IOWA CITY — Since the University of Iowa Hospitals and Clinics began testing for COVID-19 in its own laboratory nearly four weeks ago, it has run about 4,300 tests — with 14 percent coming back positive.
UIHC currently is conducting about 200 tests a day, a number that’s been rising, according to UIHC Chief Executive Officer Suresh Gunasekaran, though the testing capacity varies.
“It’s not the same amount every single day,” he said. “It’s relative to how much we have in terms of supplies coming in and out.”
The UIHC tests make up just a fraction of the state’s total coronavirus tests conducted to date, which topped 28,000 as of Tuesday in the latest report — including 3,748 positive and nearly 24,500 negative results from the State Hygienic Lab and others, like UIHC.
With health experts urging widespread testing as the way toward a return to some degree of normalcy, Gov. Kim Reynolds on Tuesday launched a “Test Iowa Initiative” aimed at “dramatically” increasing the rate of COVID-19 testing and also tracking those who have it.
“Take the test,” Reynolds advised Wednesday — pushing Iowans to the TestIowa.com website where they can take health assessment and be prioritized for testing.
For its testing initiative, the state partnered with Nomi Health and DOMO, which launched a similar initiative in Utah. Per Iowa’s $26 million contract for the initiative — which aims to test up to 3,000 more Iowans a day, or 540,000 over six months — the partners will provide all testing supplies, hardware, machines, and 540,000 testing kits, including swabs and other “necessary consumables.”
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The partners had to deliver 180,000 complete test kits to Iowa by Wednesday, followed by 90,000 complete test kits every month afterward, according to the contract. They also had to create the TestIowa.com website and health assessment, which captures a range of data including each user’s demographics, symptoms and contact with others.
An assessment algorithm scores individuals and puts them into one of five categories — clear, green, yellow, red and black depending on the responses.
Although state guidelines allow health care providers to test patients at national reference laboratories “as they deem appropriate,” the State’s Hygienic Laboratory is using a more narrow set of criteria to conserve resources.
The criteria allows testing of patients hospitalized with COVID-19 symptoms; adults over age 60 with symptoms and chronic medical conditions; anyone with symptoms who lives in a congregate setting like a long-term care center or residence hall; or symptomatic health care or other essential workers.
Although UIHC is running its own COVID-19 tests — in part to give itself more capacity and flexibility — CEO Gunasekaran said the campus is following state guidance on who to test.
The hospital also is screening asymptomatic patients for COVID-19 if they require an urgent surgical procedure, are being discharged to a long-term care facility or are being prepped for an organ transplant.
But UIHC — like the state — doesn’t have the capacity to test all asymptomatic individuals who have been in contact with a confirmed COVID-19 patient, for example, or individuals with symptoms who don’t meet other criteria.
And it’s not testing all its employees, which would add another layer of precaution.
“It is frustrating for folks … but still, there is no ability — just because you want to get tested — to get tested,” Gunasekaran said. “Even if you’ve got some pretty good reasons in your own mind, it still has to fit the (state) guidelines.”
The main reason for the stringent testing, he said, is limited resources.
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“The guidelines were set up so that we don’t exceed test capacity,” Gunasekaran said. “If I exceed test capacity and do a bunch of tests today, I may run out of supplies for the patients that show up tomorrow that really meet the guidelines.”
That puts UIHC “far from the moment” when it can continually test employees — like it does through its current screening process that scans all employee and visitor temperatures as they enter the facility.
Just one test per worker wouldn’t be enough, Gunasekaran said.
“We’d have to keep retesting them for it to be valid,” he said. “Things can change since it’s in the community.”
Plus, Gunasekaran said, that raises ethical questions.
“Just because UIHC has testing capacity doesn’t mean we should preferentially test our own employees without thinking of whether the broader community has patients that are actually sick that we might need to test,” he said. “That’s why, for us, it’s really easy. We always make the decision based on what’s best for the whole community, not just for us.”
So far, the state has reported 90 coronavirus deaths, with 272 people currently hospitalized across Iowa.
UIHC reported 38 COVID-19 inpatients as of Tuesday and 97 total inpatients to date. Its tally of UIHC employees who’ve tested positive added two Tuesday, bringing the total to 70.
Because many of its confirmed COVID-19 patients don’t need to be hospitalized, UIHC has launched a “home treatment program” — or virtual hospital — giving patients tools to monitor key health metrics and providing daily check-ins from clinicians.
UIHC has cared for more than 200 patients via its virtual hospital — with more than 60 under its care now, according to administrators.
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