Behind a nondescript strip mall in Carmel, Indiana, a short line of cars gathers mid-afternoon next to a large tent. Medical professionals stand out front, dressed head to toe in blue medical gear. People in the cars -- many of them first responders -- drive up to get checked for COVID-19.
The test involves a really long swab placed deep into the nose, towards the back of the throat.
“No, it’s not fun, but it's quick. I would say painless, but it is a little painful,” Carmel firefighter Tim Griffin says. “It's five-10 seconds and then it's all done and the burning goes away and you move on.”
Across the country, there have been shortages of COVID-19 tests. However, an Indianapolis suburb has taken an unusual step to keep residents safe. All city employees who deal directly with the public are being tested weekly -- even if they show no symptoms.
Griffin is one of the 350 Carmel city workers being tested each week. They also include police officers, EMS and sanitation workers. Then, all city employees and their dependents will be tested, bringing the total to 1,800 people.
Griffin says the testing isn’t just about protecting first responders. It also helps protect Carmel’s residents.
“We do go into homes and not just on patients that have COVID, but we're going into homes with people that are sick, very sick, you know, whether it be cancer, heart issues, diabetic problems, you name it,” he says. “So this way we know if one of us is asymptomatic and we could possibly spread it to one of those patients.”
Carmel is a large northside suburb of Indianapolis, home to professional athletes, a massive arts district and top-rated schools. The median household income here is over $100,000 a year -- about double the national figure.
Stopping the asymptomatic spread of COVID-19 is the idea behind this city’s testing initiative. Mayor Jim Brainard and health experts looked to Iceland and South Korea for solutions and decided routine testing was the best way to stop the spread.
“The goal is to slow it down, so our hospitals aren't overwhelmed,” Brainard says. “If we do that, we know we can save lives.”
Brainard says area hospitals did not have a shortage of tests, so he decided to move forward with checking city employees. And they’ve already found several COVID-19 cases, including some in people who were asymptomatic. The federal Centers for Disease Control and Prevention says some 25% of cases don’t show symptoms.
“We've had several first responders test positive, we've had several home sick,” Brainard says. “We have one in the hospital right now, and we're hopeful that he recovers soon.”
This program is costly -- Carmel expects to spend $500,000 to $600,000 for a month of testing. These costs are coming from the city’s health insurance fund, and with many elective procedures being cancelled, the city says it can handle the costs.
Just a few steps from the line of cars and the large tent the tests are taken to a private lab called Aria Diagnostics.
Peering into the lab, owner Zak Khan says Aria Diagnostics had to quickly pivot in the coronavirus crisis. The company switched from doing toxicology tests from doctors’ offices to processing hundreds of COVID-19 tests each day.
“Previously it was one account only had a handful of orders in a month, maybe 30 orders in a month,” Khan says. “Now we have 30 orders every single day from the same municipality.”
Khan’s lab turns these tests around in 24 to 48 hours. And it’s looking to speed up the process even more.
“There's a learning curve everyday we're trying to do it better, faster,” Khan says.
Aria Diagnostics now services a number of central Indiana municipalities that want first responders tested for the virus. Carmel’s testing program is the most expansive.
“I think it's a really cool study in how a municipality can utilize and leverage the power it wields,” Khan says. “To great positive effect in a very short period of time, and I don't know how else we would do that.”
With an excess of test kits produced by a local lab along with Aria Diagnostics, Carmel donated 50,000 tests to New York City.
"What Jim [Brainard] is sending us is going to help us immensely," New York City Mayor Bill De Blasio says. "And with the other pieces in place we’ll be able to reach 50,000 New Yorkers. So Jim and everyone in Carmel, I want to thank you."
De Blasio says the city has struggled to recieve adequate test kits from the federal government, and the city is now moving to purchase 50,000 test kits per week from Carmel.
This story was produced by Side Effects Public Media, a news collaborative covering public health.