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Coronavirus Numbers In Kansas And Missouri Are Low But Some Experts Question The States' Methods

Associated Press
A laboratory kit used by the U.S. Centers for Disease Control and Prevention to test for the coronavirus.

Seven people in Kansas and Missouri have tested positive for coronavirus as of Thursday, with one of those — a man in his 70s living in a long-term care facility in Wyandotte County — dead from the disease. 

The relatively low instances of infection in the region would indicate that so far, the two states seem hardly touched by the growing global pandemic.

Some public experts, however, say the testing numbers might not show an accurate picture of the COVID-19 virus in the area, and the two states' approaches to testing the virus may not be proactive enough to help contain it.

The latest updates showed that 78 people have been tested in Kansas and 73 people have been tested in Missouri. State and local health officials point to those results from those tests as evidence that the coronavirus is not spreading within communities.

However, testing at such low levels doesn’t provide the kind of data health experts need to make health decisions, according to Josh Michaud, an epidemiologist for the Kaiser Family Foundation, a non-partisan health research organization.

“If there’s a limited number of tests and only a few positives, that really doesn’t give you enough information to go on to say, ‘Well, we have a good handle on this, and we can just continue doing what we’re doing,” Michaud said.

States are able to set their own guidelines for who gets tested. Generally, that testing has been limited to people who have fever and lower-respiratory disease and have either traveled to a place where COVID-19 is more widespread or been in contact with someone who has been confirmed to have the illness.

Federal Centers for Disease Control and Prevention guidelines now also allow testing for people who have symptoms without a known source of exposure.

Kansas, however, has tighter testing guidelines. For cases without a known exposure, it only allows testing when a patient has both a fever and severe acute lower-respiratory illness, such as pneumonia.

Testing has also been limited in recent weeks because of a shortage of testing kits.

"Clearly, we've have difficulty in getting testing out to where is it needed, and then, even beyond that, getting testing more broadly, such as South Korea is doing, to know where the disease is," Michaud says. "We don’t have a good idea right now."

The CDC said on Saturday that more testing materials will be shipped to health agencies and that commercial labs, such as LabCorp and Quest Diagnostics, have been given permission to test in many areas.

However, the Missouri Department of Health and Senior Services says it will have limited information about the tests performed by these commercial labs.

In an email to KCUR, spokeswoman Lisa Cox said the Missouri Department of Health and Senior Services will only be notified when there are positive test results. The state will not know about negative test cases, the number of tests being performed or in which communities people are being tested.

That could hamper efforts to track the virus and address it in areas that need help, said Dr. Claire Standley, assistant research professor with the Center for Global Health Science and Security and the Department of Microbiology & Immunology at Georgetown University.

"I think the more information that's shared, the better," says Standley. "It's very difficult to track the numbers of cases when you do have these barriers to information sharing between the public and private sectors," Standley says.

Cox acknowledged the shortcomings of working with commercial labs in an email. "It certainly limits what we know," she wrote.

While the experts question the states' testing strategies, they applaud the new efforts to limit social contact by cancelling public events and transitioning to virtual classroom teaching before widespread COVID-19 is identified.

"At the worst case, you've disrupted people's lives," Michaud said. "And at the best case, you've actually prevented a serious epidemic in the local communities."

Alex Smith is a health reporter for KCUR. You can reach him by email at alexs@kcur.org.

As a health care reporter, I aim to empower my audience to take steps to improve health care and make informed decisions as consumers and voters. I tell human stories augmented with research and data to explain how our health care system works and sometimes fails us. Email me at alexs@kcur.org.
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