By Celia Llopis-Jepsen & Dan Margolies
Lawrence, KANSAS — The looming expiration date on Kansas’ statewide stay-at-home order worries Mary and Gary House of southeast Kansas.
Though they’re staying in as much as possible now, once life returns to normal that will change. Gary, age 79, is an attorney who defends criminal cases in Chautauqua, Montgomery and Elk counties.
He thinks of the exposure to the novel coronavirus he could face in a single jury selection.
“They may bring in 70 or 80 prospective jurors to question,” he said. “So, you’re just around a lot of people.”
The Houses want Kansas to heed the advice of epidemiologists who say states need widespread and reliable access to testing before reopening their economies.
Yet as of Sunday, Kansas had the lowest rate of testing among all 50 states. About six of every 1,000 residents have been tested.
The Kansas News Service compared total tests per state — compiled daily by the COVID Tracking Project — to 2019 population estimates from the U.S. Census Bureau.
“What we’re really concerned about is there’s not enough testing,” Mary House said. “If you want to get tested, you ought to be able to get tested.”
Kansas upgraded its testing equipment when the pandemic hit and can handle up to 1,000 tests at the state laboratory in Topeka per day. But a shortage of specialized nose swabs and other related materials have slowed the actual pace.
County health agencies hit similar hurdles. Some hospitals and clinics relying on private labs for testing report backlogs that keep patients waiting on results anywhere from a few days to more than a week.
Gov. Laura Kelly has signaled her administration won’t let up on the stay-at-home order she issued in March until testing access can reliably track the disease, even though daily death counts are projected to decline in Kansas in the coming days and weeks.
“If we move forward prematurely,” before testing supplies and contact-tracing capacity are robust and sustainable, she said Monday, “then we will inevitably find ourselves facing a second wave.”
Health secretary Lee Norman said Monday that the state lab had just received 5,000 additional swabs from the federal government amid the concerns about COVID-19 spreading in meatpacking plants of southwest Kansas. Kansas dental offices have also begun producing them on their 3D printers.
County challenges
The state has nearly 2,000 confirmed cases of COVID-19, but the real number could be many times higher. Only about 19,000 people had been tested statewide as of Monday.
The virus has killed 100 Kansans and hospitalized 400.
Testing rates vary widely by county, even among the state’s most populous areas.
Fewer than 5 in 1,000 residents have been tested in Wichita and Sedgwick County, compared to more than 10 in 1,000 in Topeka and Shawnee County.
In Johnson County, the health department has conducted just over 1,000 tests, while another 3,000 or so have been done by private labs, department director Sanmi Areola said.
He said it would take at least another 4,000 to 5,000 tests in his county to judge whether stay-at-home orders should be eased.
“And it’s been a real struggle,” he said. “We probably have fared better than some, but it’s just taking an impossible amount of energy trying to look for different ways to get the resources,” especially the swabs.
On Sunday, President Donald Trump said his administration was preparing to use the Defense Production Act to compel an unidentified U.S. facility to increase production by more than 20 million swabs a month.
Some hospitals — such as the University of Kansas Health System and Saint Luke’s Health in the Kansas City area — have managed to launch in-house testing with turnaround times within a day.
Though Kansans without serious symptoms still can’t get tested across much of the state, some health care providers say the situation is improving.
“Now we’re testing all symptomatic patients, both on an outpatient and inpatient basis,” said Larry Botts, chief medical officer at AdventHealth Shawnee Mission (formerly Shawnee Mission Medical Center).
What happens next?
Kelly has extended her order that people without essential jobs stay at home until the start of May, and it’s unclear whether Kansas will remain on lockdown beyond that.
The governor faces pressure from lawmakers and others to reopen the economy, and said Monday her administration is still working out how to do that safely.
“Absolutely no one wants to keep people home a day longer than is necessary,” she said.
Epidemiologists say testing access and results are critical to finding an exit strategy from state lockdowns. That’s in part because limited testing has made it difficult to know how widespread COVID-19 is.
“You can’t just relax physical distancing interventions in the absence of knowing where you are in the epidemic,” Harvard University professor of epidemiology Caroline Buckee told reporters in a press briefing last week. “You’d lead to enormous resurgence and a lot of deaths.”
Both diagnostic (like the typical nose swab tests) and antibody testing will play important roles, she said. Diagnostic tests look for the virus’ genetic material to see if you’re infected.
Ultimately Kansas and other states will also want to use blood tests to scour for antibodies that show what percentage of people have already had COVID-19.
Those tests are only starting to roll out, and will come with their own supply chain challenges.
Celia Llopis-Jepsen reports on consumer health and education for the Kansas News Service. You can follow her on Twitter @celia_LJ or email her at celia (at) kcur (dot) org.
Dan Margolies is a senior reporter and editor at KCUR. You can reach him on Twitter @DanMargolies.
The Kansas News Service is a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focused on health, the social determinants of health and their connection to public policy.
Kansas News Service stories and photos may be republished by news media at no cost with proper attribution and a link to ksnewsservice.org.