U.S. Sen. Jerry Moran said Sunday that much more COVID-19 testing is needed, particularly to restart the nation’s economy when the coronavirus pandemic is finally over.
"I’m of the view that we have to do a lot more testing for COVID-19 than what we do today, and we ought to do it broadly," said Moran, R-Kan., during a Zoom meeting he hosted Sunday evening to hear the concerns of 20 government, health and business leaders in Ellis County.
Moran raised the issue of current guidelines from the Centers for Disease Control and Prevention, which only recommends testing for patients with suspected infection, and said it’ll take addressing the issue of people’s health for them to feel comfortable going back to work.
"But if the CDC guidelines are built upon a scarcity of tests, so we’re not doing the things that in a public health circumstance we should do," he said, "when do we ever feel comfortable for somebody to tell us it’s OK to go back? Who has the authority to calm our fears and have it work? In my view it’s gotta be based upon science, not a politician that says it’s OK. We’ve got to prove to people that their health is not in jeopardy in order to get our economy going. While the things we’re doing, I think, are important to help our economy, until we solve the issue of how people feel about their own health, it’s going to be difficult to get an economy that is back functioning the way it was before."
Public health experts say in the next couple of weeks we’ll know if the country has succeeded with efforts to flatten the virus curve with social distancing and hand washing, he said.
But the country must get better prepared for the next time, Moran said, citing previous unsuccessful efforts to get more money for the Food and Drug Administration and CDC.
"We ought not simply breathe a sigh of relief when this is behind us," he said. "We ought to be preparing quickly for what is yet to come."
HaysMed ready for virus
Speaking during the more than hour-long meeting, HaysMed CEO Eddie Herrman said the regional hospital is prepared, following in large part on the experience of the University of Kansas Medical Center, which already has a rash of COVID-19 patients from Johnson and Wyandotte counties.
Elective procedures at the University of Kansas Health System hospitals across the state have come to a halt, he said, to preserve the personal protective equipment that’s in extremely short supply nationwide.
That has caused another issue.
"Those elective procedures make up about 55 to 60% of the volume that we do in a month," he said. "So we’ve seen a pretty big drop and crunch on the financial end of this, because all we’re doing are traumas and those procedures that you can’t delay for more than two months."
That has also preserved blood, Herrman said.
"Everybody’s had to cut back on the types of procedures that would be a high-blood utilizer, because the Red Cross has had like, in one week, I want to say, they had 4,700 blood drives canceled nationwide," he said. "And they were over 140,000 units of blood short of where they were supposed to be last week."
HaysMed is holding calls with the smaller critical access hospitals in western Kansas to provide guidance on preparing for the virus, he said.
"We feel very prepared and ready to go. We’ve increased our unit that can hold COVID-positive patients from having one negative air pressure room to eight," Hermman said. "We should be able to cohort those people in one area and if we grow from that, we already have plans on how do we expand that … For us right now it’s just kind of a waiting game at this point."
Moran asked how the hospital is doing on ventilators and personal protective equipment.
"We’re pretty good on ventilators," Herrman said, including the operating room. "Being a regional facility, we had a lot anyhow. We’ve got 19 ventilators, and then we have another 14 anesthesia ventilators. So we have the ability to still run our OR, which only now takes about four rooms, so four anesthesia machines, so we can get upwards of 30 patients that need to be ventilated."
Ellis County cross-training
Right now, with no confirmed cases as of Monday afternoon of COVID-19 originating in Ellis County, the challenge isn’t one of health care being overwhelmed, indicated Ellis County Health Department director Jason Kennedy, also in the meeting.
"Most of what we’re dealing with in this state is less about the numbers of patients at this point, it’s about the fear and the mental health," Kennedy said.
He was concerned early on about the lack of clear, consistent direction from the Kansas Department of Health and Environment to county health departments, he said, noting there’s more guidance now.
"The first couple of weeks of this was a little brutal, it was a patchwork quilt of counties making their own decision on where they go with pandemic planning," Kennedy said.
He said he called 111th District Rep. Barb Wasinger to express concern about the inconsistencies.
"We had a good conversation," Kennedy said. "I don’t know if there was some pressure at the top, but I will say that KDHE and the governor finally got on a similar page and finally provided some direction. And so I do think that helped stabilize or steady things at the county level."
With Ellis County’s budget crisis the past couple years, the health department has suffered, he said.
"We have not been immune to money problems, and public health has been one of those things that really has been pushed aside for the last eight years, nine years," Kennedy said. "Our department, specifically, is down positions, has been down positions, for the last five or six years. We’ve probably lost five positions over the last five years."
To prepare for cases locally, the department is cross-training paramedics, emergency medical technicians and nursing staff to do contact tracing and patient contact in the field on the public health side.
Ellis County is also working with health department’s in northwest Kansas to act as a central hub to quickly courier COVID-19 testing samples to Topeka.
Wasinger, also in the meeting, said she recalled Kennedy’s phone call.
"When he called me that day in Topeka it was right when everything was pretty much blowing up and he was very honestly upset and I don’t blame him," Wasinger said. "We were all shooting in the dark trying to get answers to questions and trying to figure out how we were going to deal with things with this virus."
From there, she said she encouraged KDHE officials to provide consistent messaging to the state’s health departments to quell public fears.
The more communication, she said, the better.
"I would like to see more communication, just like this meeting," Wasinger said, "…to get some calming influence to our constituents."
Hays city manager Toby Dougherty told the Zoom meeting participants that the city of Hays is prepared to deal with a localized outbreak.
"Most importantly," he said, "We stand ready to work with the county public safety people if we do have a localized outbreak."
Small hospitals struggling
Moran told the meeting that he’s had a handful of hospital executives call him about their financial troubles, pushing them pretty close to closing their doors.
With medical procedures shut down, there’s no revenue coming in, but expenses for personal protective equipment and staffing are up, he said.
He’s urged hospitals not to give up.
"If you close today, I doubt that you will ever open up tomorrow if you are a small Kansas hospital, a critical access hospital in that area that surrounds Hays," Moran said.
The recent federal COVID-19 $2 trillion stimulus legislation includes about $100 billion in hospital grants, he said, as well as some provisions aimed at improving Medicaid reimbursement, eliminating some sequestration cuts, quickly advancing Medicare payments, reimbursement of a broader array of telehealth services and at a higher rate, and higher reimbursement for COVID-19 patients.
"It’s expected that every hospital in the country will qualify for some help," he said.
National stockpile depleted
What can’t be expected, however, is any more personal protective equipment from the federal government’s National Strategic Stockpile.
"Everything I know," Moran said, "is that all PPE that is coming to Kansas from our national stockpile has been delivered and there is no more. So if we think that there is a supply sitting in Washington, D.C., in a warehouse, sitting someplace in a federal government warehouse, it does not exist."
The state should continue to make requests, however.
"But the shelves, as I understand it, are empty," Moran said, "so we gotta figure out, the business community, the community, charity, individuals, are gonna have to figure out how we better address this issue in the interim."
Continued social isolation and staying home will help, he said.
"The consequence of doing that now is it gives us a chance to catch up on PPE and other things so we’re better prepared," Moran said, despite everyone taking comfort at being in the middle of nowhere. "Most of the trends that start on the West Coast and the East Coast at some point in time end up in our laps in some fashion."