Missouri lacks COVID-19 tests, contact tracers. If this is a war, where’s the cavalry?
In some states, there are more COVID-19 tests available than there are people stepping up to be tested, mostly because there’s been so much confusion about and so many limitations on who can get tested. More than a month ago, Missouri health officials were suggesting this was one of those states.
Now, what Gov. Mike Parson says is that we need to do a lot more testing, and on this he’s right. “Once Missouri’s overall testing numbers have increased,” he said in a statement last week, “the state will reevaluate and determine what is needed moving forward.”
So do we have enough testing for COVID-19 in Missouri, or don’t we?
The short answer is still no.
And the longer answer is that where we do have testing, which remains uneven, we don’t have the contact tracers we’d need to slow an outbreak by breaking the chain of transmission. It’s robust contact tracing that together with widespread and repeated testing would allow us to get out ahead of new hotspots. You know, as both Parson and President Donald Trump said we’d do before opening up.
For every confirmed case, said Dr. Rex Archer, Kansas City’s health director, “we need to figure out where it came from and who have you exposed.” Only, “we don’t have the capability to do contact tracing,” which really involves 12 different steps. “Testing without those 12 other functions would be like a homicide investigation where you only look at the crime scene” and never interview anyone. And private labs doing COVID-19 testing, he said, often don’t even know what data needs to be collected.
As a result, he’s not pushing everyone to get tested, though without a mass testing and contact tracing program, we’re not far from where we came in months ago.
No fever, no COVID-19 test
Don Benecke, who lives right on the Lake of the Ozarks in Osage Beach, Missouri, has had a nagging cough since February, and finally went to his doctor on Friday. He wanted a COVID-19 test “to ease my mind,” he said in a phone interview. But his doctor said that since he didn’t have a fever, he didn’t qualify for a test, which isn’t true. He did send him to the hospital for a chest X-ray, which could show pneumonia but not COVID-19.
Parked right in front of his doctor’s office as he was leaving, Benecke saw a mobile coronavirus testing unit and tried to get tested. But he couldn’t because they were requiring the prescription that his doctor had mistakenly thought he wasn’t able to write.
“Everybody thinks testing is so easy to get, but I’m almost 70, and I couldn’t get one” even with a persistent dry cough, Benecke said. As he notes, this is soon going to be an even more urgent problem, because as you probably saw in all those photos of packed Lake of the Ozarks bars that made national news, “We had insanity here this weekend. I’m a person who absolutely loves these bars and pools, but they totally lost control and now our community will be a petri dish” for the coronavirus. “Now they really need community testing.”
In a statement this weekend, Parson said, “I cannot emphasize enough how important testing is to our overall recovery plan. The more testing we do, the more knowledge we have on what the situation in Missouri actually looks like, and the better-equipped we are to move forward.” Absolutely.
But as in other states and at the Centers for Disease Control, testing stats in Missouri have been muddied because they’ve been throwing together numbers for antibody tests and for the swab tests that show whether a person has COVID-19 right now.
Conspiracy theories in Facebook comments
On Parson’s official Facebook feed, you can see that there’s no consensus on whether testing is useful or on the contrary is a conspiracy “designed to get money and control you,” as one commenter said.
The whole point of a coronavirus shutdown was to buy us time.
We did that so hospitals wouldn’t be overwhelmed, but also to give us a chance to ramp up testing and contact tracing. We could have used these months to figure out how to keep people paid and fed during the future outbreaks that scientists keep telling us are coming, too.
Unfortunately, we did none of these things on the national level. Instead, the federal government has seriously hobbled the efforts of state officials by pitting them against one another.
The worst part, though, is how little that’s changed, even now. So little that it’s fair to ask if we’ve learned anything that will help us handle the next wave any better.
On Sunday, the Trump administration issued an 81-page report on testing. It promised that the federal government would buy 100 million swabs and testing vials and deliver them to states by the end of the year. But again, it left the responsibility for testing mainly up to the states in a way guaranteed to cause ongoing chaos.
If this is a war, and it is, then where’s the cavalry?