When Oklahoma’s first confirmed case of COVID-19 was reported on March 6, there were already hundreds of cases nationwide and hot spots were beginning to emerge in other states. Not considered a priority by the federal government, Oklahoma was issued a minimal amount of the reagents necessary to run a coronavirus test.
Doctors were told to be selective in ordering tests for patients, reserving the limited supply for those with the most severe symptoms.
Tests were denied for some Oklahomans with mild symptoms who were left unsure if they were at risk of spreading the virus to others.
“Oklahoma saw COVID-19 cases much later than other states and we were not getting as many government provided reagents as other states,” said Dr. Kayse Shrum, Oklahoma’s secretary of science and innovation.
Hoping to find a way to increase the state’s testing capacity, Shrum called Elizabeth Pollard, an Edmond resident who had spent 25 years working in genetic testing and was in the process of building an infection control company in Silicon Valley.
Knowing that Oklahoma State University’s diagnostic laboratory already had Thermo Fisher equipment, Pollard, who became the state’s deputy secretary of science and innovation earlier this year, called her contacts at the company and put Oklahoma in a position to order 10,000 COVID-19 test kits as soon they received FDA approval.
“It was a match made in heaven,” Pollard said about the OSU lab and Thermo Fisher.
Both Shrum and Pollard are key members of the governor’s coronavirus response team and have been central figures in crafting the state’s testing strategy, which has relied more on private companies than the federal government.
State and private labs have tested more than 13,000 Oklahomans — a rate of 330 per 100,000 residents – and the number of confirmed positive cases was at 1,327 on Monday.
Oklahoma’s rate is in the bottom third nationally, but if the state is going to significantly increase its testing in the coming days and avoid a future designation as a COVID-19 hotspot it will likely be because of Shrum and Pollard.
Shrum began appearing publicly with Gov. Kevin Stitt in mid March shortly after state epidemiologist Laurence Burnsed, who had been a participant in most media conferences with the governor, was abruptly replaced. Criticism toward state officials was intensifying as residents and health care officials complained of a lack of testing and mixed messaging.
Shrum has been described as a calm presence, a person who speaks with authority but not in complex terms, according to multiple people with knowledge of behind the scenes conversations.
Stitt embraced Shrum’s ability to communicate beyond scientific jargon and appreciated her perspective on other health consequences of the pandemic, including depression and suicide, according to multiple sources.
Stitt created a coronavirus response task force on March 15 that included Shrum, and because she was a liaison to the state medical community, the governor now had direct information from the frontlines of the pandemic.
“She is a constant voice of science, wisdom, and experience, and an exceptional team player,” said John Budd, Stitt’s chief operating officer and leader of the task force.
Budd said Shrum is working with Secretary of Health Jerome Loughridge to oversee the state’s plan to increase personal protective equipment for health care workers, ventilators, hospitals and ICU beds.
Shrum credits Pollard for helping Oklahoma compete with other states for testing kits from private labs at a time when a delayed response by federal leaders resulted in a shortage of tests available.
While testing is important to identify specific cases, inform individuals of the need to self isolate and give health care workers confirmation that they are treating a person with the virus, it is also valuable data in tracking the spread of COVID-19 and identifying local trends.
“We just don’t have enough testing to really see any specific trends yet,” said David Holt, mayor of Oklahoma City, where there are nearly 500 confirmed cases in the city’s metro.
“But I think we have seen it get a lot better lately in the ability to do more tests locally, which will be key to better understand this.”
While the state had a shortage of testing kits for most of March, it now has the ability to complete 2,800 tests each day, according to Shrum.
The number of tests performed by the state is likely to rise with more than 70 mobile testing sites throughout the state, a significant increase from the 16 in operation just a few days ago.
Last week, Stitt urged doctors to test anyone who has symptoms, such as a fever or shortage of breath. He also urged tests for those who have come in contact with another person who has tested positive for COVID-19.
“The best way to slow the curve and stop the spread … is more testing and tracing as well as continuing to practice social distancing,” Stitt said last week.
Shrum said increasing the state’s testing capacity will be critical for modeling and creating a detailed response plan.
More testing means “more clarity on what is happening in the community and it helps us project and look into the future,” Shrum said.
While most of the nearly 13,000 tests have been run through private labs, which is where most doctors and clinics send their tests, state officials say it is important for the state labs to test more Oklahomans in order to better track trends.
The state labs are also free and can process results within a day.
Most private labs report a turnaround time of 24 to 48 hours, but that accounts for only the time tests are at a lab. Many private labs are out of state in larger markets, such as Dallas and Seattle, which can take multiple days of travel.
Pollard said Oklahoma continues to compete with other states for testing kits and resources but the state recently secured 15 Abbott testing machines, which can analyze a nasal swab in just a few minutes.
However, Abbott is selecting which states to send the necessary test kits with guidance from the Trump administration. Oklahoma has received only 100 of those kits.
“We saw our first case later and there are states that are peaking faster than us and those are going to be the priority,” Shrum said.
In addition to the state Department of Health and OSU labs, the University of Oklahoma lab could be receiving tests within the next week or two, according to officials.
While the state only has 100 kits for its quick response Abbott machines, the lab at OU is researching ways to develop its own kits that could be used.
Unlike genetic tests like the ones used in Thermo Fisher machines, most rapid tests detect protein antibodies, which can take about 10 days for infected people to develop.
While the antibody machines are not as accurate as genetic tests, they could be used to test individuals to determine if they have ever had the coronavirus, which would be valuable if it’s determined an infected person develops immunity.
State testing supplies were limited less than a month ago but Shrum said supply is no longer an issue, at least not right now.
“Early on we had really pushed hard to say hospitalized health care workers and the vulnerable population were the only people who should be tested and I think our frontline professionals were listening,” Shrum said.
“But we have been able to scale very quickly and we are looking to do significantly more tests.”
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