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Health care providers test at the Baptist Health drive-through. Brian Chilson

Faced with mounting criticism about the limited amount of COVID-19 testing in the state, Governor Hutchinson on Thursday afternoon announced plans for a “testing surge” across the state today and tomorrow.

But many hospitals in the state were not informed about the surge before the governor’s announcement, and some may not have the testing capacity to meet a spike in demand.

“The Arkansas Hospital Association did not receive any information from the Health Department or the governor’s office prior to the announcement yesterday at 1:30,” said Bo Ryall, president of the Arkansas Hospital Association. “I can’t speak for every hospital, but I’ve heard from a number of them that did not receive a heads up.”

Larger hospital systems and hospitals in Little Rock may be able to handle a surge in testing, Ryall said, but medium and smaller hospitals across the state, particularly in rural areas, may struggle to handle a surge. Many of them, Ryall said, “are just not prepared and don’t have the test kits available in some areas.” Others may not have sufficient personal protective equipment (PPE), such as N95 masks, or swabs to conduct tests.

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“Also, on a Friday and a Saturday, they’re having to scramble and make some adjustments in terms of staffing needs to meet the needs of surge testing,” Ryall said.

While a few large hospitals in the state have their own testing capabilities, most hospitals are reliant on private labs, which could pose challenges with a sudden need for more tests. “Some will be at the mercy of commercial labs,” Ryall said. “If they don’t have that type of equipment or specified test kits, it could create a delay in trying to get test kits and then get test results.”

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“I think that would be an additional concern of using tests on the surge testing this weekend that would limit resuming elective surgeries next week,” Ryall said.

Hospitals may have an additional challenge meeting a bump in demand for testing capacity at this particular time. They already have a need for additional testing that will be required as they gear up to begin certain elective procedures next week. The governor has announced that the state will begin to relax a temporary ban on elective procedures at most hospitals on Monday. The Arkansas Department of Health will require a negative COVID-19 test 48 hours before such procedures begin.

Hutchinson said Thursday that he would like to increase testing from an average to 1,000 per day to 1,500 per day over the two-day surge. On Thursday, the Department of Health issued new guidance to health care providers throughout the state on testing patients for COVID-19. Previously, the health department recommended testing only certain patients with symptoms: older adults, people with underlying chronic medical conditions and people who believed they had been exposed to the virus. The new guidance recommends that providers test everyone with symptoms and anyone with a history of potential exposure to the virus — even asymptomatic patients.

The Department of Health won’t help with testing during the two-day surge. It’s testing criteria remains patients who “require a rapid diagnosis because they are hospitalized with significant symptoms or in the intensive care unit, or those who reside in an institutional facility” or those patients the department is already investigating amid its contact tracing effort.

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The University of Arkansas for Medical Sciences College of Public Health began contact tracing today for persons who’ve come into contact with positives at the Department of Correction; those showing symptoms will also be eligible to be tested.

Hutchinson expressed confidence that hospitals would have the necessary equipment to meet the demand for a testing surge. “In my discussions with the hospitals, they’re in good shape right now,” he said at Thursday’s announcement. “It’s something they always worry about for the future. That’s why you don’t want to completely deplete their inventory of PPE and swabs, because as they move into elective procedures, they have to do testing then, too — so they have to keep a level of inventory that they’re comfortable with. But it’s a high inventory now in most of them [so] that they can do this surge very comfortably and still have that inventory that’s needed.”

Ryall said that he had no reason to doubt Hutchinson had communicated with hospitals that have sufficient testing capacity to handle a surge, but reiterated that many others in the state do not have that capacity and were not warned that this surge was coming before the announcement. Hospitals were bracing for a major increase in demand, whether or not they have the capacity to meet it, he said. “I think there’s an expectation that will be more people coming in requesting tests that in the past have not been qualified for testing,” he said. “There’s a rush to shift staffing, and they will do what they can in those communities.”

The governor’s office has not responded to an email or call for comment. Meg Mirivel, the spokeswoman for the Arkansas Department of Health, said that Secretary of Health Dr. Nate Smith would be available to answer questions about preparing hospitals for the news and whether their testing supplies are adequate at a 1:30 p.m. news conference.

On testing, Mirivel said, “We felt like the capacity is there at commercial labs, and we want to make sure the capacity is being used.”

In an interview on KTLO radio this morning, Baxter Regional Medical Center CEO Ron Peterson expressed doubt that the Mountain Home hospital currently has the testing capability to handle a major surge.

“We understand where the governor is coming from,” Peterson said. “They have some really strong testing capabilities in Little Rock, and that’s really good. Unfortunately, that hasn’t spread completely out to all parts of the state. We still don’t have the testing capability here that Little Rock has.”

Peterson suggested that people interested in getting a test should find one of the testing sites located on the Arkansas Department of Health testing map. “We encourage people, if they can, to find a place,” he said. “But we are trying very hard to get more testing capability here.” Peterson said that the hospital was working with UAMS to hopefully bring one of their mobile testing vans for a community screening in the near future.

Meanwhile, in Paragould, Arkansas Methodist Medical Center president Barry Davis said that the hospital was prepared for the surge. “AMMC has testing procedures in place directed by the Arkansas Department of Health,” he stated in an email. “We are prepared for an increase in testing due to the surge and will follow our normal testing procedures.”

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UPDATE:

Asked about the AHA’s concerns at the Friday COVID-19 update, Governor Hutchinson acknowledged that he had not talked to the association, saying, “We didn’t see a need.” He said he had talked to “numerous” hospitals about the testing before announcing the surge. Hutchinson also said he had assured hospitals that do not have enough capacity for testing that “if they need supplies in the next two days, we will hand-deliver to them.”

Asked which hospitals he had consulted with, Hutchinson said he’d talked to St. Bernards in Jonesboro, Baxter Regional Medical Center in Mountain Home, the University of Arkansas for Medical Sciences and the Ozarks Community Hospital in Gravette, Hutchinson’s home town.

After the Friday press conference, Secretary of Health Dr. Nate Smith said the testing task force had discussed the need for expanded testing, but not in surge form.

Leslie Peacock contributed reporting.

The Arkansas Hospital Association has provided the Arkansas Nonprofit News Network funding in the past.

This reporting is courtesy of the Arkansas Nonprofit News Network, an independent, nonpartisan news project dedicated to producing journalism that matters to Arkansans.