Nearly two months after Gov. Laura Kelly announced that Kansas would develop a "unified" strategy to ramp up coronavirus testing, the program is enough of a work in progress that even some of the state's contractors don't yet have all the details.
A Republican legislative leader involved in testing discussions contends that the Democratic governor's administration moved too slowly in rolling out the strategy and isn't focused enough on making sure Kansas has a healthy workforce so that businesses can stay open. Kelly dismisses the criticism, and officials and contractors are confident that testing will be ramped up before the year ends.
Kansas is under immense pressure. The state health department reported more than 19,000 new confirmed and probable coronavirus cases in the seven days ending Wednesday the equivalent of one in every 150 Kansas residents testing positive. Hospitals are struggling to handle the surge in COVID-19 patients.
"We need a bridge to get to the vaccine, and the bridge, in my mind, it's testing," said Robert Thompson, the CEO of Clinical Reference Laboratory, one of the state's contractors. "If everybody knows their status, they will do what's right in order to prevent infecting others."
Kelly announced plans for the new testing strategy in late September. It calls for doubling Kansas testing, catching outbreaks more quickly and regularly screening vulnerable populations, including nursing home residents and public school students. The state is poised to spend as much as $87.5 million in federal coronavirus relief funds on the effort by years end.
The state last week announced contracts with nine companies, the University of Kansas Health System and Wichita State University to help execute the new testing strategy.
Samuel Caughron, president and CEO of the MAWD Pathology Group, said this week that the company is waiting for a "definition" of its role as a contractor. Rachael Liesman, director of clinical microbiology for the University of Kansas Health System, described its contract as "pretty rapidly developing."
Senate Majority Leader Jim Denning, a Kansas City-area Republican who has served on a governor's pandemic-response task force, said Kansas should have launched its expanded testing strategy months ago. He's also frustrated that Kelly recently blocked his effort to allocate $15 million toward testing for businesses.
He said Kansas has "incredible technology in our backyard", noting that both Clinical Reference Laboratory and the MAWD Pathology Group are based in the Kansas City suburb of Lenexa.
"If we would have started this 90 days ago, we wouldn't be in this awful mess right now with virus everywhere," Denning said. GOP legislators forced Kelly earlier this year to accept local officials' control over pandemic restrictions, including mask mandates.
Marcia Nielsen, who's leading the development of the new strategy, told Denning during a public Zoom call last week that 10% of the testing funds were set aside to help businesses. But she suggested that spending more would put businesses "ahead of people who are being hospitalized and dying in nursing homes."
Kelly said during a Statehouse news conference Wednesday that the testing strategy is being driven by public health and testing experts.
"I wish we could have done it earlier," Kelly said. "Six months ago, we didn't have the resources."
Kansas struggled to obtain supplies for weeks after the pandemic reached it in early March and initially urged testing only for people with COVID-19 symptoms, though health officials knew people could be infected but have no symptoms. Testing has increased to an average of more than 4,900 tests a day so far this month, putting Kansas is on track to test the equivalent of roughly 5% of its residents in November.
"The more the testing can be made available, the more we see what's going on therefore can respond and manage to limit the spread and know where to focus our resources," Caughron said.
As an example of the benefits of expanded testing, Liesman said aggressive screening could identify the first coronavirus case in a nursing home early, before an outbreak explodes.
"If you wait until your first symptomatic individual, you may have missed infections prior to that or you may have tested almost too late," she said.
The expanded testing is likely to include not only nasal swabs, but saliva samples. Clinical Reference Laboratory won federal emergency-use authorization in July to sell a kit that allows someone to spit into a specially-prepared tube and return it to the lab, something it recently began selling online. The company has more than 700 employees and describes itself as one of the largest privately-owned clinical testing labs in the U.S.
Such saliva testing allows people, groups or businesses to collect the samples themselves, without directly involving medical personnel in collecting samples or potentially exposing them to COVID-19. CRL already has been handling testing for universities, governments and even professional football's Kansas City Chiefs, for their stadium suite holders.
"You have to reach people at their home," Thompson said. "You have to reach people at their place of employment."
But Liesman said the University of Kansas Health System might need weeks to ramp up testing. She said it can buy new equipment but also must hire additional people. And, she said, it might face small construction projects at the KU Hospital in Kansas City, Kansas. It converted a locker room into lab space earlier this year.
"I will say that I wish we had done this sooner," Liesman said.