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States Ponder Rules of Engagement as They Reopen Amid Pandemic

Don't Expect Business as Usual With Ongoing COVID-19 Outbreak

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Above image credit: The Kansas Statehouse stands against the sky as the sun sets in the distance Monday, April 27, 2020, in Topeka, Kansas. (Charlie Riedel | AP Photol)

After six weeks of asking Kansans to stay at home, Gov. Laura Kelly is expected to announce Thursday that the state will start to reopen for businesses and some public gatherings on May 4.

Even if people can travel at-will and previously non-essential retailers can open their doors, the governor likely will leave some restrictions in place and maybe enact new rules.

Other states that have started reviving their economies amid record unemployment claims will stick with social distancing measures. And Kelly said earlier this week that control over stay-at-home orders will return to the county level to keep COVID-19 clusters from growing.

“I’m confident that our… public health officials are keeping a close eye on what’s going on in their communities,” Kelly said this week, “and that as we lift up the statewide (order), they will superimpose other restrictions if they feel that’s necessary to protect their folks.”

Kansas Gov. Laura Kelly
Kansas Gov. Laura Kelly (File)

The ability to test for the virus and trace the path of the virus — two things both Kelly and the head of the state health department head said are needed to reopen — remain sorely lacking. Kansas, at times, has ranked last in the U.S. for testing during the pandemic.

“If you are only testing a small portion of the people who may have the virus, then you don’t really know what’s going on with the virus,” said Josh Michaud, an infectious disease expert with the Kaiser Family Foundation.

About one in 1,000 Kansans have tested positive for COVID-19 so far. While the rates of infection statewide seem to be slowing in the most populous counties of Wyandotte, Johnson and Sedgwick, the rate of transmission in western Kansas has dramatically spiked in three counties with meatpacking plants. Ford and Seward counties are home to just a fraction of the population you’d see in Kansas’ suburban and urban counties, but the two rank in the top five counties for the raw number of confirmed coronavirus cases.

But Kelly and state health secretary Lee Norman said this week that hospitalizations and deaths are going down. They also said the metrics are lining up to the point that they’re “comfortable” with starting to reopen the state. Plus, the testing rate in Kansas has increased from 4,765 during the first full week of April to 7,523 last week.

“We will, without question, continue to see an uptick in the total number of cases as we do more testing,” Norman said. “That’s going to be a challenge in how to communicate that to people, because it looks like things are getting worse than the case count, but it’s not in reality.”

View From Other States

Kansas officials haven’t provided many details yet on what the recovery plan will look like for businesses or residents, though a filing in a federal case over the weekend noted that the new restrictions “will be significantly less restrictive than those currently in place.”

The National Governors Association provided a list of 10 steps that state leaders should take. Georgia, South Carolina and Mississippi already have reopened.

Closer to Kansas, Missouri will lift its statewide stay-at-home order on May 4, but things will resume in “gradual” and “strategic” phases. The initial stage lets businesses open if the six-foot social distancing recommendation can be followed “in most cases,” as well as taking other measures like occupancy limits and split shifts to protect employees and patrons. Missouri also will not restrict the number of people who can gather as long as “necessary precautions” and social distancing happen.

On Friday, Iowa will let businesses in nearly 80% of its counties start operating again. The counties must have fewer or no new cases of COVID-19 over two weeks. Restaurants, gyms, stores and libraries can let in 50% of usual capacity.

There will be no restrictions on religious gatherings in Iowa as long as they follow social distancing and health guidelines, but events are limited to 10 or fewer people.

Kelly similarly had restricted religious services, an executive order that was upheld by the state Supreme Court. But she was sued in federal court by two Baptist churches in April, and recently compromised by promising a new executive order allowing large gatherings.

It's not clear whether The Bottleneck in Lawrence will be among the businesses allowed to reopen in Kansas after the state-at-home order is lifted.
Most businesses will be able to reopen once Kansas lifts the stay-at-home restriction, though it’s not clear whether concert venues like The Bottleneck in Lawrence will be included. (Contributed | Kansas News Service)

Colorado will phase things more slowly under a “Safer At Home” doctrine, which still doesn’t allow more than 10 people to gather at a time. Colorado started allowing curbside pickups at retail stores earlier this week, and will let in-person shopping starting Friday. Up to half of an organization’s staff can work together starting May 4, but businesses must screen workers for symptoms if they have more than 50 employees at any location.

Colorado counties can extend stay-at-home orders, which Kelly said will happen in Kansas, too. The stay-at-home order in Kansas City, Missouri, lasts through May 15. Johnson and Wyandotte counties are expected to follow Kansas’ apparent lead and lift them on May 4.

Sedgwick County leaders are debating what’s best for Wichita — the state’s biggest city — and its surrounding communities.

Wichita Regional Chamber of Commerce board chair Junetta Everett wrote to the county commissioners, saying they were “encouraged by the data” and that decisions “can be smart and safe while still addressing the critical challenges businesses and workers are facing right now.”

But the Medical Society of Sedgwick County wants commissioners to extend the stay-at-home order locally through at least May 10 because the county hasn’t “demonstrated a robust program of testing” and isn’t on the downslope of cases.

“Though our cases are not increasing exponentially,” the panel wrote to the commission, “it is unknown whether the peak has occurred in Sedgwick County.”

Testing and Tracing

Widespread testing for the coronavirus is a major component of reopening guidance from the White House and epidemiologists across the country and the world.

Kelly said testing “is the only way that we can safely reopen our economy.” Kansas State University announced this week it would test any student or staff or faculty member with symptoms or exposure to someone with a confirmed case of the virus. Norman said that Kansas has the ability to test everyone who is symptomatic.

The World Health Organization recommends testing enough people until 10% or fewer of tests are positive. Twelve percent of Kansas’ coronavirus tests are coming back positive, a figure that’s slowly increased during April, according to data from The COVID Tracking Project. (Kansas is lower than the 19% positive national test rate.)

A new study from Harvard researchers says Kansas needs to test 265 more people daily by Friday in order to have solid data on the spread of COVID-19. The Harvard researchers said their testing goals were shaped in part by what might be possible, rather than ideal.

Kansas officials say anyone who has symptoms can be tested.
Kansas officials say anyone who has symptoms can be tested. (Contributed | Kansas News Service)

Without tests, Michaud with the Kaiser Family Foundation said, Kansas could be blindsided by another increase in cases and forced to restart dramatic efforts to mitigate the impact of the virus.

“You might not even realize that there’s an increase going on until it’s very far along, ” Michaud said. “We’d be back to square one.”

Indeed, a database managed by the Institute for Health Metrics and Evaluation (IHME), an independent global health research center at the University of Washington, suggests that Kansas may be wise to move much more carefully to reopen.

Experts, including Norman at one time, have been interested in tracking antibodies — essentially how many people have been infected. The New York Times reported antibody tests can be inaccurate and it’s not clear whether having the antibodies means you’re immune to the coronavirus. The World Health Organization has advised against relying on antibody tests to make reopening decisions, and the tests aren’t widely available.

A more helpful measure is contact tracing. That entails teams of people identifying new cases, finding who those testing positive have been in contact with. Then, the system would put people in isolation who either contracted the virus or were exposed to it.

Norman said this week that people are being trained to do contact tracing in Lyon, Ford, Finney and Seward counties. The last three are the epicenter of both the Kansas beef-processing industry and major COVID-19 clusters. The state said more than 350 cases have been confirmed in meatpacking facilities.

However, an analysis by NPR shows Kansas currently doesn’t have enough people to meet the need for contact tracing. Kansas is hoping to deploy 400 people overall — including some volunteers. That would equal 14 contact tracers per 100,000 residents, though public health recommendations call ideally for 30 per 100,000 people.

Crystal Watson of Johns Hopkins Center for Health Security told NPR that states “shouldn’t undershoot” contact tracing, noting that putting money toward the practice will help control COVID-19 and reduce further economic impacts.

KCPT is committed to serving you with high-quality information and entertainment through this challenging time. Visit kept.org/coronavirus.

Erica Hunzinger is the news editor of the Kansas News Service. Alex Smith is a health reporter for KCUR 89.3 in Kansas City. Kansas News Service health reporter Celia Llopis-Jepsen and KMUW reporter Nadya Faulx contributed to this report.

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