Kentucky and Rhode Island have different coronavirus test rates

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The difference suggests that Rhode Island probably has a better idea of ​​how the virus spreads across the state, which makes it better prepared to curb it.

The contrast provides a clear illustration of the challenges posed by a state-by-state testing strategy, in the absence of a national plan coordinated by the federal government.

The White House’s decision to delegate responsibility for coronavirus testing to states is starting to shape how those states can respond to the pandemic, experts say. While some states with vast health care resources have made more progress in tracking the virus, others are struggling to catch up. And this gap could become much more critical as restrictions are relaxed and public servants try to determine who can return to work.

“This is what you get when you get a 50-state pandemic strategy,” said Ashish Jha, director of the Harvard Global Health Institute. “Pandemics affect us all equally. We don’t have a country where each state is supposed to be self-sufficient in all matters related to pandemic preparedness. “

Rhode Island is not only a small state in size, but also in size. Just over 1,000 square miles, it has 13 hospitals, as well as the headquarters of the country’s largest pharmacy chain, CVS, a company that has been an integral part of its testing success. CVS tests represent 40% of the state’s total.

“We just have a lot of health care for our size,” says Jeffrey Bratberg, professor of pharmacy practice at the University of Rhode Island. “We only have a million people. “

By contrast, Kentucky tried but could not get the same access to test and treatment supplies. He reserved his limited tests for those with symptoms and front-line workers, hospitalizing 33% of his 3,050 confirmed cases and admitting 17% of them to intensive care units. These figures appear to be the highest ICU hospitalization and admission rates in the country, based on partial data collected by the Covid Tracking Project, which contains data from some states but not others.

Governor Andy Beshear (D-Ky.) Mobilized early to respond to the pandemic, restricting residents’ activities, coordinating activities with neighboring states and organizing daily briefings. But the state encountered problems from the start to gain access to diagnostic tests and personal protective equipment.

“One of the reasons there is a high rate in Kentucky is that we have had limited testing,” said the governor during his briefing on Monday evening. “And what we have done is that we have prioritized it for those who are sickest. “

Limited testing means Kentucky only detects the most severe cases requiring hospitalization and intensive care, which may explain its high rates.

Beshear also said that the state’s demography plays a role. According to the Centers for Disease Control and Prevention, 25% of adults in Kentucky smoke, a rate second after West Virginia. Smokers and those with other lung conditions are more vulnerable to the coronavirus. Kentucky also has the highest cancer rate in the country and a high incidence of asthma, said Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky.

“This disease attacks the lungs,” said Chandler, a former state attorney general and congressman.

Kentucky doctors quickly admitted people who tested positive for the coronavirus, Beshear said, adding that it had boosted hospitalization rates. “We think our doctors are very proactive, which is really important,” he said.

Beshear has worked hard to increase the testing capacity of his state. Kentucky recently signed an agreement with the Kroger grocery chain to provide driving tests, with the goal of performing 20,000 tests in the next five weeks.

The tests, the results of which will be returned in approximately 48 hours, are reserved for healthcare professionals, first responders and people with significant symptoms, as well as those with milder symptoms but who have been exposed to a person infected with the virus.

Originally, Kentucky sent numerous out-of-state tests, which resulted in long wait times for certain results. A Louisville resident, who spoke on condition of anonymity to discuss private health issues, said he and his wife had been able to get tested by a doctor they knew in early March after learning that they had been exposed. But by the time he tested positive two weeks later, he had been hospitalized and put a ventilator in the intensive care unit.

Gravity Diagnostics, based in Covington, Kentucky, is speeding up testing in the state, which health officials say will speed up the results.

Nancy Galvagni, CEO of the Kentucky Hospital Association, said testing companies continue to prioritize supplies in states experiencing severe epidemics, an ongoing challenge for its members. There are 155 Abbott Laboratories machines in the state that can run tests, she noted, but they need a software upgrade to handle the coronavirus tests that are currently shipped to hot spots. In addition, the state has received more than a dozen different Abbott machines to run the company’s rapid tests – but each needs at least one test kit cartridge to validate the results. These are rare.

“It’s a recurring theme,” said Galvagni, who added that she understood why other states rank higher in needs than Kentucky. “We are not a hot spot. We get low priority over things. ”

But without comprehensive nationwide testing, it will be difficult for the United States to see or predict where the next serious epidemics will occur, experts say.

Rhode Island had 39,333 coronavirus tests on Tuesday, compared to 32,820 in Kentucky. The small state of New England has 171 deaths from the disease, while Kentucky has 154. At the same time, Rhode Island has identified more cases of coronavirus than Kentucky – 5,500, compared to 3,050 for this last.

With a similar number of deaths, it means the disease seems less severe in Rhode Island, where the current death rate is only 3.1%, compared to 5.0% in Kentucky. Part of this could be due to the fact that Kentucky may not have been able to identify as many of its less severe coronavirus cases.

When it comes to coronavirus testing in Rhode Island, CVS has proven to be crucial. The company has set up a car rapid test site at a casino in Lincoln, R.I., which uses new technology from Abbott Laboratories to perform 1,000 tests per day, which represents 40% of the state’s total.

It is one of only five such sites CVS has across the country that can accommodate multiple lanes, the company said.

“The combination of larger test sites and on-site test results has helped maximize the efficiency and security of these new sites, while helping the state prevent the spread of the virus,” said the spokesperson. word of the CVS, Joseph Goode.

“As far as I know, if people want a test, they seem to get it,” said Bratberg of the situation in Rhode Island. “Two of my students were tested and had no problem getting the test. “

Rhode Island’s tests are wide enough for anyone to be diagnosed, said Bratberg, but not yet wide enough to monitor for the extent of asymptomatic infections – people with the disease who can get it propagate. Yet, compared to other states, Rhode Island is in a strong position, and it continues to expand testing.

Other factors make things worse in Kentucky.

A third of Covid-19’s deaths have occurred in nursing homes, said Donna Arnett, dean of the College of Public Health at the University of Kentucky.

“We are a state that biases the old and the sick,” said Chandler.

Sarah Moyer, who heads the Louisville Metro’s Department of Public Health and Welfare, said the state was trying to build testing capacity so people could return to work, but had not yet reached this point.

“I wish we had more tests for essential workers right now. This is where we could grow if we could, “said Moyer. “In the future, we need to increase this capacity and continue if we are to start opening up the economy.”

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