Arkansas Department of Health to double testing capacity, address issues raised in CDC report

Testing and contact tracing continue to concern Gov. Asa Hutchinson and state healthcare officials. The Arkansas Department of Health (ADH) is doubling testing capacity, and a working group is addressing issues with minority outreach in Northwest Arkansas.

Known COVID-19 cases in Arkansas totaled 29,733 on Tuesday, up from 28,939 on Monday. Of the 794 new cases, 33 were from correctional facilities. There are 6,558 active cases. The number of deaths rose from 323 to 331. The number of COVID patients hospitalized in Arkansas was 445 on Tuesday, up from 439 on Monday. There are 91 patients on ventilators, up from 89 on Monday. Of the known cases since March 11, 22,844 have recovered.

The top five counties for new infections were Pulaski (111), Washington (68), Sebastian (52), Pope (41) and Johnson (37). Those five counties accounted for 40.6% of new community cases reported Tuesday.

As of Tuesday at 1 p.m., there were 3,387,053 U.S. cases and 135,984 deaths. Globally, there were 13,165,663 cases and 574,615 deaths.

TESTING ISSUES
Arkansas Secretary of Health Dr. Nate Smith said the ADH lab completed 1,832 tests Monday, which was an all-time high and more than was tested by the lab in all of March. But Smith said Arkansans “wait far too long” for test results, and the demand on commercial labs from rising cases in Arizona, California, Florida, Texas and other states reduces the number of commercial lab test results in Arkansas. He said the ADH plans to double testing capacity by acquiring two “high thru-put instruments.”

Gov. Hutchinson said the new equipment is part of his challenge to Smith to invest in resources – people, space, testing machines and supplies, etc. – so the state can better respond to testing and contact tracing needs if the national testing supply chain continues to be stressed. Funding for the plan Smith develops will have to be approved by the Arkansas Legislative Council.

The governor’s frequent pleas for the White House to do more to address the nationwide problem with testing supplies has been joined by Arkansas’ Congressional delegation – U.S. Sens. John Boozman and Tom Cotton, R-Ark., and U.S. Reps. Rick Crawford, R-Jonesboro; French Hill, R-Little Rock; Bruce Westerman, R-Hot Springs; and Steve Womack, R-Rogers. The delegation sent a letter to Vice President Mike Pence, chair of the White House Coronavirus Task Force, asking the president to “take the necessary action to bolster the nation’s supply of testing reagents to ensure that these strides in testing can continue.”

“Arkansas hospitals have had their internal testing capacity severely limited and are losing contracts with external labs due to a shortage of reagents. This creates an immediate dilemma with respect to the state’s testing requirement before elective procedures, and also raises concerns about the general ability to ramp up testing as the infection rate increases,” noted a joint statement from the delegation.

The ADH also approved a $20 million contract with Arkansas Foundation for Medical Care to add 350 contact tracers. General Dynamics Information Technology, which was awarded the first $20 million contact tracing contract, had 83 of 350 contact tracers hired as of July 9.

CDC NORTHWEST ARKANSAS REPORT
A team from the U.S. Centers for Disease Control and Prevention in Northwest Arkansas in early June issued a report critical of efforts to respond to the outbreak within Hispanic and Marshallese communities. The report said people were sent back to work before testing results were known, and education efforts were not enough.

As of June 13, the CDC report noted that Hispanics are 17% of the population in Benton and Washington counties, but known COVID cases among Hispanics was 45% of the cases in the two counties. Marshallese/Pacific Islanders are 1.5% of the Northwest Arkansas population, but 19% of cases in the region.

“ADH conducts COVID-19 case investigations and contact tracing and provides testing for the community including Hispanic and Marshallese populations; however, with only one Spanish-speaking and 8 Marshallese-speaking case investigators in Benton and Washington Counties, ADH is unable to adequately respond to increasing case counts to address specific cultural and language barriers. In addition to the ADH, multiple other institutions and organizations are contributing to the COVID-19 response in NW Arkansas with limited coordination between these institutions,” the report noted.

Following are the targeted responses recommended in the CDC report.
• Use data-driven approaches to prioritize testing in settings with the highest COVID-19 burden.
• Prioritize contact tracing and case investigation for high occupancy households and settings.
• Coordinate with community partners to provide targeted communication and education.
• Coordinate a multisector and multiagency plan that organizes and converges efforts to slow the spread of COVID-19 and reduce health, social and economic barriers.
• Reduce missing data by prioritizing the collection of key variables (e.g., race/ethnicity, address, employment, co-morbidities, possible contacts/exposures).

Of the CDC report, Gov. Hutchinson said “we take that very seriously,” with an ADH working group responding to the CDC findings. Smith said he is “very sympathetic” to the challenges faced by the minority communities.

“This [CDC report] is just telling us that we need to continue doing the work that we already know we need to do, and we’re glad that the CDC was actually able to get down and talk to members of the community and confirm our impressions that we need more linguistically and culturally appropriate messaging,” Smith said.