Oh, Iowa! If you don't test people there is no COVID
Reynolds, Pedati knew about free testing program but didn't tell Iowans because of course not.
This is a long one so buckle up friends.
In June, Dr. Caitlin Pedati of the Iowa Department of Public Health and Governor Kim Reynolds advisor Traci Vitek, former Trump HHS official and health care lobbyist - were made aware of a free COVID19 testing program - yet told no one.
The program through the US Department of Health and Human Services would reach most at risk communities in rural areas, homeless shelters, domestic violence shelters, schools, elder care facilities and congregate settings -- but no one knew about it.
Test Iowa is still floundering - infectious disease experts, public health experts and data analysists, disability rights advocates, pharmacists, elected officials - are left with one conclusion: Could it just be the Reynolds administration is actively discouraging broad testing - because if you don’t test, there is no deadly pandemic, right?
The program - Tested and Protected - is a US Department of Human Services funded program designed to reach rural areas, underserved populations, and those most at risk for COVID19 exposure.
State Senator Sarah Trone Garriott who represents District 22 covering parts of West Des Moines, Waukee and Clive, told me via email, "I was forwarded information about this program from a colleague in non-profit work. I was surprised to find out that it was available to schools—I hadn’t heard of it through IDPH or IDE, even though I specifically have been asking for testing resources for schools.”
Trone-Garriott has been pushing IDPH IDE and school boards in her districts pursue over $700 mm of federal US Department of Education dollars (ESSER) to implement surveillance programs.
“I forwarded the information about this program to administrators and school boards in my district and shared about it publicly. One school board member indicated that they were not aware of it, but I’m not sure about the others. When I asked program coordinators how it was promoted, they indicated that in June this information was shared with Traci Vitek in the Governor’s office and Dr. Pedati of IDPH."
I reached out Tested and Protected Midwest Coordinator and confirmed that Pedati and Vitek both received personal phone calls and comprehensive outreach emails from the program. But he told me the Governor and IDPH haven’t show interest in the project.
Earlier this week, Waukee schools rejected the federal testing program because it is a “random” testing program. (To be clear it is absolutely surveillance testing however it is not a random program. It very, very regimented to ensure pool testing for positive cases leads to immediate follow up with another round of completely free testing).
Trone Garriott who represents the Waukee district replied to me: "I have heard some saying that they can’t…but I can’t get them to explain where they are getting that information, or who is prohibiting them."
According to the Midwest Coordination Center there is no barrier for schools - or any other facility that participate in the service. Several school boards have told Trone-Garriott that they need a “waiver” to conduct testing. However the Iowa Department of Education maintains a blanket waiver for schools. This is because schools recieve medicaid funding for children with IEPs - some of those kids require simple medical tests - like blood sugar - during the school day.
I reached out repeatedly to IDPH spokesperson Sarah Ekstrand when I asked why the IDPH and Governor's office didn't let shelters, churches, schools, etc,. know this program was freely available.
First the ask (this went to Pat Garrett w/Governor Reynolds office as well)
And the response:
This is a non answer and I have followed up via email and via text to ask again: why didn’t IDPH Dr. Caitlin Pedati — and importantly — Traci Vitek from the governor’s office - didn’t simply link to this program? Maybe a Tweet out there about “hey this is available”
My question was and remains: Why did IDPH and the Governor’s office not provide this critical information to Iowans?
My follow up:
And - as is one of my preferred methods to try and get Pat’s attention - I repeatedly chased an answer re: Vitek via DMs:
Ms. Vitek is a direct link to the Governor’s office. (Note: yes she was with the Trump administration and yes she is a career lobbyist - and it is unclear what role she actually has at the Governor’s office. She was 'health and policy advisor’ in June. Now she is heading the department on aging).
I called her publicly listed Iowa government phone number - 515 - 725 - 2094 - and it was a recording telling me that no I can’t leave a message for this number and that is how Iowa’s government is working for you.
Documents submitted to the US Department of Education by the IDPH and the IDE show they coordinated to provide a ‘return to learn’ program in order to recieve the third tranche of federal funding for schools (ESSER ARP):
This is just a screenshot of the 44 page document (available here)
About Test Iowa:
“The two women I spoke with understood my concern about the lack of accessibility of tests in my community and worked to help figure out a solution. I think they genuinely want to help but do not have the authority to change the decisions. They were all professional and kind. I am ultimately happy we are being allowed to help serve as a pick-up location, but frustrated that it was all this difficult and this much work and took so long.”
West Des Moines School Board said a Test Iowa official told the district there were no tests available to schools because demand had overtaken supply.
Yesterday, my friend Maureen in Marshalltown told me “[this person] who works with [spouse] drove all the way to Ankeny to get a frickin test.”
Marshalltown health department doesn’t have Test Iowa tests. Neither does my home county - Grundy County - this is a common refrain around the state (google it up).
Getting Test Iowa kits taken over a week for some people and when a pharmacist in northern Iowa asked to become a pick up location (as in have tests on hand for community members to pick up) it was red tape, obfuscation and a three week wait for simple approval.
Pharmacies - they are vax sites why not Test Iowa sites?
I have been fielding many emails and DMs from fellow Iowans who are gravely concerned about the Reynolds Administration’s ongoing failure to present Iowans with data about the Delta variant of COVID19. This came from an Iowa pharmacist. I will let her email speak for itself (I have only edited out identifying information per their request).
I work in a community pharmacy in a rural community in central Iowa. The only pick-up location in town when I started this process is at a free clinic that is only open once or twice a month. I am not sure if the church where it is based out of was handing out the kits outside of the clinic hours or not.
The Test Iowa site has a very simple application process to become a pick-up site. It gives no guidance on what type of facility is allowed to be a pick-up site, so I didn't think it would be an issue. Since we've been vaccinating for COVID-19 since March, it seemed like it wouldn't be an issue.
A week after filling out the application, I had received no follow-up and no kits had been shipped to our location. I called the number listed on the Test Iowa website. The person I spoke with was very nice, but had no idea why we hadn't received any kits. She promised to look into it and called me back later that day. She explained that we were not allowed to be a pick-up location because we are a business and not a health care facility. She did think it was odd and was going to bring it up to her boss.
I mentioned at the time that there were yoga studios in Des Moines that were serving as pick-up locations, which seemed contradictory.
Again, she thought that was odd and was going to ask about that. I told her I didn't want them disqualified because I thought it was important to have access at lots of locations.
I just checked now and the yoga studios are no longer listed on the Test Iowa site. The worker did mention that demand for kits was very high and that they were having trouble keeping up. I suspect this might be part of the reason pharmacies were left out - if even one pharmacy in every county applied, it would be a significant increase in demand for tests.
Upon being denied as a pick-up location, I contacted the local director of the county public health to encourage her to be a pick-up location. I mentioned we had tried but were unsuccessful.
Last week I got a call from the State Hygienic Lab stating that my pharmacy could serve as a pick-up location on behalf of the county public health. It would have to be listed that way on the Test Iowa website, as they didn't want it to look like they were favoring our pharmacy since other pharmacies are still not allowed to be pick-up sites.
I was happy to agree to that, as ultimately my goal is to make finding a test kit easier for community members that need them. Our kits arrived last Friday afternoon. I called the Hygienic Lab to let them know of the arrival so they could update their website.
From start to finish, it took about 3 weeks to get approval and for kits to arrive. In the meantime, I would send people to neighboring communities' pick-ups or to Hy-Vee to buy a rapid test.
My personal opinion is that this seems like another road block to limit access to tests and to keep positive case numbers low (if you don't test/make it hard to test, people won't know they have it). Most locations have normal business hours of 8-4 or similar, with no or little weekend availability for pick-up.
I know that for me, it would make it nearly impossible to pick a test up, as my work hours are the same (once factoring in commute time) as the locations closest to me. A friend who works in government medical fraud speculated that maybe the state is worried that pharmacies would try to bill for this service. I have no idea if that is part of the reason for not allowing pharmacies to serve as pick-up locations or not. I also have a concern that ultimately this will raise costs of health insurance because people are instead going to their doctor to get an order for a test, which will then likely be billed to insurance. And obviously it's another way to hurt the under/uninsured. It's an unnecessary cost since there is federal funding to cover this.
Regarding testing at schools, I received an email (that went to all pick-up locations) yesterday that said that if we know the person picking up is picking them up for use at a school (like a school nurse or administrator), we are to advise them that the Iowa Dept of Education has a process in place to ensure proper use of the kits and that they need to contact the Dept to ensure compliance. Until you mentioned it to me, I had not heard of it. My [redacted] is a teacher in the Des Moines area and had never heard of it either.
Sorry that this got quite long. If you have specific questions, please let me know. I understand that if someone really dug around into locations on the map, they'd be able to identify me and I accept that as a risk.
The two women I spoke with [at State Hygienic Lab] understood my concern about the lack of accessibility of tests in my community and worked to help figure out a solution. I think they genuinely want to help but do not have the authority to change the decisions. They were all professional and kind. I am ultimately happy we are being allowed to help serve as a pick-up location, but frustrated that it was all this difficult and this much work and took so long.
And then the pharmacist followed up just this week with this:
“I am now getting Pick Up Site emails from Test Iowa and one today mentioned something about that if schools need tests, they should be contacting Test Iowa directly and that we shouldn’t be supplying those.”
So now? Now I have to find out who is responsible for making that decision. Ultimately it doesn’t matter though because the buck stops at Reynolds feet.
The most important thing — in addition to keeping the pressure on Iowa’s leadership — is testing. This is a simple but critical mitigation tool - you know - since we can’t wear masks.
Here is the website - Tested and Protected via the Midwest Coordination Center (I made a special button there):
Nonye Williams, MBA, MPH State Liaison – Iowa - Office: 614-424-4180
A few things to note:
these aren't the deep nasal swabs - they are lower nasal swabs so not painful and training for correct use can be completed by anyone who takes the required webinar based training program offered through Tested and Protected Midwest Coordination Center.
If rural locations don't have access to courier service the program provides free Fed Ex pick-up
If there is a positive test within the testing pool the program will immediately notify the facility AND conduct follow up testing immediately.
If for some reason a facility cannot dedicate a computer or have capacity to scan sample vial barcodes this program will provide a laptop computer to the facility for use during the program.
Tested and Protected has doctors who can write blanket prescriptions for any facilities in the state of Iowa that require them if no in-state physician can/will.
This is absolutely possible given it is a federal program so that shouldn't preclude anyone from accessing testing.
Test results are stripped of any personal information and reported to the CDC - as is the way with any/all testing programs or tests through your own doctor.
This is critical.