The University of Minnesota has unrolled a proposal for wide-scale COVID-19 testing — up to 20,000 tests per day — that could, in theory, help reopen the state’s economy and get people safely back to work.

And they’re asking Gov. Tim Walz and state lawmakers for $20 million to help them do it.

The goal is to dramatically expand two types of testing on a statewide basis for both the COVID-19 virus and antibody resistance to the virus.

The logic goes that many residents have unknowingly already carried the virus but have shown few, if any, symptoms, and could be cleared to return to work.

Discussions of whether people who have already been infected can be re-infected continue nationally, but for now, most experts point to natural antibodies as the best weapon humans have against the novel coronavirus.

State officials have yet to weigh in on the specifics of the U of M plan, and it appeared Thursday many had yet to see them.

“I have not seen that proposal in any detail,” said Jan Malcolm, Commissioner of the Minnesota Department of Health, in a conference call with reporters on Thursday afternoon. Gov. Walz, who spent part of the day conferring with governors from throughout the Midwest, did not participate in the call.

Malcolm cautioned that widespread testing would require resources such as swabs, which have been in high demand: “Do we have capacity at the (clinical) points in the community to do that?”

The governor’s stay-at-home order — which took effect March 27 — is currently scheduled to be lifted May 4, but many expect business closures to continue in whole or in part, at least for certain industries, if public health officials foresee escalating deaths and widespread infection.

SWAB TEST

U of M researchers previously invented a Polymerase Chain Reaction swab test to identify the active virus in patients, as well as a serologic blood sample test to determine which patients have antibodies — evidence they’ve already had the virus and likely are now immune.

The U’s goal is to conduct 10,000 antibody and 10,000 PCR tests per day across the state to determine who is at risk of infection and who is cleared for take-off.

What about supply chain issues dogging testing efforts across the states?

In a statement, U of M officials noted the tests are locally-developed, “discovered by U of M researchers and manufactured in Minnesota. This means the University’s testing regimen operates outside the existing supply chain and will not be stymied by overtaxed international testing demand.”

U CAN HANDLE STATE-WIDE TESTING

Meanwhile, officials said the university has campuses across the state and already works hand-in-hand with the M Health Fairview hospital network, Essentia Health at the medical school campus in Duluth, and the Red Lake Nation and other tribal communities. The U’s reach ensures they can facilitate testing statewide, they said.

In Minnesota and other states, swab testing to determine if someone has coronavirus has until now been prioritized for the very ill, seniors in care facilities and healthcare workers with known exposures.

That provides limited information about the path of the disease through the state, and no information about who has already been infected and may now be immune.

U of M officials hope the one-two punch — a combination of swab and blood tests for everyone — will yield better information and a gradual return to work. The two tests combined would cost about $25 to $30 person, or could be cheaper or more expensive depending upon volume and economies of scale.

HOW RELIABLE ARE BLOOD TESTS?

Here’s another question: How reliable are blood tests?

On April 7, the Minnesota Department of Health cast some doubt on the many serological blood tests hitting the market, noting many testing products have not been approved by the Federal Food and Drug Administration as a trusted way to detect the virus. Tests, they said, should only be done in clinically-certified laboratories.

A blood test alone without the nasal swab tells only half the story because antibodies can take up to 11 days to show up in someone’s blood after infection.

And here’s another wrinkle: a positive test result could be due to a past or present infection from something else non-COVID-19, such as other strains of common human coronaviruses.

Still, “given the stealth of this virus, I think it is a very important tool,” said Joanne M. Bartkus, director of the Minnesota Department of Health laboratories, in an interview last week.

“We are actively discussing how to use it and what questions we can use it to answer,” she said.

PLENTY OF QUESTIONS REMAIN

Bartkus is part of a working group that is advising Walz and other state leaders on the best way to respond to the outbreak that has killed 94 Minnesotans and sickened more than 1,900.

Plenty of practical and political questions remain about the U’s proposal.

Not the least of them is funding, what groups or sectors of the economy should be tested first, how quickly testing can be rolled out statewide, how long a nonessential worker would yet have to remain at home if they have never had the virus, and what to do when residents decline to be tested.

Working with M Health Fairview, the U of M has already begun antibody testing for front-line healthcare workers at Bethesda Hospital in St. Paul, which has been converted into a COVID-19 patient facility for the very ill.