Newton said that this center will help food workers know if they have the virus, even if they show no signs, offering assurance to their employers, co-workers and patrons. JOHN SPINK / JSPINK@AJC.COM

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“Our capacity to test won’t be hampered by staffing issues or capacity issues. It will be hampered by testing availability issues, if it is hampered at all,” said Landry Merkison, Clayton County’s fire chief and head of emergency management.

Gwinnett is running near capacity, a health department spokesman said, and its largest testing event yet is set to take place Friday at Georgia International Horse Park. It can test some 1,200 people.

Cobb’s DPH drive-thru recently expanded its hours. Locals interviewed by The Atlanta Journal-Constitution arrived in recent days to find they were the only ones in line.

“I couldn’t believe I was out there and there was no one there,” said Jamie Bissinger, 68, of Acworth, who was tested April 22 with her husband.

None of them had symptoms, but Bissinger tested positive.

“I thought, ‘I’m not even sick’,” she said.

Lifting barriers

Barriers that kept some from receiving testing may not be as high as they used to be. The statewide requirement that patients get a physician referral is gone, and walk-up sites are beginning to open up.

Los Angeles-based CORE Response and the Arthur M. Blank Family Foundation opened a site Thursday with walk-up capacity at Mercedes-Benz Stadium. Among those eligible are food service workers who have no symptoms.

DPH has added about 50 pop-up testing sites in in rural areas with small populations, while Fulton County opened a new mobile walk-up site. It is visiting southwest Atlanta, South Fulton, and other areas where health insurance is scarce.

“We haven’t run out of anything yet,” said Dr. David Holland, chief clinical officer for the Fulton health department. “But like with everyone, the supply is not well-guaranteed. We continue to get shipments in, but we’re never entirely sure when they’re going to arrive, or how much.”

Getting the message

The success of Dr. Toomey’s 100,000 testing goal depends on the public learning that it is easier to get tested than it was. This may be difficult. Kemp’s decision to reopen the state may give some the impression that the virus is no longer a threat.

“My hope is that does not translate to people saying, ‘Now there’s no need for me to be tested because things are starting to slow down’,” said Merkison, Clayton County’s head of emergency management.

Some residents may believe they can’t afford a test, Dr. Ford said. Private companies advertise testing for $100 or more.

“There’s been a real misunderstanding there’s a cost,” Dr. Ford said. “There is absolutely no cost.”

Communications from state leaders remain vague, which could be a reason why more Georgians aren’t getting tested, said Georgia State’s Dr. Heiman.

“Surely we can do a much better job on who should and shouldn’t go to be tested,” he said.

Staff Writer J. Scott Trubey contributed to this report.