The Wall Street Journal - 20.03.2020

A4| Friday, March 20, 2020 PWLC101112HTGKRFAM123456789OIXX ** THE WALL STREET JOURNAL.

THE CORONAVIRUS PANDEMIC

cess about 250 tests a day, but

a backlog means results take as

many as five days, a health de-

partment spokesperson said.

After initially offering wide-

spread testing, Minnesota offi-

cials retrenched Tuesday, lim-

iting testing to health-care

workers, inpatients at hospi-

tals and people in group living

facilities. Kris Ehresmann, a

Minnesota health official, said

high demand made testing ev-

eryone who might be infected

impossible. “Reserving these

laboratory tests for the sickest

individuals is the right thing

to do,” she said.

Thestatewasforcedto

freeze 1,700 samples due to a

shortage of supplies, Gov. Tim

Walz said Wednesday.

On Wednesday, South Da-

kota Gov. Kristi Noem said its

state lab was forced to tempo-

rarily stop processing tests be-

cause it ran out of the neces-

sary supplies. Ms. Noem said

they have been trying for weeks

to get more of the chemicals

used to process the tests from

suppliers and had asked Vice

President Mike Pence to help.

When the coronavirus first

hit the U.S., all tests were sent

to the federal Centers for Dis-

ease Control and Prevention,

which was slow to make them

available. As cases surged this

month, the federal government

began allowing state and local

authorities, as well as private

companies, to conduct the

tests themselves.

But local rollouts have been

slowed by a cascade of prob-

lems. Many areas lack enough

test kits. Some are short on

protective gear that providers

need to conduct the tests. And

the volume of people trying to

get tested has become a logis-

tical nightmare.

Anxious for help as cases

rise, states including Minne-

sota and New Mexico have

called on the federal govern-

ment and manufacturers for

assistance obtaining supplies

such as personal protective

equipment and testing devices.

The Trump administration,

meanwhile, has said it is shift-

ing its strategy for containing

the outbreak away from testing

and toward social distancing.

The Department of Health

and Human Services didn’t re-

spond to a request to comment.

Federal health officials have

said in congressional testimony

that they are aware there are

possible shortages of chemicals

used in the tests. They have

said they have ramped up the

deployment of test kits to states

and are supporting efforts for

more drive-through tests.

In Ojai, Calif., north of Los

Angeles, Colleen Byrum tried

in vain last week to get a test

after she began running a 103-

degree fever. At first, the 61-

year-old was told by a recep-

tionist on the phone at Ojai

Valley Community Hospital to

come to the emergency park-

ing lot for a test, she said.

When she arrived, she was told

that wasn’t possible and she

should see her doctor Monday.

Upset, Ms. Byrum called the

emergency room back and was

given a number for the CDC,

which went to a recorded mes-

sage telling her to call back

Monday. After calling the ER

again, she was given the num-

ber to the county infectious-

disease response team, which

also led to a voice message. The

ER finally told her she didn’t

meet the criteria to get tested

because she hadn’t traveled to

China, been on a cruise ship or

been in contact with someone

known to have the coronavirus.

Finally, she was able to reach a

local doctor, who said there

weren’t enough testing kits.

“It’s hard to advocate for

yourself when you’re sick. It is

not only physically exertional,

it is emotionally exertional,”

she said.

The novel coronavirus out-

break is spreading to vulnera-

ble, elderly residents, with

scores of cases at facilities

around the U.S., from Illinois to

Oregon and Wyoming, follow-

ing the deadly outbreak in a Se-

attle-area nursing home.

By Wednesday, 35 coronavi-

rus deaths were tied to the Life

Care Center of Kirkland, Wash.,

and at least 10 other elder-care

facilities in the area have had

cases as well. Residents of such

facilities have also died in New

Orleans and Kansas City, Kan.

Health officials and research-

ers say they expect to see more

coronavirus cases in elder-care

facilities, despite aggressive

steps by the industry and fed-

eral nursing-home regulators to

limit visitors and isolate resi-

dents. The respiratory illness

caused by the virus, Covid-19, is

often much more serious in

older people and those with un-

derlying health conditions.

Among other challenges,

nursing homes are struggling

to secure enough protective

equipment such as masks,

while federal data show many

have been cited for infection-

control problems in the past.

Elder-living facilities are also

at risk because residents live in

tight proximity, with staff inter-

acting closely with them.

Covid-19 can spread with few

noticeable symptoms, or early

symptoms that can mimic other

conditions, such as influenza.

As a result, one case can quickly

swell into a major outbreak.

This week, a widespread

outbreak was found at a nurs-

ing home in Willowbrook, Ill.,

according to the Illinois public-

health department. A case was

identified this past weekend,

and after aggressive testing at

the Chateau Nursing and Reha-

bilitation Center, the state said

45 infections were found there

by Thursday, affecting both res-

idents and staff.

“Long-term-care residents

are our most vulnerable popu-

lation and at the greatest risk

of severe illness,” said Ngozi

Ezike, Illinois’s public-health di-

rector, on Wednesday. A repre-

sentative for Chateau didn’t re-

spond to a call or emails.

Suspected or confirmed

cases have hit 19 long-term-

care facilities in Florida, ac-

cording to a spokesman for the

Florida Agency for Health Care

Administration. The state

didn’t specify the facilities.

In Oregon, an outbreak has

infected 14 residents plus a

staff member at a state-owned

veterans home in Lebanon. The

first resident showed symp-

toms on March 8, and positive

tests came back days later. All

other residents have now been

cleared by testing, a spokesman

for the state Department of

Veterans Affairs said.

For many younger and mid-

dle-aged people with no under-

lying conditions, Covid-19 leads

to few or minor symptoms.

Older people have far higher

death rates from the disease.

One large study in China found

a mortality rate of 14.8% in

people ages 80 and older, and

8% in people ages 70 to 79, but

just a 2.3% mortality rate over-

all in the population studied.

The death of a novel corona-

virus patient in Kansas was at

the Life Care Center of Kansas

City, part of Life Care Centers

of America Inc., the same com-

pany that owns the facility in

Kirkland. The Kansas facility

rated just one out of five stars

on Medicare’s Nursing Home

Compare quality-ranking site.

A Life Care spokeswoman

said no other cases have been

confirmed at the Kansas City

facility. She pointed to previous

statements that said the facility

is implementing all protective

guidelines and said the resident

didn’t have respiratory symp-

toms when admitted to the

hospital, but the virus was de-

tected after death. She didn’t

respond to a question about the

Medicare rating.

Industry groups represent-

ing elder-care facilities said

their members were following

federal guidelines and working

aggressively to avoid and con-

tain infections. “Our members

are doing their utmost to keep

residents, staff and communi-

ties healthy,” said Katie Smith

Sloan, CEO of LeadingAge,

which represents nonprofit

providers of aging services.

BYJONKAMP

ANDANNAWILDEMATHEWS

Nursing

Homes

Struggle

With Cases

Social Distancing Is

Containment Focus

The Trump administration

plans to increasingly empha-

size social distancing as the

primary method to contain the

new coronavirus, a shift away

from its recent focus on accel-

erating widespread testing as

a containment tool, according

to officials.

Top White House officials

have recently started saying

testing will prioritize seniors

aged 65 and older, front-line

health-care workers and pa-

tients hospitalized with symp-

toms amid a dwindling national

supply of testing chemicals

and ingredients.

State health departments

in Utah and Minnesota already

have said they must limit who

gets tested, and a senior

Trump administration official

said most people will face a

long wait for testing if they

aren’t in prioritized categories.

Trump administration offi-

cials had pledged that testing

would be widespread. Vice

President Mike Pence said on

March 3 that any American

could get tested subject to

doctors’ orders, with no restric-

tions. And during a March 6

visit to the Centers for Disease

Control and Prevention, Mr.

Trump said, “Anybody that

wantsatestcangetatest.

That’s what the bottom line is.”

Social distancing refers to

limiting people to small gather-

ings, shutting businesses and

schools, and ensuring people

keep 6 feet apart.

The Trump administration

has been criticized for not hav-

ing enough tests available. Ini-

tially all tests had to come

from the CDC. The FDA on

Feb. 29 expanded testing to

academic labs, but there are

continuing complaints from

people who say they can’t get

tests. The FDA said late Mon-

day that it would allow private

companies to begin marketing

coronavirus test kits directly to

the public.

—Stephanie Armour

Health-care workers donned protective gear Thursday at a drive-through coronavirus testing site in Arlington, Va.

KEVIN LAMARQUE/REUTERS

virus in 2015 and kicked into

gear during the new coronavi-

rus outbreak in late January.

Doctors, medical staff, labora-

tories and political leaders took

on roles and followed protocols

established in recent years.

Dr. Lee, and others like him,

represent the final checkpoint

many countries’ health systems

rattled. One reason it has man-

aged to check the virus’s

spread and bring down its in-

fection rate has been an effi-

cient testing network that al-

lowed it to quickly isolate

those infected. The country has

run nearly 300,000 tests, dou-

ble that of Italy’s tally despite

having less than a third of con-

firmed coronavirus cases.

And the U.S., though ramp-

ing up capacity, has screened

only about one-tenth of what

South Korea has, based on the

number of tests conducted at

the Centers for Disease Con-

trol and Prevention facilities

and other public-health labs.

America’s numbers may not

quickly balloon either: The

Trump administration is plan-

ning to prioritize social dis-

tancing over blanket testing.

South Korea’s testing net-

work was a legacy of a deadly

outbreak of the MERS corona-

in this system, a coordinated

diagnostics operation that

knits together 633 test sites

and more than 100 laborato-

ries nationwide. It is a uniform

setup: The labs use the same

testing equipment, do the

same training and make deci-

sions based on the same infor-

mation.

At 8 a.m., every South Ko-

rean laboratory uploads the

results of their coronavirus

tests to a shared database, al-

lowing for public and private

hospitals around the country

to monitor their patients’ re-

sults and report them to the

Korea Centers for Disease

Control and Prevention. Hospi-

tals upload testing details to

an online directory created by

experts from an infectious-dis-

ease medical society.

South Korea crucially let lo-

cal biotech firms craft their

own tests based on disease

modeling that used the

Covid-19 genetic test code re-

leased by China in January.

The first company won ap-

proval for its kit on Feb. 4—

two weeks before infections

surged. Now, South Korea has

five test-kit suppliers that use

different materials but all de-

ploy the same testing method.

But test availability is only

half of the equation, said Lee

Wang-jun, chairman at the

Myongji Hospital in Seoul and

an adviser for the South Ko-

rean government’s Covid-

response team.

“There’s no point in just

having a lot of testing kits,”

said Dr. Lee, noting Myongji

has two testing machines run-

ning all day.

Innovation also played a

key role. The government in-

troduced drive-through testing

sites that minimized contact

and sped up testing, an idea

that has quickly been adopted

in some states in the U.S.

SEOUL—Lee Hyuk-min sets
his alarm at 4:45 a.m. He rolls
out of bed, sits down at his
home office desk within min-
utes and then begins his day’s
work: analyzing a chart of
novel coronavirus test data,
separating the positives from
the negatives.
A clinical microbiologist,
Dr. Lee gets six batches of test
results throughout the day. He
reviews most of them at the
laboratory where he works at
Yonsei University Health Sys-
tem’s Severance Hospital in
Seoul. He punches out by
11 p.m. But he is typically wo-
ken up in the middle of the
night to review even more.
“It’s tough,” Dr. Lee said,
“but it’s tough for everyone.”
South Korea has absorbed
an onslaught of novel coronavi-
rus infections that has left

BYDASLYOON
ANDTIMOTHYW.MARTIN

South Korea Testing Checks Outbreak

Percentageofthepopulation

testedforcoronavirus

Source: the governments

Note: South Korea as of March 19; Italy, U.K.

and Norway as of March 17; U.S. as of March

16; France from Feb. 24 through March 10.

0 0.3 0.6%

SouthKorea

Norway

Italy

U.K.

France

U.S.

hundreds of cars for almost two
hours, only to be turned away
again with no explanation.
“It’s making this worse,” the
29-year-old said of the confu-
sion. “It’s contributing greatly
to the sense of fear.”
As cases of Covid-19 have ex-
ploded, state and local govern-
ments are taking on the task of
testing for the coronavirus that
causes it—and they have been
quickly overwhelmed. Slowed
by equipment shortages and
struggling to keep pace, officials
have set up a chaotic patchwork
of testing sites, with access
varying wildly from one place to
another. Now some states and
counties are pulling back, using
their limited resources to test
only the most vulnerable.
Testing is critical for infected
people to get the treatment
they need and for health offi-
cials to accurately track the
spread of the coronavirus. But it
has proceeded far slower than
experts said is necessary, in part
due to a slow federal response.
That reality is playing out
across the country, as people
try but often fail to get help
from local governments.
The mobile testing clinic in
Denver that Ms. Willingham at-
tempted to access was tempo-
rarily moved by the Colorado
Department of Health to the
tiny mountain town of Tellu-
ride, six hours away; the state’s
ski communities have been
hard hit. Officials said they had
no plans to reopen one in Den-
ver and have pivoted to tar-
geted testing of the most vul-
nerable people throughout
Colorado. The state can pro-

Continued from Page One

U.S. Tests

Beset by

Confusion

121

U.S.recoveries

86,

World-wide recoveries

Coronavirus Daily Update

As of 11:25 p.m.EDT Thursday

Source: Johns Hopkins Center for Systems Science and Engineering

14,

U.S.cases

244,

World-wide cases

205

U.S.deaths

10,

World-wide deaths

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