Kansas eyes May 3 to begin reopening, but testing supplies ‘nowhere near’ what’s needed

After a month under lockdown, Kansas faces a herculean task if it has any hope of safely meeting Gov. Laura Kelly’s goal of beginning to reopen the state on May 3.

The state ranks last in testing for the coronavirus, a dubious distinction health officials insist Kansas must improve upon before residents start to resume their lives. A minuscule 0.7 percent of the Kansas population has been tested, half the U.S. total of 1.4 percent.

The governor’s target will require a stunning testing turnaround that not even she is confident Kansas can achieve.

“We are nowhere near where we need to be with testing supplies,” Kelly said Thursday. “It’s the biggest frustration that I have.”

As May approaches, state officials are deploying an everything-but-the-kitchen-sink strategy to improve testing.

They’ve begged federal authorities for supplies. They’ve tried their luck in the private market. They’re looking into retrofitting existing labs missing equipment needed to process COVID-19 tests.

Kansas has even enlisted dentists with special 3D printers to manufacture hard-to-get nasal swabs.

None of it, so far, is enough to allow Kansas to conduct the kind of population testing that Lee Norman, the state’s top health official, wants in order to determine the prevalence of the disease. And hopes of widespread, on-demand testing remain a fantasy.

Wichita and surrounding Sedgwick County, the state’s second most-populous, illustrate the problem. The county’s volume of testing has been so low that its health director, Adrienne Byrne, said “we can’t really have confidence in what our numbers are or are not telling us.” Just over 3,000 people have been tested in a county with more than 500,000 residents.

“We don’t have adequate testing supplies,” Byrne said. “They’re slowly starting to trickle in, more than ever before, still not near what we need.”

Still, local officials across Kansas are preparing for what happens when the governor’s stay-at-home order expires in early May. They are drawing up their own rules and guidelines, weighing public health and economic needs as they plan to reopen.

“The goal is to do this responsibly, but also not to be knee-jerk about it,” Wichita Mayor Brandon Whipple said. “We need to be responding to what medical experts, public safety experts say much more than what we want.”

Kelly could issue a new order to keep Kansans at home, but the longer statewide restrictions drag on, the more tenuous her position becomes. The Democratic governor is under pressure from Republicans to outline a plan for reopening and she has promised to detail metrics this coming week for easing the lockdown.

The Legislature must reconvene by May 21 and some members are clamoring to change the state law that has provided Kelly sweeping powers during the crisis. Senate President Susan Wagle, a Wichita Republican, said senators want “some sort of check on the governor’s powers.”

Rep. John Eplee, an Atchison Republican and a family physician, said Kansas needs to listen to science, but also face “the reality” that the economy needs to begin restarting. People are growing “increasingly restless,” he said.

“We’re sort of at crossroads, honestly, with medicine and science versus the politics and reality of getting our society going again,” Eplee said.

No widespread testing

Norman, who is leading the public health response to the virus, said April 17 that population testing of 15,500 residents — 0.5 percent of the state’s population — would be enough to determine where COVID-19 is throughout the state.

Population testing, combined with testing sick people in virus hot spots, would be a “sufficient number” to track infections as the economy reopens, Norman said.

It would also represent a massive jump in the number of people tested. So far, roughly 21,300 people have been tested.

On Friday, he elaborated that he wants each of 105 counties to achieve a rate of 5 tests per 1,000 people. Many counties have already exceeded that rate, he said.

So far, testing has been almost exclusively reserved for those with symptoms. A population test would target people regardless of symptoms. But until the right materials are in hand, Norman’s plan remains just that.

“We are still not doing population testing because we don’t have the supplies to do that,” Ashley Goss, the Kansas Department of Health and Environment deputy secretary of public health, told lawmakers Thursday.

And it’s nowhere near the widespread, on-demand testing that doctors and other health officials describe as a gold standard for going back to normal.

Eplee said broad testing is needed, especially for first responders, health professionals and food workers.

“At some point, we need to have it on request so people can feel safe in what they’re doing,” Eplee said.

Kansas has received at least $625 million in federal coronavirus relief and is expected to get more next week, with Sedgwick County collecting nearly $100 million and Johnson County $116 million.

But specific requests for testing supplies and other equipment have largely gone unfulfilled, according to Kelly.

Kelly has gone as far as raising her frustrations with Vice President Mike Pence during a one-on-one call earlier this month. She has said the state, which has kept the number of hospitalizations and deaths relatively under control, is a victim of its own success.

In a major exception, however, federal officials last week sped supplies to four counties experiencing outbreaks tied to meatpacking plants. The state received 2,000 Abbott tests, which deliver results in minutes rather than hours or days, and 5,000 other tests that must be sent to labs.

“But just in terms of regular shipments of tests and test supplies that we need, we continue to not get that response,” Kelly said.

The state has been sending supply requests to the Federal Emergency Management Agency, but Kelly said officials have now been told to ask for supplies from the Centers for Disease Control and Prevention instead.

“That was news to us,” she said.

On Friday, Sen. Jerry Moran, R-Kansas, touted legislation passed by Congress this past week that’ll put $25 billion into ramping up testing nationally.

Roughly $11 billion of that will be distributed to states, including $21 million that will be immediately available to Kansas, Moran said. The money will help the state’s testing capacity, but it won’t raise it to the level that Kansas officials desire.

“I would say with the goal of broad testing, this is still probably, in my view, insufficient,” Moran said. “More testing than this is required.”

Moran said he had a Zoom call with officials from 14 Kansas hospitals on Thursday and they all told him that they’ll need the ability to test every patient before they can begin to open their facilities to non-emergency patients

“My goal, which I have not succeeded at, is to try and determine why Kansas is so low on the state in testing now… How can we help the state of Kansas to where we’re doing more testing compared to states around us?” Moran said.

Health officials say they are doing whatever they can to improve testing.

Just a few weeks ago, Kansas faced a severe shortage of the nasal swabs needed for the tests. But the state this past week began producing thousands of its own through a partnership with dentists who have 3D printers.

Goss said several labs in Kansas have the capacity to process coronavirus tests but lack key equipment. KDHE is trying to bring those labs online.

Steve Stites, the chief medical officer for the University of Kansas Health System, said the hospital is up to conducting 500 tests a day and has volunteered 50 staffers to help KDHE with contact tracing. Ultimately, the state agency wants 400 people involved in tracing efforts.

Stites said that it’s true Kansas will open up before it has the ability to do broad community testing, a reality for all 50 states.

“As society opens back up again, our next big challenge is to keep it that way and that’s going to be about personal responsibility,” Stites said.

Life or death calls

In the absence of widespread testing, counties are preparing to make potentially life-or-death decisions when Kelly’s statewide order ends. Local officials will have to determine acceptable levels of risk as commerce resumes.

Sedgwick County manager Tom Stolz said the county is working with businesses to come up with a framework for social distancing, sanitation, handwashing and disinfecting surfaces.

“That’s all going to be a critical part of reopening,” he said.

The county is also low on personal protective equipment, or PPE, Stolz said. Restrictions and requirements will be largely dependent on the availability of supplies.

“If you took the limitation of PPE off the table, and the limitation of testing off the table, this whole conversation would be very different,” Stolz said.

“But the reality of it is there is a shortage, so I don’t know how we could require our citizens to do something that they can’t achieve.”

Stolz said Thursday that the county is waiting to see what Kelly does with the stay-at-home order before moving forward with plans of its own.

“We’re hopeful that the data is going to show we’re on the downward cycle of this, and we have at least some PPE and businesses have a pretty good plan going forward” before reopening, he said.

In Johnson County, county commissioners allocated $400,000 to purchase sample collection kits and start its own drive-thru testing clinic.

Officials aim to test 2,000 randomly selected residents, some with symptoms and some without, to better understand the outbreak – a smaller version of the kind of population testing that Norman wants to conduct.

“Can we quickly set up a safe and efficient testing site for symptomatic individuals? I will tell you that, yes, we are pretty close to doing that,” Sanmi Areola, Johnson County public health director, said.

He said the county also needs a robust testing program for health care workers. It has started screening front-line workers, including first responders and health care providers. But so far, only about 200 essential workers have been tested.

Areola said that securing testing supplies, such as swabs, remains a challenge.

“Every health director will tell you that we’re continuing to struggle with having enough supplies to collect samples,” he said.

Officials are pushing for a slow approach to reopening the economy, saying that certain businesses will likely open before others.

“We do know there will be phases in which we have to roll back restrictions,” said Joe LeMaster, county public health officer. “That’ll be a gradual process, in which we monitor the process over time.

The county may need to reimpose restrictions if a sharp increase in cases and hospitalizations occurs, he said.

In a best-case scenario, the rollback of restrictions will lead to sporadic clusters that would include cases popping up in companies, factories and nursing homes.

“That’s our best case scenario,” Areola said. “Our worst case scenario is that we have a broad outbreak, close to what we currently have or even worse.”