Even as Gov. Greg Abbott eases restrictions meant to stymie the spread of the coronovirus, Texas is falling far short of what medical experts say are necessary benchmarks for testing, an American-Statesman analysis found.

In Travis County, for example, about 8,400 tests had been administered through April 13, or about 7 out of every 1,000 residents. In Hays County, the rate is 6 out of 1,000; and in Williamson County, it’s only 4½ out of 1,000.

Some counties appear to have had few, if any, tests administered — suggesting that politicians may have little grasp on the movement of the virus through vast rural areas. At least 65 Texas counties, as of April 13, had five or fewer tests administered. At least 26 of those counties had zero tests administered.

Less than a week later, as of Monday, there are at least three known positive cases in one of those counties that had performed zero tests; a handful of others have one to two known positive cases.

The county-by-county, per capita cumulative breakdown — based on the most recent data available — reflects a wider picture: Texas as a whole is one of the bottom performers nationally in terms of testing per capita, with only about 5 out of 1,000 people across the state tested. In New York and Louisiana, epicenters of the disease’s spread, the number of people tested is nearly 30 out of 1,000.

Even as the U.S. as a whole struggles to ramp up daily testing, the country, on a per capita cumulative basis, is now among the leaders.

But, looking at a very small sample size, in many places — including Travis County — the rate of positive tests appears to be increasing, not decreasing, suggesting that the spread of the disease is outstripping the deployment of tests.

As of April 8, 8.9% of Travis County tests were positive; by April 13, that figure was up to 9.2%. (Williamson and Hays counties had virtually level percentages of positive results.) Those dates are the only two for cumulative numbers of tests administered that state officials have thus far made available.

Overall, the current positive rate statewide is 10.2%, or 19,458 positive results out of 190,394 total COVID-19 tests administered.

With more than 770,000 positive results out of more than 4 million tests administered overall, as of Monday, the positive-result rate nationally is nearly 20%, according to The Atlantic’s COVID Tracking Project.

New York, the hardest-hit state, has a 41% positive rate.

Testing promised

The U.S. now trails only Italy in terms of tests administered per capita, with 11,821 tests per 1 million people, according to a report Monday in Business Insider.

That’s a big uptick since early March, when the U.S. had administered fewer COVID-19 tests per capita than many other countries with large coronavirus outbreaks — just 5 tests per 1 million Americans, according to the Centers for Disease Control and Prevention.

Still, Dr. Anthony Fauci, the nation's top infectious diseases expert, said Monday on ABC's "Good Morning America" that testing nationally needs to double or triple above current levels of about 1.5 million to 2 million tests per week.

Public health experts say widespread testing is key to the coronavirus fight because it will help sick individuals isolate themselves from those who are healthy; instill confidence in economic activity; and give authorities a better sense of the disease’s spread.

On Monday, state parks in Texas reopened, one of several Abbott-ordered measures to peel back restrictions on social movement. Visitors must wear face coverings or masks, maintain a distance of 6 feet from non-family members, and cannot gather in groups of more than five.

Effective Wednesday, the ban on nonessential surgery will be loosened to allow doctors to perform procedures, such as diagnostic testing for cancer, without having to get an exemption, as long as they don’t deplete hospital space and personal protective equipment needed to treat COVID-19 patients.

And beginning Friday, retail stores in Texas will be able to reopen for delivery of items to customers’ cars, homes or other locations.

At a news conference on Friday, Abbott was asked about concerns over testing, and what strategies and benchmarks he will use as he looks to relax restrictions and jump-start the Texas economy.

Citing recent talks with the White House, he said Texas would be receiving a "dramatic increase" in testing — "not just testing those who may show symptoms, but also being able to test entire communities so that we have better information." Pressed on specific numbers and a timeline, Abbott said Texans can expect a "massive amount of testing capability coming to Texas by late April or early May."

On Monday, Abbott announced that the Texas National Guard will mobilize more than 1,200 personnel as part of COVID-19 mobile testing teams; one of the first 45-member teams has deployed to Fredericksburg.

Troubled data

To reopen the United States by mid-May, the number of daily tests performed between now and then should top 500,000, according to estimates by Harvard University researchers.

On a daily basis, Texas is currently hovering at 27 tests per 100,000 people per day; the Harvard researchers suggest a minimum of 152 tests per 100,000 people each day as a prelude to opening up the economy.

"(It’s) entirely possible to do quite a lot of reopening of parts of the economy — if we had testing," Dr. Joseph McCormick, professor of epidemiology at the Brownsville campus of the University of Texas Health Science Center at Houston, told the Statesman. "People are going to be skittish, which is why we have to have all this testing in place. Nobody is going to want to go into a hospital for an elective medical procedure and come out with the COVID virus."

Even the county-by-county data that the Statesman analyzed illuminates something about the lack of knowledge local and state officials have as they make crucial public health and economic decisions.

For one thing, Andrews County in West Texas — population 17,487 — had seen 12 positive cases as of April 13, according to data supplied by the state, but only one test administered.

That discrepancy is "likely a reflection of the fast flow of data from a variety of sources," said Chris Van Deusen, a spokesman for the state Department of Health Services, the lead state agency in the coronavirus fight.

Some local officials say they don’t have easy access to the county data themselves.

"We do not have testing numbers from the many private and public-private testing sites," city of Austin spokeswoman Sam Haynes said. "Those sites are mandated by an executive order issued by Gov. Abbott to report their testing to the state, but not to the county or city in which they are administered."

Ongoing surveillance

But cumulative data may not be as handy as daily testing numbers, said Claus Wilke, a University of Texas biologist who studies the evolution of viruses. "What really matters is: If you needed a test today, could you get one?" he said.

He continued: "Have the people I interacted with gotten tested? If I go to the grocery store, can I be pretty confident that people who work there are getting tested? What about the doctor’s office? If you could just make it so, you’d want grocery store employees and nurses to get tested weekly. And this isn’t about testing once: You want ongoing surveillance to make sure people are tested."

In an April 7 paper titled "A National COVID-19 Surveillance System: Achieving Containment," released by Duke University, a team of researchers — led by Mark McClellan, now a medical adviser on Abbott’s Strike Force To Open Texas — suggests the top criterion for achieving containment is a "widespread diagnostic testing system," especially "those with exposures or at higher risk of contracting or transmitting the virus (health care workers, those in congregate settings)."

The paper also calls for ongoing surveillance and tracing mechanisms to track people who have coronavirus-related symptoms, as well as widespread testing to detect people who have built up immunity.