Coronavirus in rural America (Part XXXXI): Are "rural" states doing better with testing?

I was struck when listening to this NPR segment this morning that many of the states meeting the minimum testing guidelines are rural, by one measure or another.  They are Alaska, Hawaii, Montana, North Dakota, Oregon, Tennessee, Utah, West Virginia and Wyoming.

The story, by NPR's Rob Stein, quotes Ashish Jha, director of the Global Health Institute at Harvard University:

But each state's specific need for testing varies depending on the size of its outbreak, explains Jha. The bigger the outbreak, the more testing is needed. 

On Thursday, Jha's group at Harvard published a simulation that estimates the amount of testing needed in each state by May 15. In the graphic below, we compare these estimates with the average numbers of daily tests states are currently doing.

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To make their state-by-state estimates, the Harvard Global Health Institute group started from a model of future case counts. It calculated how much testing would be needed for a state to test all infected people and any close contacts they may have exposed to the virus. (The simulation estimates testing 10 contacts on average.) 

"Testing is outbreak control 101, because what testing lets you do is figure out who's infected and who's not," Jha says. "And that lets you separate out the infected people from the noninfected people and bring the disease under control."

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Several states with large outbreaks — New York, Massachusetts and Connecticut, among others — are very far from the minimum testing target. Some states that are already relaxing their social distancing restrictions, such as Georgia, Texas and Colorado, are far from the target too.

Here's an April 24 story out of Texas about the 50 counties in the Lone Star State with no cases, perhaps attributable to the lack of testing. 

Finally, here's a link to an op-ed by the Republican governors of several states--again states often popularly thought of as "rural"--about their decisions not to clamp down on economic activity to the extent many other more populous--and blue--states did.  Participating governors are from Iowa, Missouri, Wyoming, Arkansas and Nebraska.  Wyoming is the only one of these states on the list above, of those states meeting the minimum guidelines for testing to suggest re-opening is possibly appropriate.  The op-ed appeared in the Washington Post on May 5.