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As COVID-19 Cases Increase In Iowa, So Does Demand For Testing

HM Treasury
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As COVID-19 cases have increased in Iowa, so has the demand for more testing for the coronavirus.

As new COVID-19 cases continue to climb across Iowa, the state has seen an increase in demand for testing, but getting access to a coronavirus test for some Iowans isn't always as simple as just requesting one.

Mirroring the national trend, Iowa has seen an uptick in COVID-19 cases in the past two weeks, with young adults ages 18 to 40 making up the majority of the new cases.

In some parts of the country that have seen recent surges, demand for testing is outstripping supply.

Iowa has dramatically increased its testing capability since March, when the state was processing just several hundred tests a day and tests were restricted to the most vulnerable Iowans. On Wednesday, the state reported conducting more than 7,400 tests, one of the highest daily counts.

This week Gov. Kim Reynolds announced the state’s Test Iowa program has been surpassing its daily goal of 3,000 tests a day.

But Reynolds said demand for COVID-19 tests has been growing recently, pushing the limits of the state’s capacity to process tests at the state’s drive-thru test sites and at the State Hygienic Lab.

“While our volume of tests are in good supply,” Reynolds said. “We are considering different ways to adjust operations at some of our testing sites and at the State Hygienic Lab so that we can further expand capacity and meet the demands of Iowans who want to be tested.”

Reynolds said more than 350,000 Iowans have been tested for COVID-19 since March, and 21 percent, or 85,000, of those tests have been through Test Iowa, which launched in late April.

Between June 30 and July 3, 13,600 Iowans had been tested through Test Iowa. The sites were closed on July 4 and do not operate on weekends

Credit Test Iowa
Test Iowa
A screenshot of a message on the state's Test Iowa site reporting no available time slots for a testing site.

The state’s testing program, which is run by Utah-based Nomi Health, currently has sites in 18 counties spread across the state. State health officials make the decision to open and close the sites depending on viral activity and the county’s capacity for testing. The program is free and requires Iowans to take an online assessment and then schedule an appointment.

Unlike many other testing options in the state, Test Iowa has been available since late May to anyone who would like a test, regardless of symptoms or exposure.

But for Iowans who can’t access a Test Iowa site, this often means requesting a test through their local health provider, where requirements for testing can be more restrictive.

The U.S. is still facing a testing shortage, and the Centers for Disease Control and Prevention currently recommend testing people who are showing symptoms or have had contact with someone who has the virus. But the agency also says public health officials may test someone to track the spread of the virus.

Diane Ferguson, the administrator at the Pocahontas County Health Department, said testing in the rural northwest Iowa county is done through doctors’ offices and the local hospital.

She said most people who have been tested in Pocahontas County, which has seen an increase in cases in the past two weeks, are either symptomatic or have been exposed to someone with the virus.

“I think it depends on the provider’s discretion that if they've been exposed and they're worried about it, and maybe they're running some symptoms or low temp, they may just go ahead and test them,” Ferguson said.

UnityPoint Health, one of the state’s largest healthcare providers, said it only tests patients who are symptomatic, being discharged to long term care facilities or being admitted to the hospital, according to an email from spokesperson Christine Zrostlik.

Courtney Greene, UnityPoint's Director of Communications, said they encourage their asymptomatic patients who are interested in testing to reach out the state department of health through Test Iowa.

Spokespeople for the University of Iowa Hospitals and Clinics, Broadlawns, McFarland Clinic and MercyOne have similar policies, with their clinics only providing testing to those who have symptoms, have been exposed to the virus or are essential workers with some exceptions for those who are traveling or playing sports.

The way it works is that people who want a test are generally asked to call clinics ahead of time for a screening to determine eligibility. 

Laura Shoemaker, a spokesperson for UIHC, said it tests all patients admitted to the hospital and undergoing proedures. Patients requesting a test are screened through an in-person or telehealth appointment. They are issued a test if they are symptomatic or considered "high exposure risk."

"They would be asked a series of screening questions to determine their level of exposure risk. For example, closeness in proximity to positive person, length of contact, enclosed quarters, etc. If the person was within 6 feet of the COVID-positive individual for more than 15 minutes without a face covering, they might be deemed high exposure risk and ordered a test," Shoemaker said in an email.

Unlike the Test Iowa program, tests at medical facilities come with a price tag anywhere from $60 to more than $200. Under the Families First Act passed in March, Congress has required that health insurance companies need to cover the test for the duration of the public health emergency, but this doesn’t apply to short-term, limited duration plans.

The legislation also makes funding available to reimburse providers for uninsured patients, but doesn’t require their tests to be covered.

Cedar Rapids resident Molly Monk said she contacted her doctor in June with chest pain, She said after undergoing some x-rays and bloodwork, her doctor said Test Iowa was her “only route” for a COVID-19 test because she was not an essential worker.

Monk said she got a test at the Linn County Test Iowa site on June 18 and four days later got four emails saying her test was damaged and unusable. She said she was retested at the same Test Iowa site that day.

Two days later, Monk said she got two emails, one saying her test was negative and another that said her test was unusable again.

“I called the hotline and they said that it was a software error that was sending me the damaged emails, and that my test was negative,” Monk said. “The lack of transparency around the whole situation makes me kind of doubt that though.”

The Des Moines Register reported that state officials confirmed about 270 tests taken June 18 at the Linn and Marshall county Test Iowa locations were damaged by leaked samples and an equipment malfunction at the State Hygienic Lab.

But testing could be crucial as cases have increased among young people. Public health experts have expressed concern that there could be more asymptomatic spread of the virus, and experts say widespread testing and contact tracing are necessary to control the spread of the virus and reopen the country.

The state’s Test Iowa site reports 75 to 80 percent of people with the virus have minor or no symptoms. And according to state data, nearly 40 percent of the state’s cases are in people between 18 and 40.

Iowa had been reopened for nearly a month when Reynolds removed the capacity limit on businesses on June 12. This week, she hinted at possibly putting some restrictions back in place for bars, which she said were driving some of the increase in cases among young people.

“The consequences of COVID-19 continuing to spread among young adults increases the likelihood that the virus will continue to spread and then will spread to others, including those who are most vulnerable,” she said.