New executive orders allow out-of-state doctors to practice telemedicine and for motor carriers to exceed weight limits with medical supplies; KDHE developing estimates of potential health impact; child care providers encouraged to stay open
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TOPEKA — Gov. Laura Kelly on Sunday announced she had issued executive orders to expand the use of telemedicine and waive restrictions on motor carriers who are delivering relief for COVID-19.
At least 66 residents have tested positive for the coronavirus, and two have died. Local health officials in the state’s most populous areas have accelerated restrictions on social activity in hopes of halting the rapid spread of COVID-19.
The governor’s orders, signed on Friday, take effect immediately and are in place for as long as Kansas remains under a state of emergency.
"Kansans elected me to serve as governor, and their health and safety is my No. 1 priority," Kelly said. "I am committed to leading the state forward during what are truly unprecedented times. While each of these orders has a specific purpose, together they will make sure Kansas families can access needed care and supplies until we have weathered this storm."
Under the new executive orders, the Kansas Board of Healing Arts is blocked from enforcing any law, rule or regulation that requires in-person examinations in order to issue a prescription or administer medication. The order leaves in place state law that bans the use of telemedicine for administering abortions.
Out-of-state doctors may provide telemedicine services in Kansas if they are licensed in another state. All physicians are encouraged to utilize telemedicine, including those under self-quarantine.
The order for motor carriers who are actively participating in COVID-19 relief and restoration allows truck drivers to haul 10% more than their licensed weight, up to 90,000 pounds.
It also loosens rules for licenses, certification and permits.
"Expediting the transport of resources into the state will enable us to meet the increasing demand for medical supplies, groceries — and yes, even toilet paper," Kelly said.
’Stay at home’ orders
County health officials in Douglas, Johnson, Wyandotte and Leavenworth counties have issued "stay at home" directives limiting movement of people for nonessential tasks effective 12 a.m. Tuesday because of the person-to-person community spread of the coronavirus.
Johnson and Wyandotte counties announced the 30-day order Saturday and Douglas and Leavenworth counties followed on Sunday.
"This public health order to stay at home is being issued to slow the rate of community spread of COVID-19 through intensified social distancing," said Allen Greiner, chief medical officer of the Wyandotte and Kansas City, Kan., unified government. "Without such efforts, it is estimated that each COVID-19 positive patient could infect between 2.6 to four additional people."
Exemptions to the county orders included government services, child and health care, grocery stores, pharmacies and restaurants providing delivery, carry-out or drive-through services.
The intent of the county action is to intensify compliance with social distancing recommendations. The general advice is to stay six feet away from people, even if they don't display symptoms that include a cough, fever and shortness of breath.
Johnson County has documented 28 positive tests for the coronavirus, Wyandotte County has 14 and Leavenworth County is at 4.
Lee Norman, secretary of the Kansas Department of Health and Environment, said he was bringing together critical-care specialists to develop high-level estimates of what could happen if more critically ill patients required intensive-care care in hospitals.
The study group is expected to produce, perhaps within two weeks, a forecast of Kansas in terms of prevalence of infection and the percentages of those experiencing severe illness, requiring ICU beds and ventilators. The analysis will include an estimate of the portion unlikely to survive. The per-capita report will be released publicly, he said.
"It's information not meant to scare, but it's meant to be helpful," Norman said.
Norman said a key question was whether graphic representation of the rise in COVID-19 infection in Kansas would resemble a Nike logo swoosh or flatten to appear like an overturned bowl.
"What happens if we have a Nike swoosh and it just keeps going on the up and up?" Norman said. "What happens if this is not seasonal? If it doesn't drop down in spring, summer, fall?"
He said planners had to weigh a cluster of factors that included population densities across the state and spread of coronavirus into the 105 counties.
"With every additional week that goes by, even with every additional case, we're drawing and connecting the dots. Will it be a Nike swoosh? Or, will it peak out and drop back down?" the KDHE secretary said.
On Sunday, the number of confirmed cases in Kansas jumped to 65 from 55 the day before.
The state no longer provides daily updates on the number of tests being conducted across the state. Instead, KDHE is focusing efforts on providing a daily point-in-time count of positive test results.
"Numbers were getting too high and with private labs coming on board, it became too significant of a lift to continue doing on a daily basis during a pandemic," said Kristi Zears, the agency’s spokeswoman. "So, we changed to reporting positive cases in line with how CDC is doing it."
Child care access
KDHE is recommending licensed child care facilities to maintain continuity of operations in accordance with any directives from local health officials.
Child care providers, including preschools, may accept new enrollees.
"Child care professionals provide a critical service in our state," Norman said. "They allow parents who are our doctors, nurses, police officers, firefighters and more to respond to this pandemic. Child care facilities have very strict regulations regarding the number of children in the facility, as well as health and safety guidelines that must continue to be met."
Families in search of licensed care providers can turn to Child Care Aware of Kansas for assistance. The organization can be reached at 877-678-2548.
KDHE recommends making informed decisions by reviewing compliance history and other information in the agency's online database of licensed child care providers.
The agency said families who need flexible options or irregular care might consider having someone come into the home. Informal care arrangements between friends, family and neighbors don't require a license if they involve caring for no more than two children for less than 20 hours per week.
Check back for updates as this story develops.