Gov. Kim Reynolds boasted about the work the State Hygienic Laboratory (SHL) has done processing COVID-19 tests — and stressed her administration’s commitment to protecting residents of long-term care facilities — during her news conference on Wednesday, shortly after the Iowa Department of Public Health and SHL sent long-term care facilities a letter announcing “SHL will be unable to provide and process routine tests for Iowa’s long-term care facility staff members” as mandated by the federal government.
On Aug. 26, the Centers of Medicare and Medicaid Service (CMS) issued a rule requiring nursing homes and other long-term care facilities to conduct “routine testing of staff, including consultants, contractors, volunteers” and others who enter the facilities, in addition to testing staff and residents with symptoms of the virus and during an outbreak in a facility.
The new rule is based on standards set by the U.S. Department of Health and Human Services.
Since the beginning of the pandemic, many public health experts have called for routine testing of staff and others working or regularly visiting long-term care facilities. Some states already require it. Even though Gov. Reynolds often talks about her concern for the well-being of long-term care facility residents — calling them “the most vulnerable” — Iowa has not set any requirements of its own for testing in the facilities.
The new routine testing requirement is meant to ensure the earliest possible detection of a potential source of infection in a long-term care facility and prevent the virus from spreading among residents, who are all at high risk of severe complications or death. `
According to the letter IDPH and SHL sent facilities, “the volume and frequency that will be generated by the new requirement for routine staff testing, in addition to the testing already occurring across the state, will exceed the current capacity of SHL. Therefore, SHL will be unable to provide and process routine tests for Iowa’s long-term care facility staff members for the purpose of complying with the CMS rule.”
IDPH said SHL will continue to run tests for staff and residents who have symptoms of the disease or when an outbreak in the facility has been detected. (Iowa has an unusually high threshold for declaring an outbreak in a long-term care facility. IDPH requires three residents to test positive before a facility is declared to have an outbreak. Minnesota, by contrast, only requires a single positive test of any resident, staff member or contract worker for an outbreak to be declared.)
The letter also noted that IDPH is aware the federal government “intends to supply rapid point-of-care (POC) diagnostic testing supplies and equipment to long-term care facilities in Iowa.” The department added, “Information on the availability and use of POC testing will be provided as soon as it is available.”
Reynolds did not mention the state’s inability to provide routine testing for long-term care facilities as she talked about COVID-19 testing on Wednesday.
“From the start our priority was to develop a long-term testing strategy that would ensure Iowans would have access to tests when and where they needed them,” the governor said.
She praised the work of SHL, pointing out the laboratory processes 42 percent of the COVID-19 test samples collected in Iowa. The governor went on to highlight the importance of testing in long-term care facilities.
“Early on, as we were still working hard to secure testing supplies we know that it would be critical to prioritize testing for those most vulnerable to the virus, including residents of long-term care facilities,” Reynolds said. “Even when supplies were limited, we worked closely with facilities to test symptomatic residents and staff, and assist with surveillance testing of the entire facility when outbreaks occurred. And we remain committed to this approach.”
The governor even had SHL Director Dr. Michael Pantella speak during the news conference, and describe the work the laboratory is doing and how it has expanded its capacity since the beginning of the pandemic. Pantella did not mention SHL’s inability to process the newly required routine testing, or the letter that was sent that day.
Neither did IDPH Medical Director Dr. Caitlin Pedati, who also spoke at the news conference.
According to the IDPH COVID-19 information site, there are currently 39 ongoing outbreaks at Iowa long-term care facilities, including one in Johnson County and two in Linn County.
IDPH was also reporting on Thursday that another 918 Iowans had tested positive for COVID-19 during the 24-hour period ending at 10 a.m. That total included 26 residents of Johnson County and 51 residents of Linn County.
The department reported another 14 deaths from the virus during the same time period, bringing Iowa’s COVID-19 death toll to 1,248.