Elected officials say reduced coronavirus testing in Johnson County is a problem
Kim Fader spent Thursday morning calling her mother’s long-term care home in Overland Park and asking health officials for Johnson County and the state of Kansas why a resident isolated with fever and respiratory issues, known symptoms of COVID-19, was not being tested.
Fader, a project manager in the epidemiology department at Columbia University in New York, was told the person wouldn’t be tested because their symptoms weren’t severe enough to require hospitalization. That, she learned, is the policy in Johnson County.
“This is very frightening,” Fader said. “If you’re wanting to increase the number of cases this is what you should do.”
Similar stories have been shared across the region since the state health department announced Wednesday that testing for the novel coronavirus would be reduced in Johnson County to conserve test kits.
Lee Norman, secretary of the Kansas Department of Health and the Environment, said Johnson County, which has reported the largest number of presumed positive cases in Kansas, will have less testing as the virus is now spreading by community transmission.
Johnson County will stop testing anyone with minor symptoms, instead testing only those who need to be hospitalized. The measure, Norman said, is intended to prevent the state from running out of testing resources.
Several local and state leaders said they were frustrated with the lack of testing and called for a better response.
State Sen. Barbara Bollier, a Democratic candidate for the U.S. Senate, criticized the federal government and President Donald Trump.
“Every Kansan deserves access to testing — that is what the president promised,” said Bollier, a retired physician who lives in Mission Hills. “I’m disappointed that the federal government has not followed through and as a result, puts our communities at risk through inadequate testing. Expanded testing is needed to understand the scope of this pandemic in Kansas.”
Others, such as Johnson County Commissioner Mike Brown, expressed frustration with the health department
“I very much take exception however with the KDHE secretary, Lee Norman, making Johnson County sound like a lost cause,” Brown said. “We are the largest populated county in Kansas at nearly 600,000 people and the economic engine of Kansas. I expect a lot more from those with such power and authority. “
Brown added that there would be no “reasonable way” to ensure there are enough tests for every possible scenario.
Stephen Morse, a professor of Epidemiology at the Columbia University Medical Center in New York, said he understands that health departments must develop policy to conserve COVID-19 test kits but he is “mystified” by their scarcity.
“We have the capacity to do better, we have done better in the past, and I’m very surprised at how slow it’s been to develop,” Morse said.
Such policy is difficult to develop, he said, because the only way to know who should be tested for a virus is to compile data through testing. He said he hopes health departments will be able to “take a more realistic approach” soon if more kits become available.
As of Thursday afternoon there had been 36 presumed positive cases of the rapidly spreading virus in Kansas. Sixteen of those were reported in Johnson County.
On Wednesday Norman told Kansas lawmakers there were about 500 test kits in the state. Kansas Republican Sen. Jerry Moran was working with Norman to obtain 2,500 test kits and samples.
Concerns at nursing home
Fader received a notice from Village Shalom, an independent living and nursing home facility in Overland Park, Wednesday. The notice explained that a resident was isolated and experiencing symptoms consistent with COVID-19. However, the notice said “no recommendation for testing of COVID-19 has been made at this time.”
Fader said she then called the Olathe health department and the state COVID-19 hotline and was told by both that because the facility was already doing everything it could do about the case by isolating the patient, testing wasn’t necessary.
This logic, Fader said, does not consider the investigations done for cases to determine who has come into contact with a coronavirus patient.
“When you think about how spread has been stopped in other locations around the world, this has proved to be very important,” she said. “Someone would surely have contact with multiple staff members and other residents.”
Village Shalom did not respond to The Star’s request for comment in time for publication.
Johnson County health department spokeswoman Barbara Mitchell said it is “up to the healthcare provider” to make the decision and that the highest risk patients must be prioritized.
Morse, the epidemiology professor, said that he understands the county’s decision but that there should be an extra level of concern for potential cases in nursing homes where there are a large number of people moving in and out and an older population.
The virus, he said, may start with minor symptoms but could become severe quickly.
“I’d be particularly cautious in nursing homes and other places where you might have a lot of vulnerable people,” Morse said.
One solution, he said, could be to screen to rule out diseases, like the flu, with similar symptoms. There is no policy in Johnson County for such screenings.
Johnson County policy shift
The federal Centers for Disease Control and Prevention guidance says local authorities should shift from a strategy of containment to mitigation once community transmission has been established in order to conserve resources.
The guidance, however, does not specify how that should apply to the testing of potential patients.
The World Health Organization says people who should be tested include those who are hospitalized with symptoms as well as those who exhibit symptoms and have had contact with a confirmed patient or have traveled or resided in areas of community transmission.
U.S. Rep. Sharice Davids, a Democrat whose district includes Johnson and Wyandotte counties, issued a statement Wednesday in response to the state’s new testing guidelines, saying the Trump administration has failed in its leadership on the issue.
Davids is now self-quarantined after coming in contact with another member of the House of Representatives who tested positive for the virus.
U.S. Sen. Pat Roberts, a Kansas Republican, said he is working with the state health department on response to the virus, including testing.
“This is a serious situation and we all need to work together. This is not a partisan issue and throwing blame around does nothing to help,” he said in a statement to The Star Thursday.
‘Where are the tests?’
State and local elected officials expressed frustration Thursday with the lack of available tests.
Amanda Adkins, a Republican congressional candidate for Kansas’ 3rd District, said she appreciated the state’s decision to conserve resources but said it was not a long-term solution.
Adkins said she has seen problems with both the availability of tests and the speed with which they can be processed. She released a statement Thursday supporting a bill proposed by Missouri Republican Sen. Josh Hawley to improve the management of medical supplies.
“Given the seriousness of the situation the American people and people in Kansas they expect a bigger plan than that,” she said. “(The approach) only deals with the day to day, here and now, but not the broader surveillance and risk management.
“You’re not going to be able to do that if you don’t have a broader testing program.”
Adkins’ competitor in the 3rd District Republican primary, Adrienne Vallejo-Foster, said in a statement to The Star that her son was denied testing at a drive-thru location Thursday morning. However, she said, limiting testing in Johnson County was a necessity.
“While I wish we were not in this position, I support the decision,” Vallejo-Foster said in the statement. “Priority needs to be given as to who gets tested.”
Despite the frustration, officials expressed confidence in local and state health authorities.
Kansas Rep. Jarrod Ousley, a Democrat from Merriam, said he trusted state health officials but worries that the move will limit the county’s ability to understand the scope of the outbreak.
“You’re asking people to change their habits and honestly put a financial burden on a lot of families,” Ousley said. “If you don’t have the documents or the data or the test results to back it up then it makes it a little bit of a taller ask for some people, I would fear.”
Two of Ousley’s Democratic colleagues in the Legislature, Brett Parker and Cindy Holscher, both of Overland Park, said that they understand the desire for testing but that the situation has evolved.
“Containment is difficult at this point, and that’s why we’re seeing the shift,” Holscher said.
Johnson County Chairman Ed Eilert argued that less testing is not ideal but is needed to conserve supplies and ensure that residents with serious symptoms receive test results as fast as possible.
Still, Johnson County residents are pleading for more resources, concerned that people showing symptoms will never be tested.
“This lack of awareness of actual cases will only justify the behavior of naysayers and cause more cases. Where are the tests?” one resident wrote on Twitter.
Johnson County Commissioner Becky Fast said she worries that the changes in testing have caused more panic across the county. She said given the limited supply of tests across the country, the county is responding as best as it can.
“It’s about targeting the testing to those who are most severe, so it’s not that no one is going to get testing,” Fast said. “Many areas of the country now don’t have any supplies or protective gear. But our county has passed protective orders, we are in line for federal funding, we are working with major hospital CEOs and testing labs to have more kits and supplies.”
The Star’s Jonathan Shorman and Bryan Lowry contributed to this report.
This story was originally published March 19, 2020 at 5:34 PM.
