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To reopen businesses and public spaces safely, experts say, states need to be testing and contact tracing on a massive scale. But only a handful of states are doing enough testing to stay on top of potential outbreaks, according to a state-by-state analysis .

Among those, Tennessee stands out for its aggressive approach to testing. In Tennessee, anyone who wants a test can get one, and the state will pick up the tab. The guidance has evolved to 鈥�,鈥� and the state started paying for it in April.

It鈥檚 still rare for a community to encourage such broad symptom-free testing.

鈥淚n most places, you still need to show you have the signs and symptoms of COVID-19 to get a test,鈥� research professor听 of Georgetown University said. 鈥淚t鈥檚 really patchwork.鈥�

Ample testing, preferably including people who are not symptomatic, can help contain future outbreaks of COVID-19 by giving health officials the knowledge to act quickly to suppress any new cluster of cases.

Because of testing shortages, many states still have limitations on who can get a test. Some states, such as Alabama, are inviting people without symptoms to be tested, but only if . A few counties in Nevada have started asymptomatic testing,听and Rite Aid in a dozen states has opened up its walk-in testing, but it鈥檚听.

Tennessee鈥檚 commitment to testing so broadly has helped it pull ahead of most other states in its rate of testing. According to , Tennessee is doing more than double the minimum number of tests needed to control its outbreak.

Tennessee Department of Health Commissioner gave credit for much of the state鈥檚 testing success to private, commercial labs.

鈥淲e鈥檝e called on almost all of them to say, 鈥榃e need you to ramp up, because you鈥檙e about to get a flood of tests,鈥� and that鈥檚 exactly what we鈥檝e given them,鈥� Piercey said at a daily briefing in late April.

In one weekend, it was more than 11,000 tests.

But private labs are shouldering the testing load in most states. What鈥檚 novel in Tennessee is that the state guaranteed payment to those companies upfront.

So, rather than making them bill various health insurance plans 鈥� which are required to cover coronavirus testing but still create paperwork 鈥� the state is picking up the tab. And the typical rate set by the federal government 听to $100 a swab.

Memphis-based听听has been processing the bulk of the state-collected swabs. The company declined to comment for this story.

Nashville-based Aegis Sciences Corp. jumped in more recently and is already听听to 7,000 tests a day. CEO said the guaranteed payment was a big motivator.

鈥淐learly, it鈥檚 beneficial for the lab companies like us to receive the assurance of payment,鈥� Basile said. 鈥淭hat鈥檚 definitely a positive. And it gives us the confidence to put the effort and the capital in to make this happen.鈥�

And coronavirus testing requires more investment right now because the swabs and chemicals necessary to do it are in such high demand.

The tax dollars are well spent, said , faculty director of the听 which has been tracking testing capacity by state. He said Tennessee鈥檚 investment could more than pay for itself since ample capacity is seen as a necessity to reopen businesses. Jha said he鈥檚 been recommending this approach to government officials across the country.

鈥淚f the state says they鈥檒l just pay everybody 100 bucks every time you do a test, that strikes me as very smart policy,鈥� he said.

Tennessee officials said they鈥檙e banking on being reimbursed by the federal government at some point.

The Tennessee Department of Health doesn鈥檛 yet know exactly how much it鈥檚 on the hook for. But the tab grows by millions of dollars a week. Aside from weekend drive-thru events, the state is also paying to process the weekday testing being done by local health departments in 95 counties.

On a recent Sunday, more than 800 people were tested at a site in Hendersonville. Christine Garner was willing to wait in her minivan as she slowly moved through the parking lot of a local high school. 鈥淚 said, 鈥業 know there will be a long line, but we鈥檒l just sit and wait.鈥� We charged our tablets, and I鈥檓 doing sight words with the kids,鈥� she said.

Garner closes refinanced mortgages for a living, which puts her in close contact with multiple families a day 鈥� often in their homes. Still, she had no symptoms. And her closest contact to someone with COVID-19 was secondhand.

鈥淚鈥檓 just hypersensitive to any change in my body at all. I think a lot of people are,鈥� she said.

All this testing access is generally a good thing, said Dr. Kelly Moore, a pandemic consultant, formerly of the state health department. She refers to the test takers as primarily 鈥渢he worried well鈥� since nearly 99% of them have tested negative at some testing events.

鈥淚f these highly motivated, worried well people coming out for free tests are not taking up scarce resources we need for someone else, then it鈥檚 definitely not a problem to test them,鈥� Moore said.

But there鈥檚 a potential downside. All those negative test results improve a state鈥檚 closely watched positivity rate 鈥� that is the percentage of cases coming back positive. A low rate of positives is seen as a sign that a community is doing enough testing. But it鈥檚 possible to miss pockets of infection among people who might not have the awareness or resources to get tested.

鈥淲e can鈥檛 draw conclusions about what鈥檚 going on in the whole community based on this self-selected group of people who are so motivated they come out to get tested,鈥� Moore said.

Recently, Tennessee started using its testing muscle in a more targeted way and is also testing everyone who lives or works in 听and听. And on May 7, the National Guard started testing .

This story is part of a partnership that includes , and Kaiser Health News.