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Limited COVID-19 testing kits limit Eastern Washington providers, long-term care facilities

Two weeks ago, a resident of Bonaventure Senior Living in the Tri-Cities died at the hospital. A few days later, health officials announced it was Benton County’s first COVID-19 death.

Today, the retirement community, which has both independent and assisted living, is all but locked down, with daily temperature screenings for residents and staff. There have been nine confirmed cases of COVID-19 at Bonaventure, with four residents hospitalized as of Friday. Two more residents have died since the first woman in mid-March. And efforts to get more of the 172 residents tested have been challenging.

The local health district has no testing kits to offer long-term care facilities.

“At this point, we certainly don’t have the capability to pull that off because where do you get enough testing supplies?” asked Heather Hill, communicable disease program manager at the Benton-Franklin Health District.

Local skilled-nursing and long-term care facilities that have health care providers on staff can help order tests for residents who need them, but facilities that do not, like Bonaventure, are largely relying on their residents’ ability to get tested through their own health care providers or private sector lab companies.

Pam Gray, chief operations officer at Bonaventure, secured 20 test kits from PLS Scientific LLC, an Oklahoma-based lab. The test kits will enable the nurse on staff at Bonaventure Tri-Cities to test residents, after consulting their health care providers. While Gray is pleased she was able to secure kits after several voicemails and emails, she wishes she could have secured them sooner.

“I think it’s a failure through the whole system,” she said, “but at the end of the day, I only care about my own residents.”

Testing supplies are not just limited in the Tri-Cities. Several Eastern Washington communities are running low or never had enough to begin with. At a news conference Monday, Gov. Jay Inslee said a state Department of Health worker drove to Spokane late last week to pick up 40 kits and drive them to Yakima.

“That’s how both dire and dedicated we are to solve this problem,” Inslee said.

The majority of the United States’ testing capacity lies in the private sector, Surgeon General Jerome Adams said on a news media call March 16, noting that the fewer than 100 state health labs nationwide are not equipped to process millions of tests. But if the private sector is the answer, then just about any entity can vie for the materials. Gray, with Bonaventure, said the Oklahoma company would send only 20 kits because of the high demand they were seeing already.

“We need a federal mobilization of the manufacturing capability of the United States to make these test kits. We have that capability, but we haven’t mobilized the companies that have the ability to do this yet,” Inslee said Monday at a news conference. “This would require federal leadership to get this done.”

President Donald Trump mobilized the private sector to make ventilators, invoking the Defense Production Act last week, as Inslee noted, but not yet for testing kits.

Inslee said Washington likely has the second-highest testing per capita in the country.

So far, 65,462 Washington residents have been tested for COVID-19, and 46% of those tests have been for residents of the tri-county Seattle metro area. In Spokane County, 3,712 residents have been tested. In Yakima County, only 857 residents have been tested. In the Tri-Cities area, 842 residents have been tested.

Less testing means less data about the virus. Beyond that, it has led to some numbers Inslee characterized as “disturbing” Monday. In Skagit County, 21% of tests taken have come back positive. In Adams County, 19% of tests have come back positive. In Benton and Franklin counties, 16% and 15%, respectively.

“These numbers are two to three times higher than what we’ve experienced in the two weeks before,” Inslee said.

In Spokane County, however, where people have been tested more than any other county in Eastern Washington, 3.7% of the tests have come back positive, according to the state health department.

Limited testing capacity has led health officials and providers to be particular about who gets testing. Hill, with Benton-Franklin Health District, said at-risk individuals with symptoms are the people who should be tested, but that still is not enough to test symptomatic residents in every long-term care community with cases in the Tri-Cities.

“We don’t seem to have enough testing supplies for even those people,” she said last Friday.

In Spokane, where the county emergency coalition established a drive-thru screening site, not everyone with symptoms can be tested. The Spokane County Fair and Expo Center site also is running low on supplies. As of Monday night, workers had tested more than 800 people, city spokeswoman Julie Humphreys said. That leaves fewer than 200 test kits available. Local health care providers can and do order tests for patients as well, and the county has put in requests for more testing supplies.

David Luke, an Alaska resident staying in Spokane, had mild flu-like symptoms and decided to self-isolate March 13. Even 10 days later, he was not feeling well, so he waited an hour at the fairgrounds. He was told he didn’t qualify to be tested and that tests were in short supply. So he went back to where he is staying.

Then Friday, he had a fever that spiked above 101 degrees. He felt sicker than he had in years, he said. He called one of the hospital’s virtual care hotlines and was told he still didn’t qualify.

“I gave her all this data and the response was, ‘Unless you hit 104 (degrees); or a lower temperature with violent shaking and chills; or significant difficulty breathing,’ and I didn’t meet the criteria,” Luke said.

By Monday, Luke’s fever broke, and he now is back to just a cough. He is not upset that he did not get tested, but wishes he could just to give the county the valuable data point.

Spokane County Health Officer Dr. Bob Lutz said no cases have shown up in retirement communities besides at Holman Gardens. In the Tri-Cities, there are 45 COVID-19 cases in five senior living facilities.

The need for increased testing is vital as the number of cases increases in Eastern Washington, which Lutz anticipates in the coming weeks. Until then, saving and prioritizing tests for at-risk people is likely to continue.

“We started off with a limited amount of test materials, and a limited amount of test materials exists,” Lutz said last week. “If they are used up, then no more testing. They’ve put in requests for more materials, but again those haven’t been made available to us yet.”

Reporter Adam Shanks contributed to this story.

Arielle Dreher's reporting for The Spokesman-Review is primarily funded by the Smith-Barbieri Progressive Fund, with additional support from Report for America and members of the Spokane community. These stories can be republished by other organizations for free under a Creative Commons license. For more information on this, please contact our newspaper’s managing editor.