In reversal, Kansas will count all positive COVID cases, even asymptomatic ones

Reviewed by Emily Henderson, B.Sc.May 14 2020

Kansas leaders will include asymptomatic COVID-19 cases in their assessments of virus trends as they evaluate when to take further steps to ease stay-at-home orders and other social distancing measures.

The move represents a reversal after NPR station KCUR in Kansas City, Missouri, reported last week that the state was omitting these cases from its data, painting an overly optimistic picture of the outbreak. Kansas had instead looked at "symptom onset" data — a metric that by definition excludes people who test positive for the coronavirus but don't develop symptoms.

The policy change was enacted Monday, said a spokesperson for the Kansas Department of Health and Environment.

Kansas entered the first phase of the state's "reopening" plan last week, allowing gatherings of 10 or fewer people and letting libraries and child care facilities reopen. Gov. Laura Kelly, a Democrat, said in a news conference last week that leaders would take additional steps cautiously.

"We'll continue to reevaluate Kansas' disease spread, testing rates, hospitalizations, personal protection equipment availability and other factors before moving from one phase to the next," said Kelly. "Science and data will dictate how quickly or how slowly the reopening unfolds."

Kansas' efforts to track and mitigate COVID-19 have been hampered by years of low health funding, which advocates say have left the local, county and state health departments unprepared for the pandemic.

The symptom-onset metrics undercounted coronavirus cases in Kansas, according to epidemiologists. Graphics representing that data seemed to show that new cases had been declining over the past several weeks, when they actually had been increasing.

Kansas has been testing large populations in nursing homes, prisons and meatpacking plants — a proactive measure not all states are doing. That effort is finding hundreds of asymptomatic and presymptomatic cases. But the symptom-onset data excludes people who never get symptoms and delays reporting people who test positive and eventually get sick with COVID-19.

This story is part of a reporting partnership that includes KCUR, NPR and Kaiser Health News.