By BRIAN A. HOWEY

INDIANAPOLIS - With 12 confirmed coronavirus cases and no deaths, Gov. Eric Holcomb declared earlier this week that Indiana is “remarkably prepared.” Yet as of Friday morning, the Indiana State Department of Health has conducted only 73 tests for the virus. Dr. Woody Myers, the presumptive Democrat challenger to Holcomb, told Howey Politics Indiana  that he sees a “potential catastrophe” unfolding in the state.

“The next two or three days are more important than the next two or three weeks,” said Myers, a former Indiana health commissioner under Govs. Robert Orr and Evan Bayh. “In the next two or three days, the priority needs to be testing, testing, testing. The only way we can know where we are is to confirm where the virus is in the bodies of potential patients. That is the only way we can use what we call contact tracing.”

Dr. Anthony Fauci of the National Institutes of Health acknowledged the United States cannot process coronavirus tests as quickly, easily or in the same volume as other countries — even as the virus spreads to 44 states — and that’s “a failing,” he told Congress on Thursday. “The system is not really geared to what we need right now, what you are asking for. That is a failing. The idea of anybody getting it easily the way people in other countries are doing it, we’re not set up for that. Do I think we should be? Yes. But we’re not.” 

“I just got off a call with one of our clinic managers who said that somebody was absolutely demanding to be tested, and did not meet the criteria by a longshot,” Dennis Murphy, president and CEO of Indiana University Health, told the IBJ. He added: “This is something we don’t control. The state health department today is controlling the access to the testing and who meets criteria to get that testing.”

Gov. Holcomb announced several steps on Thursday, including waivers for school closings and the limiting of crowds to no more than 250 people. That came on the same day that the NCAA cancelled March Madness and the NBA suspended its schedule. “This is a time when we must do all we can to reduce the spread of COVID-19, protect our most vulnerable populations and reduce their potential to acquire or spread this virus,” said Holcomb. “While some actions are drastic, now, not later, is the time to act.” As for the lack of available testing, Gov. Holcomb and the ISDH did not respond to HPI's request for comment.

In an HPI Interview  Friday morning, Myers said, “I’m seeing the beginning of a potential catastrophe with the public health care system. I don’t think it has to be inevitable, but unless we make some significant changes and do them quickly, what’s about to happen will overwhelm the system. It’s exposing the flaws and inadequacies and the failures in the underlying public health infrastructure. We’re also seeing a severe challenge to the medical lab cushion. I don’t know if we’ve come together institutionally as a state and as a nation to overcome the situation. If we change course now, it’s not too late.”

Here is our interview with Dr. Myers:

HPI: Just 73 Hoosiers have been tested; nationally that is 1,700. Why is testing so important?

Myers: The only way we can know where we are is to confirm where the virus is in the bodies of potential patients. That is the only way we can use what we call contact tracing, to see who’s been in touch with that person; who was with that person for dinner, who was exposed to that person at work over the period of the previous week or two. Then we might see who is at high risk and can prioritize with respect to testing. On airplanes, there’s a six foot radius where that passenger’s seat was. It’s not perfect because that passenger can talk to people, go to the bathroom, interact with folks up and down the cabin, including the flight attendants. But it’s a good place to start. Figuring out where that person has been is vital to determining who should be tested and where that person goes if they are positive. Without knowing who’s positive already, we have no way to initiate that process and that person can continue to spread the virus. The single most egregious failure of the United States health care system by far has been the inadequate inability to process tests. We knew this was coming last fall, we did not ramp up. We failed to increase the capacity for testing. We failed to utilize public sector labs. We failed to utilize the private sector labs. We failed to ramp up the most diagnostically important component, which is testing.

HPI: Dr. Fauci called it a “failing” before Congress. Is it too late?

Myers: The problem right now is we don’t know what we don’t know. We really don’t know where we are. So it’s too early to say we’re turning a corner. He wants to be optimistic and doesn’t want to scare people, but the fact is we don’t know where we are.

HPI: In a state of 6.7 million people, how many tests should we have?

Myers: We should have a system for unlimited capacity if demand calls for it. The way it should work is the laboratory industry should be working with the public sector laboratories so there are always test kits available to match demand. Demand will fluctuate, but there’s always calculations in the industry of what kind of inventory they need based on demand. 

HPI: WTHR had a story on Indianapolis hospital bed capacity, which is almost filled before the virus wave comes. What could we be facing in the next couple weeks?

Myers: The complexity of this is that any bed won’t do. We have to have a special kind of bed and a special kind of room, a negative pressure room. If you don’t have negative pressure in a room, that means that all of the droplets which contains the virus that are infectious to others in the room … the negative pressure room keeps those droplets in the room. Negative pressure rooms are vital. The first thing I called for in my editorial was an inventory of negative pressure rooms in the system so we know how those beds are being utilized. So that if you’ve got two beds open in Fort Wayne and you have somebody sick in Muncie, you can send them to Fort Wayne. You don’t want to put somebody in the hospital and then have them spread the virus to all the other sick people. That is irrational. That is a major mistake if we do that. The inventory of negative pressure beds is crucial. Do we want our doctors calling around to every hospital to find out? Spending all that time trying to determine what’s open? No, we don’t. 

HPI: How many negative pressure beds are there in Indiana markets?

Myers: I don’t know. That’s a good question. We need to know. And, at the same time, I can guarantee you that whatever that number is, it’s not enough. There’s a capacity in certain facilities to increase that number. That’s why I called for a leadership group which can say … here are the top five things to do. Let’s all of us in the public/private sector work together to do that. I would suspect that if that group was formed, it would find there is the need for more negative pressure rooms. That’s the kind of planning we need right now so we can prepare for this onslaught of patients, because once we identify the patients once our laboratory problem gets fixed, critically ill patients are going to need to be hospitalized. We need to know where they should go and physicians need to gear up with the right kind of supplies to make sure they can take care of them. Ventilators save lives. We need to know what the ventilator capacity is in our hospitals in our state. We need to do that now. I strongly believe in other states that already started this in Washington and California. I don’t want them to have all the advantages of getting that inventory. All of this to me strongly suggests a lack of leadership. We need public/private leadership in our state to determine the priorities. We need to think ahead of the virus. We’re playing catch-up right now. The virus is ahead, we are behind, and we’ve got to overtake by out-thinking it. Today that’s not what we’re doing.

HPI: On Monday Gov. Holcomb aid the state is “remarkably prepared” and then he came out with a list of recommendations against gatherings of more than 250 people and waivers for school closures. Is that assessment valid and are his actions enough?

Myers: I wouldn’t use our governor and “leadership” in the same sentence right now. I don’t see the leadership that we need. I don’t want to say that one person should have all the answers. But that one person can convene the right people with the answers. I have no doubt there are some very talented people in the State Department of Health who are working on this 24/7. The issue is how they are working with other departments within the state; how they are working with the private sector entities; the prioritization of their predictive ability to see what’s happening down the road and meeting that challenge. With respect to that (crowd size) number, it’s not scientifically created. It’s an arbitrary number that is basically designed to deter huge crowds … designed to limit the spread from one person to another. It’s a way for the public to begin to think about aggregation.

HPI: Given that we’re suspending NBA schedules, basketball tournaments and school classes, where do you think we’re going to be in two weeks?

Myers: The next two or three days are more important than the next two or three weeks. In the next two or three days, the priority needs to be testing, testing, testing. What happens when the first case is presented at Michigan City Prison? What do we do? Where are those prisoners going to go? Are they going to stay there?  Who’s going to take care of them? Are the guards going to do their normal 12-hour shifts? Will they then go home to their families? All of those questions need to be wrestled with right now. We’ve already had the report that a guard in a jail in Hancock County tested positive, and all the prisoners who he had contact with have been tested and have been isolated until their tests come back. Has his family been tested? All of those questions need to be wrestled with today, and then that will determine what we need to do two or three weeks from now. That’s the kind of leadership I have not seen and heard. If it’s going on behind the scenes I will be pleased and surprised. I worry about nursing home patients. We know the epicenter in Washington state was a nursing home. Have the staff been all properly trained? Don’t ask me about two or three weeks from now; ask me about this weekend and what we’re going to do differently this weekend than in the past.

HPI: What’s your advice to the average Hoosier?

Myers: What we should not do is panic. The adults in the room should use our brains. I would suggest the No. 1 website you should read is the Center for Disease Control and Prevention. If there is a single source of information you should trust, that would be the one. Make sure your family has supplies to get through the foreseeable future.