WASHINGTON (AP) — Spend what it takes, Washington said as it confronted the coronavirus. Well over $2 trillion later, it’s unclear where that spending will end.

One of the lasting legacies of the coronavirus pandemic will be staggering debts and deficits on the U.S. balance sheet, with shortfalls hitting levels that would have been unthinkable just a few decades ago.

It’s a fiscal clamp that is likely to persist for a generation, or even into perpetuity, with debt levels having passed the point of easy return in a capital where lawmakers are increasingly incapable, or unwilling, to constrain them.

The latest, and dire, projection from the Congressional Budget Office, released Friday, states the U.S. deficits will mushroom to $3.7 trillion in 2020, fueled by the four coronavirus relief bills signed into law by President Donald Trump. A fifth bill is already in the works, and will be “expensive,” according to House Speaker Nancy Pelosi, D-Calif.

The deficit for 2021 is estimated to tally $2.1 trillion, double previous CBO estimates.

The report predicts a devastating hit to the economy this quarter at an annualized rate of decline of 40% — probably the sharpest economic shock ever — accompanied by a 15% unemployment rate this spring and summer. For the entire year, the economy is predicted to shrink by 5.6%.

CBO Director Phillip Swagel cautioned that there is “enormous uncertainty” to the projections, given the unprecedented nature of the crisis, but it’s plain the economic shock is unlike anything seen since the Great Depression.

“Challenges in the economy and the labor market are expected to persist for some time,” Swagel wrote in a blog post. He said the economy is likely to begin rebounding in the third quarter, but the jobless rate will remain about 10% by the end of 2021.

On the government front, coronavirus-related figures point to red ink unparalleled since World War II. Economists generally say the most significant measure of debt and deficits is to compare it against the size of the economy, and by that measure the debt is soon to rival the record. CBO says publicly held debt will reach 101% of gross domestic product by the end of this year, just below the post-war high.

The deficit was entrenched long before the virus, with federal revenues shrinking to well below historic averages and the spending side of the ledger rising thanks to record Pentagon expenditures and the addition of baby boomers to Medicare and Social Security.

Even Washington’s few remaining spending hawks say red ink should not be a focus for now as the government faces unemployment levels not seen since the Great Depression and shutdown orders lasting well into next month or beyond.

“Right now, I think the wise move for Congress is to keep the economy afloat regardless of what it costs,” said Brian Riedl, an economic and budgetary policy analyst at the free market Manhattan Institute think tank. “That being said, the budgetary cost is enormous, cannot be ignored, and makes it even more important that lawmakers begin thinking about how to fix the federal budget after this is over.”

But when policymakers inevitably are forced to take on deficits, virtually none of them will have any experience in doing so. The era of successful action ended long ago, with a hard-won 1997 law that capped a decade’s worth of politically costly but ultimately effective reduction measures.

In the interim, a divisive brand of politics has taken hold. No one has even seriously tried tackling the debt since a failed effort by former GOP Speaker John Boehner of Ohio and President Barack Obama almost a decade ago.

Republicans are beginning to warn of the coronavirus costs now — GOP Sen. Ben Sasse on Friday called Washington’s spending habit “suicidal” — but the party passed deficit-financed tax cuts when controlling all of government in 2001 and 2017. Those twin tax bills mean that a steadily more liberal Democratic Party won’t endorse the kinds of deficit-cutting steps they endorsed in the 1990s.

There’s also no agreement on what levels of debt and deficits are sustainable, and the number of deficit doves has swelled over the past decade. Those skeptical of the fiscal warnings note that the government has run large deficits for well over a decade without the predicted increase in interest rates, economic stagnation or a European-style fiscal crisis.

“There’s zero reason to be concerned about the short-term macroeconomic impact of the deficit,” said Harvard University economist Jason Furman, a former economic policy adviser to Obama. “Interest rates are very low. The Fed has a lot of tools to ensure that they stay very low, and the bigger short-run macroeconomic concern is an insufficient response.”

The CBO has long said that lawmakers eventually will be forced to tackle the government’s chronic financial woes, if for no other reason than the looming insolvency of Social Security and Medicare. When Social Security runs out of reserves in the next decade, the system will be able to pay only 79% of benefits.

The problem is landing in the lap of whoever is elected in November in a race that’s been transformed by the crisis.

The presumptive Democratic nominee, former Vice President Joe Biden, supported numerous deficit-reduction bills over his long career but has moved significantly to the left in hopes of uniting party progressives behind him.

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/4/1587763100698.png" alt="President Trump signed the latest relief bill Friday -image courtesy White House" />
 <figcaption>President Trump signed the latest relief bill Friday -image courtesy White House</figcaption>
 </figure>WASHINGTON (AP) — Spend what it takes, Washington said as it confronted the coronavirus. Well over $2 trillion later, it’s unclear where that spending will end.One of the lasting legacies of the coronavirus pandemic will be staggering debts and deficits on the U.S. balance sheet, with shortfalls hitting levels that would have been unthinkable just a few decades ago.It’s a fiscal clamp that is likely to persist for a generation, or even into perpetuity, with debt levels having passed the point of easy return in a capital where lawmakers are increasingly incapable, or unwilling, to constrain them.The latest, and dire, projection from the Congressional Budget Office, released Friday, states the U.S. deficits will mushroom to $3.7 trillion in 2020, fueled by the four coronavirus relief bills signed into law by President Donald Trump. A fifth bill is already in the works, and will be “expensive,” according to House Speaker Nancy Pelosi, D-Calif.The deficit for 2021 is estimated to tally $2.1 trillion, double previous CBO estimates.The report predicts a devastating hit to the economy this quarter at an annualized rate of decline of 40% — probably the sharpest economic shock ever — accompanied by a 15% unemployment rate this spring and summer. For the entire year, the economy is predicted to shrink by 5.6%.CBO Director Phillip Swagel cautioned that there is “enormous uncertainty” to the projections, given the unprecedented nature of the crisis, but it’s plain the economic shock is unlike anything seen since the Great Depression.“Challenges in the economy and the labor market are expected to persist for some time,” Swagel wrote in a blog post. He said the economy is likely to begin rebounding in the third quarter, but the jobless rate will remain about 10% by the end of 2021.On the government front, coronavirus-related figures point to red ink unparalleled since World War II. Economists generally say the most significant measure of debt and deficits is to compare it against the size of the economy, and by that measure the debt is soon to rival the record. CBO says publicly held debt will reach 101% of gross domestic product by the end of this year, just below the post-war high.The deficit was entrenched long before the virus, with federal revenues shrinking to well below historic averages and the spending side of the ledger rising thanks to record Pentagon expenditures and the addition of baby boomers to Medicare and Social Security.Even Washington’s few remaining spending hawks say red ink should not be a focus for now as the government faces unemployment levels not seen since the Great Depression and shutdown orders lasting well into next month or beyond.“Right now, I think the wise move for Congress is to keep the economy afloat regardless of what it costs,” said Brian Riedl, an economic and budgetary policy analyst at the free market Manhattan Institute think tank. “That being said, the budgetary cost is enormous, cannot be ignored, and makes it even more important that lawmakers begin thinking about how to fix the federal budget after this is over.”But when policymakers inevitably are forced to take on deficits, virtually none of them will have any experience in doing so. The era of successful action ended long ago, with a hard-won 1997 law that capped a decade’s worth of politically costly but ultimately effective reduction measures.In the interim, a divisive brand of politics has taken hold. No one has even seriously tried tackling the debt since a failed effort by former GOP Speaker John Boehner of Ohio and President Barack Obama almost a decade ago.Republicans are beginning to warn of the coronavirus costs now — GOP Sen. Ben Sasse on Friday called Washington’s spending habit “suicidal” — but the party passed deficit-financed tax cuts when controlling all of government in 2001 and 2017. Those twin tax bills mean that a steadily more liberal Democratic Party won’t endorse the kinds of deficit-cutting steps they endorsed in the 1990s.There’s also no agreement on what levels of debt and deficits are sustainable, and the number of deficit doves has swelled over the past decade. Those skeptical of the fiscal warnings note that the government has run large deficits for well over a decade without the predicted increase in interest rates, economic stagnation or a European-style fiscal crisis.“There’s zero reason to be concerned about the short-term macroeconomic impact of the deficit,” said Harvard University economist Jason Furman, a former economic policy adviser to Obama. “Interest rates are very low. The Fed has a lot of tools to ensure that they stay very low, and the bigger short-run macroeconomic concern is an insufficient response.”The CBO has long said that lawmakers eventually will be forced to tackle the government’s chronic financial woes, if for no other reason than the looming insolvency of Social Security and Medicare. When Social Security runs out of reserves in the next decade, the system will be able to pay only 79% of benefits.The problem is landing in the lap of whoever is elected in November in a race that’s been transformed by the crisis.The presumptive Democratic nominee, former Vice President Joe Biden, supported numerous deficit-reduction bills over his long career but has moved significantly to the left in hopes of uniting party progressives behind him.

Coronavirus relief pushing US deficits to staggering heights

SHAWNEE COUNTY — Law enforcement authorities are investigating a burglary and attempted burglary and have made an arrest.

Just after 1:30 a.m. Friday, officers were called to Lowes, 1621 SW Arvonia Place in Topeka in reference a subject that had smashed through the south door of the store attempting to gain entry, according to Lt. Manuel Munoz.

The subject left the scene prior to officers’ arrival without gaining entry into the store. A short time later, officers were called to Menards, 6401 SW 17th in Topeka on a similar report that a subject had broken through a door and was currently inside the store. 

Officers located the subject identified as 42-year-old Curtis E. Wright inside Menards and took him into custody.

&nbsp;Wright was booked into the Shawnee County Department of Corrections on requested charges of Attempted Aggravated Burglary (Lowes, Burglary (Menards, Criminal damage to property and a Violation of Stay Home Order, according to Munoz.

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/4/1587849108355.png" alt="Wright photo Shawnee Co." />
 <figcaption>Wright photo Shawnee Co.</figcaption>
 </figure>SHAWNEE COUNTY — Law enforcement authorities are investigating a burglary and attempted burglary and have made an arrest.Just after 1:30 a.m. Friday, officers were called to Lowes, 1621 SW Arvonia Place in Topeka in reference a subject that had smashed through the south door of the store attempting to gain entry, according to Lt. Manuel Munoz.The subject left the scene prior to officers’ arrival without gaining entry into the store. A short time later, officers were called to Menards, 6401 SW 17th in Topeka on a similar report that a subject had broken through a door and was currently inside the store. Officers located the subject identified as 42-year-old Curtis E. Wright inside Menards and took him into custody.&nbsp;Wright was booked into the Shawnee County Department of Corrections on requested charges of Attempted Aggravated Burglary (Lowes, Burglary (Menards, Criminal damage to property and a Violation of Stay Home Order, according to Munoz.

Police catch suspect during burglary of Kan. home improvement store

KANSAS CITY (AP) — A vehicle struck two pedestrians Saturday evening on the east side of Kansas City, Missouri, killing a man and seriously injuring a woman, police said.

Officers responding to the scene arrested the driver, the Kansas City Police Department said in a news release. The westbound Cadillac sedan hit the man before turning southbound and striking the woman at about 7:20 p.m. It then crashed into a yard.

A 68-year-old Kansas City man died at the scene, police said. The woman was taken to a hospital where she is listed in serious condition.

KANSAS CITY (AP) — A vehicle struck two pedestrians Saturday evening on the east side of Kansas City, Missouri, killing a man and seriously injuring a woman, police said.Officers responding to the scene arrested the driver, the Kansas City Police Department said in a news release. The westbound Cadillac sedan hit the man before turning southbound and striking the woman at about 7:20 p.m. It then crashed into a yard.A 68-year-old Kansas City man died at the scene, police said. The woman was taken to a hospital where she is listed in serious condition.

Driver arrested after man killed, woman hurt in KC crash

JEFFERSON CITY, Mo (AP) — Last autumn, when schools were in session, sports stadiums full and no one had even heard of the COVID-19 disease, the Missouri health department made an eerily foreshadowing request.

It asked the state for $300,000 to buy supplies and services in case of a large-scale disease outbreak. The goal was to fill a gap between local and federal sources.

Today, as states are spending billions of dollars buying supplies in the fight against the coronavirus, that October funding request appears woefully insufficient. Yet it highlights a stark fact: States were not stocked for a pandemic and have been scrambling to catch up.

An Associated Press review of more than 20 states found that before the coronavirus outbreak many had at least a modest supply of N95 masks, gowns, gloves and other medical equipment. But those were often well past their expiration dates — left over from the H1N1 influenza outbreak a decade ago.

The shortage of supplies stemmed from a variety of factors — a decline in public health funding, a cost-saving dependence on having inventory on hand only for immediate use and a belief that the federal government could come to the rescue with its Strategic National Stockpile.

In hindsight, the federal stockpile proved insufficient for a nationwide viral outbreak, and a worldwide competition for scarce supplies revealed the folly of counting on rapid deliveries.

“You could see it in almost every state, in every locality, and the federal government level: depleting the resources, depleting the inventory, and hoping when you need them they will be available,” said Gerard Anderson, a health policy professor at Johns Hopkins University, which has tracked coronarivus cases and deaths across the world.

The coronavirus crisis spawned a political blame game over the shortage of protective gear for medical workers and the hunt for ventilators. Some governors harangued the federal government for leaving them in the lurch. President Donald Trump faulted states, tweeting earlier this month: “The complainers should have been stocked up and ready long before this crisis hit.”

Before the World Health Organization issued a Jan. 9 advisory about the coronavirus emerging in China, Missouri had a supply of 663,920 N95 respirator masks, 253,800 surgical masks, 154,000 gloves, 17,424 face shields and 14,048 gowns. All were leftovers provided by the federal Centers for Disease Control after the H1N1 flu pandemic of 2009-2010, and well beyond their shelf life.

Other states also were relying on old supplies. Officials in California, Colorado, Connecticut, Illinois, Michigan, Nevada, New Hampshire, New Mexico, Ohio, Pennsylvania, Virginia, Vermont, Washington and West Virginia all told the AP that their stashes included at least some leftovers from the H1N1 flu.

Some old N95 masks no longer sealed properly on people’s faces or had elastic bands that disintegrated. But a CDC study found that many expired masks still could work, and states distributed them to hospitals and medical clinics.

Missouri, like some other states, had spent nothing to replenish the expired equipment. And even when asking for $300,000 last October, the state Department of Health and Senior Services stressed that it wasn’t trying to build a big reserve.

“Since outbreaks and the resources needed are not predictable, purchasing a large stock of supplies that could expire or become obsolete is not a responsible use of state funds,” the health agency said in a budget document submitted to Gov. Mike Parson and state lawmakers.

That funding request for the fiscal year that starts in July still was pending in the state House when Missouri’s first coronavirus case was confirmed last month. Since then, Missouri has ordered about $40 million of protective medical supplies for health care workers and emergency responders.

Missouri Health Director Randall Williams told the AP that it didn’t make sense to load up on supplies ahead of time without knowing what was needed. For example, he said, bug spray would have been more useful than face masks during the 2015-2016 epidemic of the Zika virus, which is spread by mosquitoes.

“If you spend money on prevention and whatever comes your way isn’t that, then you have less money for response” when an emergency occurs, Williams said.

Federal public health funding for states has been on a downward slide since new programs were launched after the 2001 terrorist attacks and anthrax scare. The Public Health Emergency Preparedness program provided $675 million last year — down 28% since 2003, according to the nonprofit Trust for America’s Health. The Hospital Preparedness Program provided $265 million last year — down by almost half during that same period.

Colorado used to have two medical stockpiles. But the state received minimal federal funding for storing supplies left over from the H1N1 pandemic and none to buy new supplies. The stockpile in Denver was dissolved last fall and its remnants transferred to one in Grand Junction. Those supplies had all been distributed by the beginning of March, as the coranavirus was spreading.

Ohio, like many states, began storing some supplies after the 2001 terrorist attacks. But its financial commitment has waned after each crisis was averted, said Deborah Arms, president of the Ohio Nurses Association, who led the state health department’s prevention division from the late 1990s to 2008.

“It’s always difficult for public health in these kinds of disasters to be able to advocate for continual funding ... for something that might take 10 years to see a result,” she said.

Michigan, which has the third-highest coronavirus death toll among U.S. states, had 53,500 gloves left over from past epidemics, 5,120 N95 masks, 5,000 surgical masks and just 500 face shields among its pre-coronavirus supplies.

The state could not afford the cost of replacing expired items nor the warehouse fees for storing more, said Michigan Department of Health and Human Services spokeswoman Lynn Sutfin.

Michigan Gov. Gretchen Whitmer said the state had counted on the federal government to be prepared for a pandemic.

“No one could have said that they would come in and build a state stockpile. That’s never been the role and the assumption,” she told the AP. “Yet if I could turn back the clock, that’s precisely what we would have started doing.”

Contrary to Trump’s assertion that states bore the primary responsibility for stockpiling medical supplies, many states had depended on the federal government to store provisions in case of emergencies.

New Hampshire’s emergency operations plans call for maintaining a small reserve of supplies, but then “very much relying on the national stockpile for anything more than, say a week,” said state Health and Human Services Commissioner Lori Shibinette.

Virginia Secretary of Finance Aubrey Layne said he had viewed stockpiling supplies as a federal responsibility.

“Are we probably going to start stockpiling stuff now?” Layne asked. “The answer is yes.”

Even before the latest crisis, some experts had urged stocking up on supplies as a way to lessen the disruption to supply chains and avoid having to compete with other governments as a crisis is unfolding. A&nbsp;<a href="https://wwwnc.cdc.gov/eid/article/15/6/08-1196_article" target="_blank">June 2009 report</a>&nbsp;published in the CDC’s journal Emerging Infectious Diseases recommended a “stratified purchase plan” — buying essential items periodically as money became available.

“Supplies need to be ordered far in advance of a pandemic to avoid major problems with back orders and supply shortfalls,” the report concluded.

Instead, public health offices, hospitals and medical clinics have largely been ordering supplies as they are needed. But just-in-time buying doesn’t work when supply chains collapse and every state and country competes in world markets for scarce equipment during a pandemic.

“We’ve short-shrifted our public health structure, because we don’t need it until it happens. But then it’s too late to build it when there’s a pandemic,” said California state Sen. Richard Pan, a pediatrician.

Sean Dunn, an Ohio lobbyist who has represented hospitals, product distributors and a health care services company, said government and health officials need to rethink their approach.

“The notion of having to keep stores of anything, until a couple of weeks ago, was an old-fashioned notion,” Dunn said. “This is going to change our mindset.”

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/4/1587674507600.png" alt="Missouri Governor Mike Parson watches as PPE arrives at a state warehouse on March 26- photo office of Missouri governor" />
 <figcaption>Missouri Governor Mike Parson watches as PPE arrives at a state warehouse on March 26- photo office of Missouri governor</figcaption>
 </figure>JEFFERSON CITY, Mo (AP) — Last autumn, when schools were in session, sports stadiums full and no one had even heard of the COVID-19 disease, the Missouri health department made an eerily foreshadowing request.It asked the state for $300,000 to buy supplies and services in case of a large-scale disease outbreak. The goal was to fill a gap between local and federal sources.Today, as states are spending billions of dollars buying supplies in the fight against the coronavirus, that October funding request appears woefully insufficient. Yet it highlights a stark fact: States were not stocked for a pandemic and have been scrambling to catch up.An Associated Press review of more than 20 states found that before the coronavirus outbreak many had at least a modest supply of N95 masks, gowns, gloves and other medical equipment. But those were often well past their expiration dates — left over from the H1N1 influenza outbreak a decade ago.The shortage of supplies stemmed from a variety of factors — a decline in public health funding, a cost-saving dependence on having inventory on hand only for immediate use and a belief that the federal government could come to the rescue with its Strategic National Stockpile.In hindsight, the federal stockpile proved insufficient for a nationwide viral outbreak, and a worldwide competition for scarce supplies revealed the folly of counting on rapid deliveries.“You could see it in almost every state, in every locality, and the federal government level: depleting the resources, depleting the inventory, and hoping when you need them they will be available,” said Gerard Anderson, a health policy professor at Johns Hopkins University, which has tracked coronarivus cases and deaths across the world.The coronavirus crisis spawned a political blame game over the shortage of protective gear for medical workers and the hunt for ventilators. Some governors harangued the federal government for leaving them in the lurch. President Donald Trump faulted states, tweeting earlier this month: “The complainers should have been stocked up and ready long before this crisis hit.”Before the World Health Organization issued a Jan. 9 advisory about the coronavirus emerging in China, Missouri had a supply of 663,920 N95 respirator masks, 253,800 surgical masks, 154,000 gloves, 17,424 face shields and 14,048 gowns. All were leftovers provided by the federal Centers for Disease Control after the H1N1 flu pandemic of 2009-2010, and well beyond their shelf life.Other states also were relying on old supplies. Officials in California, Colorado, Connecticut, Illinois, Michigan, Nevada, New Hampshire, New Mexico, Ohio, Pennsylvania, Virginia, Vermont, Washington and West Virginia all told the AP that their stashes included at least some leftovers from the H1N1 flu.Some old N95 masks no longer sealed properly on people’s faces or had elastic bands that disintegrated. But a CDC study found that many expired masks still could work, and states distributed them to hospitals and medical clinics.Missouri, like some other states, had spent nothing to replenish the expired equipment. And even when asking for $300,000 last October, the state Department of Health and Senior Services stressed that it wasn’t trying to build a big reserve.“Since outbreaks and the resources needed are not predictable, purchasing a large stock of supplies that could expire or become obsolete is not a responsible use of state funds,” the health agency said in a budget document submitted to Gov. Mike Parson and state lawmakers.That funding request for the fiscal year that starts in July still was pending in the state House when Missouri’s first coronavirus case was confirmed last month. Since then, Missouri has ordered about $40 million of protective medical supplies for health care workers and emergency responders.Missouri Health Director Randall Williams told the AP that it didn’t make sense to load up on supplies ahead of time without knowing what was needed. For example, he said, bug spray would have been more useful than face masks during the 2015-2016 epidemic of the Zika virus, which is spread by mosquitoes.“If you spend money on prevention and whatever comes your way isn’t that, then you have less money for response” when an emergency occurs, Williams said.Federal public health funding for states has been on a downward slide since new programs were launched after the 2001 terrorist attacks and anthrax scare. The Public Health Emergency Preparedness program provided $675 million last year — down 28% since 2003, according to the nonprofit Trust for America’s Health. The Hospital Preparedness Program provided $265 million last year — down by almost half during that same period.Colorado used to have two medical stockpiles. But the state received minimal federal funding for storing supplies left over from the H1N1 pandemic and none to buy new supplies. The stockpile in Denver was dissolved last fall and its remnants transferred to one in Grand Junction. Those supplies had all been distributed by the beginning of March, as the coranavirus was spreading.Ohio, like many states, began storing some supplies after the 2001 terrorist attacks. But its financial commitment has waned after each crisis was averted, said Deborah Arms, president of the Ohio Nurses Association, who led the state health department’s prevention division from the late 1990s to 2008.“It’s always difficult for public health in these kinds of disasters to be able to advocate for continual funding ... for something that might take 10 years to see a result,” she said.Michigan, which has the third-highest coronavirus death toll among U.S. states, had 53,500 gloves left over from past epidemics, 5,120 N95 masks, 5,000 surgical masks and just 500 face shields among its pre-coronavirus supplies.The state could not afford the cost of replacing expired items nor the warehouse fees for storing more, said Michigan Department of Health and Human Services spokeswoman Lynn Sutfin.Michigan Gov. Gretchen Whitmer said the state had counted on the federal government to be prepared for a pandemic.“No one could have said that they would come in and build a state stockpile. That’s never been the role and the assumption,” she told the AP. “Yet if I could turn back the clock, that’s precisely what we would have started doing.”Contrary to Trump’s assertion that states bore the primary responsibility for stockpiling medical supplies, many states had depended on the federal government to store provisions in case of emergencies.New Hampshire’s emergency operations plans call for maintaining a small reserve of supplies, but then “very much relying on the national stockpile for anything more than, say a week,” said state Health and Human Services Commissioner Lori Shibinette.Virginia Secretary of Finance Aubrey Layne said he had viewed stockpiling supplies as a federal responsibility.“Are we probably going to start stockpiling stuff now?” Layne asked. “The answer is yes.”Even before the latest crisis, some experts had urged stocking up on supplies as a way to lessen the disruption to supply chains and avoid having to compete with other governments as a crisis is unfolding. A&nbsp;<a href="https://wwwnc.cdc.gov/eid/article/15/6/08-1196_article" target="_blank">June 2009 report</a>&nbsp;published in the CDC’s journal Emerging Infectious Diseases recommended a “stratified purchase plan” — buying essential items periodically as money became available.“Supplies need to be ordered far in advance of a pandemic to avoid major problems with back orders and supply shortfalls,” the report concluded.Instead, public health offices, hospitals and medical clinics have largely been ordering supplies as they are needed. But just-in-time buying doesn’t work when supply chains collapse and every state and country competes in world markets for scarce equipment during a pandemic.“We’ve short-shrifted our public health structure, because we don’t need it until it happens. But then it’s too late to build it when there’s a pandemic,” said California state Sen. Richard Pan, a pediatrician.Sean Dunn, an Ohio lobbyist who has represented hospitals, product distributors and a health care services company, said government and health officials need to rethink their approach.“The notion of having to keep stores of anything, until a couple of weeks ago, was an old-fashioned notion,” Dunn said. “This is going to change our mindset.”___

State supply stocks sparse and dated before virus

The small town has zero COVID-19 cases but is under the same stay-at-home orders as everywhere else.

By LAURA ZIEGLER, <a href="https://www.kcur.org/community/2020-04-22/distancing-diaries-residents-of-neodesha-kansas-miss-gathering-on-main-street">Kansas News Service</a>

Bill Goodwin teaches high school English in Neodesha, Kansas. Population: 2,300.

As of Tuesday, there was only <a href="https://www.coronavirus.kdheks.gov/DocumentCenter/View/921/4-21-20-update-numbers" target="_blank">one COVID-19 case in all of Wilson County</a>, where Neodesha is located in the southeast part of the state.

When
 Kansas Gov. Laura Kelly shut down all the schools on March 17, 
Goodwin’s students began taking his classes online from home.

Just like communities across the globe, Neodesha's residents are grieving the loss of their ability to gather.

“For
 Neodesha, that didn’t happen when the colleges and sports teams 
cancelled their professional seasons,” Goodwin says. “It didn’t happen 
when the movie theaters or bars and restaurants closed.”

Neodesha doesn’t have either a bar or a movie theater. It has a handful of fast-food places: a Subway, Sonic and Pizza Hut.

The sense of isolation set in when all the school activities got canceled.

“Gone
 then were the high school baseball and softball games, the track 
meets,” Goodwin says. “Gone were the middle and high school vocal and 
band concerts. Gone was high school graduation.”

While the density
 of city life creates exponentially higher infection rates, it also can 
ease the burden of social distancing. In a small town like Neodesha, 
young and old alike see one another at these school activities, 
sometimes more than once on the same day.

Not long after the <a href="https://www.kcur.org/health/2020-03-28/kansas-governor-issues-a-statewide-stay-at-home-order-which-starts-monday">Governor’s stay-at-home order</a> went into effect, some residents did what they thought was a logical thing to bring people together.

They organized a cruise down Main Street.

Hundreds
 came out in their cars, grinning and honking, rolling down their 
windows to shout greetings to each other. Goodwin says people were giddy
 to be gathering again.

“Some people just couldn’t resist the 
opportunity to socialize and they got out of their vehicles and gathered
 with others to do the same."

The city has prohibited any more such events.

Goodwin
 says like everywhere, you’ve got your defiant residents who don’t 
follow the rules, and no one knows if they’ll ruin it for others by 
either getting infected or infecting others.

But he says there 
have been other natural and man-made disasters that required people to 
sacrifice and come together, and they did.

“And the town became stronger than before.”

Laura Ziegler has been a producer with NPR in Washington D.C. and national NPR reporter covering the Midwest. Currently she’s a community engagement reporter and producer at KCUR. Email her at lauraz@kcur.org or reach her on Twitter @laurazig.&nbsp;

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/4/1587651480950.png" alt="Bill Goodwin teaches high school English in Neodesha. Courtesy photo" />
 <figcaption>Bill Goodwin teaches high school English in Neodesha. Courtesy photo</figcaption>
 </figure><h2>The small town has zero COVID-19 cases but is under the same stay-at-home orders as everywhere else.</h2>By LAURA ZIEGLER, <a href="https://www.kcur.org/community/2020-04-22/distancing-diaries-residents-of-neodesha-kansas-miss-gathering-on-main-street">Kansas News Service</a>Bill Goodwin teaches high school English in Neodesha, Kansas. Population: 2,300.As of Tuesday, there was only <a href="https://www.coronavirus.kdheks.gov/DocumentCenter/View/921/4-21-20-update-numbers" target="_blank">one COVID-19 case in all of Wilson County</a>, where Neodesha is located in the southeast part of the state.When
 Kansas Gov. Laura Kelly shut down all the schools on March 17, 
Goodwin’s students began taking his classes online from home.Just like communities across the globe, Neodesha's residents are grieving the loss of their ability to gather.“For
 Neodesha, that didn’t happen when the colleges and sports teams 
cancelled their professional seasons,” Goodwin says. “It didn’t happen 
when the movie theaters or bars and restaurants closed.”Neodesha doesn’t have either a bar or a movie theater. It has a handful of fast-food places: a Subway, Sonic and Pizza Hut.<figure>
 <img src="https://media.eaglewebservices.com/public/2020/4/1587651578364.png" alt="The few restaurants in Neodesha have started curbside service. Courtesy photo" />
 <figcaption>The few restaurants in Neodesha have started curbside service. Courtesy photo</figcaption>
 </figure>The sense of isolation set in when all the school activities got canceled.“Gone
 then were the high school baseball and softball games, the track 
meets,” Goodwin says. “Gone were the middle and high school vocal and 
band concerts. Gone was high school graduation.”While the density
 of city life creates exponentially higher infection rates, it also can 
ease the burden of social distancing. In a small town like Neodesha, 
young and old alike see one another at these school activities, 
sometimes more than once on the same day.Not long after the <a href="https://www.kcur.org/health/2020-03-28/kansas-governor-issues-a-statewide-stay-at-home-order-which-starts-monday">Governor’s stay-at-home order</a> went into effect, some residents did what they thought was a logical thing to bring people together.They organized a cruise down Main Street.Hundreds
 came out in their cars, grinning and honking, rolling down their 
windows to shout greetings to each other. Goodwin says people were giddy
 to be gathering again.“Some people just couldn’t resist the 
opportunity to socialize and they got out of their vehicles and gathered
 with others to do the same."The city has prohibited any more such events.Goodwin
 says like everywhere, you’ve got your defiant residents who don’t 
follow the rules, and no one knows if they’ll ruin it for others by 
either getting infected or infecting others.But he says there 
have been other natural and man-made disasters that required people to 
sacrifice and come together, and they did.“And the town became stronger than before.”Laura Ziegler has been a producer with NPR in Washington D.C. and national NPR reporter covering the Midwest. Currently she’s a community engagement reporter and producer at KCUR. Email her at lauraz@kcur.org or reach her on Twitter @laurazig.&nbsp;

Distancing Diaries: Residents of Neodesha miss gathering on Main 

TOPEKA— The number of confirmed coronavirus cases in Kansas increased by 118 to a total of 3174, the state health department reported Sunday afternoon.

<a href="https://www.coronavirus.kdheks.gov/160/COVID-19-in-Kansas">Click here&nbsp;</a>for additional numbers from the KDHE

TOPEKA— The number of confirmed coronavirus cases in Kansas increased by 118 to a total of 3174, the state health department reported Sunday afternoon.Coronavirus deaths were reported at 118.<a href="https://www.coronavirus.kdheks.gov/160/COVID-19-in-Kansas">Click here&nbsp;</a>for additional numbers from the KDHE<figure>
 <img src="https://media.eaglewebservices.com/public/2020/4/1587921222060.png" alt="" />
 <figcaption></figcaption>
 </figure>

KDHE: Latest coronavirus numbers in Kansas

By NOMIN UJIYEDIIN, <a href="https://www.kcur.org/news/2020-04-23/black-kansans-at-least-7-times-more-likely-to-get-coronavirus-than-white-kansans">Kansas News Service</a>

LAWRENCE — The more Kansas tests people for the 
coronavirus, the clearer it becomes that black Kansans are being 
disproportionately affected — a sobering trend that is true in 
communities across the U.S.

Black Kansans are three times more 
likely to test positive for COVID-19 than white people, and more than 
seven times more likely to die from the virus. Latinos are also about 
three times as likely to test positive for COVID-19.

The data mirrors trends seen in across U.S. cities like New York, Chicago and Detroit, as well as other states.

Kansas’ data points also follow the lines of racial disparities in health care treatment and access. Black Americans have <a href="https://www.cigna.com/health-care-providers/resources/african-american-black-health-disparities" target="_blank">higher rates of obesity</a>, diabetes, asthma and other health conditions.

“These
 disparities are nothing new,” said Crystal Lumpkins, an associate 
professor at the University of Kansas Medical Center who studies public 
health communications.

The Kansas Department of Health and Environment has cautioned that <a href="https://www.coronavirus.kdheks.gov/160/COVID-19-in-Kansas" target="_blank">its coronavirus race data</a> is incomplete, because of “the high number of individuals tested with no race and ethnicity reported.”

In an email, spokeswoman Kristi Zears said the agency needs more data on race and ethnicity from test providers.

“KDHE is working to expand testing in areas throughout Kansas,” she said.

But
 outreach to black communities should have happened earlier, Lumpkins 
said. State and county governments, health departments and medical 
providers hadn’t spent much time reaching out to black communities even 
before the pandemic.

Lumpkins
 said her community in Wyandotte County, which has one of the largest 
black populations in the state, didn’t get much information about the 
pandemic early on. Now, the county has the most cases in Kansas, and 
nearly half of its COVID-related deaths are black individuals.

Things
 could have been different, Lumpkins said, if officials had more 
proactively consulted her community in the preceding years.

“One 
of the things I’m hearing from my community members is that many times, 
we don’t feel like we’re included,” she said. “It comes across as very 
tangential or something that is done after the fact.”

Lumpkins 
also said the lack of communication had allowed rumors to spread — such 
as a myth that African Americans couldn’t get the coronavirus.

“African
 Americans, because of history, have been more likely to not trust the 
information from those types of organizations,” she said. “It is really 
incumbent upon these entities to recognize that.”

Black 
communities across the country tend to have less access to amenities 
that improve health, like grocery stores and outdoor recreation. Many 
black Americans also have to travel farther to access hospitals and 
pharmacies.

That can lead to poorer health outcomes overall, said 
Rashawn Ray, a fellow at the Brookings Institute and sociology professor
 at the University of Maryland.

“Structural factors undergird pre-existing health conditions — and people’s exposure to COVID-19,” Ray said.

Broderick
 Crawford, who’s the president of the New Bethel Church Community 
Development Corporation in Kansas City, Kansas, believes “80 to 90% of a
 person’s health does not occur inside of a medical facility at a 
clinic. It happens outside of that.”

Crawford said the response 
from health officials and hospitals has been inadequate, partially due 
to discrimination against the black community. His neighborhood doesn’t 
have a grocery store, which means less access to healthier foods. There 
aren’t many jobs nearby that people can walk to, and some may not feel 
safe walking or exercising outside at all.

“There’s not been any 
urban renewal in this particular area,” he said. “It’s those kinds of 
things that have negatively impacted our community.”

Data from the Bureau of Labor Statistics shows that <a href="https://www.bls.gov/opub/reports/race-and-ethnicity/2018/home.htm" target="_blank">higher percentages of black people</a> work in the service, transportation, production and shipping industries than other groups.

“We
 put these factors together and it leads to blacks being more exposed,” 
Ray said. “We also know that black Americans are more likely to be in 
these new ‘essential service’ jobs.”

Overall, Kansas needs to 
obtain and provide more demographic information when it comes to 
coronavirus testing, Ray said, including gender, age and location.

“We
 need to collect more data,” he said, “then be able to funnel resources,
 testing and triage centers to predominantly black neighborhoods that 
are under-resourced.”

Nomin Ujiyediin reports on criminal 
justice and social welfare for KCUR and the Kansas News Service. You can
 follow her on Twitter <a href="https://twitter.com/nominuj" target="_blank">@NominUJ</a>.

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/4/1587651230339.png" alt="Wyandotte County has the most cases of the coronavirus in Kansas, and nearly half of the virus-related deaths are black individuals. Julie Denesha / KCUR 89.3" />
 <figcaption>Wyandotte County has the most cases of the coronavirus in Kansas, and nearly half of the virus-related deaths are black individuals. Julie Denesha / KCUR 89.3</figcaption>
 </figure>By NOMIN UJIYEDIIN, <a href="https://www.kcur.org/news/2020-04-23/black-kansans-at-least-7-times-more-likely-to-get-coronavirus-than-white-kansans">Kansas News Service</a>LAWRENCE — The more Kansas tests people for the 
coronavirus, the clearer it becomes that black Kansans are being 
disproportionately affected — a sobering trend that is true in 
communities across the U.S.Black Kansans are three times more 
likely to test positive for COVID-19 than white people, and more than 
seven times more likely to die from the virus. Latinos are also about 
three times as likely to test positive for COVID-19.The data mirrors trends seen in across U.S. cities like New York, Chicago and Detroit, as well as other states.Kansas’ data points also follow the lines of racial disparities in health care treatment and access. Black Americans have <a href="https://www.cigna.com/health-care-providers/resources/african-american-black-health-disparities" target="_blank">higher rates of obesity</a>, diabetes, asthma and other health conditions.“These
 disparities are nothing new,” said Crystal Lumpkins, an associate 
professor at the University of Kansas Medical Center who studies public 
health communications.The Kansas Department of Health and Environment has cautioned that <a href="https://www.coronavirus.kdheks.gov/160/COVID-19-in-Kansas" target="_blank">its coronavirus race data</a> is incomplete, because of “the high number of individuals tested with no race and ethnicity reported.”In an email, spokeswoman Kristi Zears said the agency needs more data on race and ethnicity from test providers.“KDHE is working to expand testing in areas throughout Kansas,” she said.But
 outreach to black communities should have happened earlier, Lumpkins 
said. State and county governments, health departments and medical 
providers hadn’t spent much time reaching out to black communities even 
before the pandemic.<h2>'We don't feel like we're included'</h2>Lumpkins
 said her community in Wyandotte County, which has one of the largest 
black populations in the state, didn’t get much information about the 
pandemic early on. Now, the county has the most cases in Kansas, and 
nearly half of its COVID-related deaths are black individuals.Things
 could have been different, Lumpkins said, if officials had more 
proactively consulted her community in the preceding years.“One 
of the things I’m hearing from my community members is that many times, 
we don’t feel like we’re included,” she said. “It comes across as very 
tangential or something that is done after the fact.”Lumpkins 
also said the lack of communication had allowed rumors to spread — such 
as a myth that African Americans couldn’t get the coronavirus.“African
 Americans, because of history, have been more likely to not trust the 
information from those types of organizations,” she said. “It is really 
incumbent upon these entities to recognize that.”Black 
communities across the country tend to have less access to amenities 
that improve health, like grocery stores and outdoor recreation. Many 
black Americans also have to travel farther to access hospitals and 
pharmacies.That can lead to poorer health outcomes overall, said 
Rashawn Ray, a fellow at the Brookings Institute and sociology professor
 at the University of Maryland.“Structural factors undergird pre-existing health conditions — and people’s exposure to COVID-19,” Ray said.<h2>'There's not been any urban renewal'</h2>Broderick
 Crawford, who’s the president of the New Bethel Church Community 
Development Corporation in Kansas City, Kansas, believes “80 to 90% of a
 person’s health does not occur inside of a medical facility at a 
clinic. It happens outside of that.”Crawford said the response 
from health officials and hospitals has been inadequate, partially due 
to discrimination against the black community. His neighborhood doesn’t 
have a grocery store, which means less access to healthier foods. There 
aren’t many jobs nearby that people can walk to, and some may not feel 
safe walking or exercising outside at all.“There’s not been any 
urban renewal in this particular area,” he said. “It’s those kinds of 
things that have negatively impacted our community.”Data from the Bureau of Labor Statistics shows that <a href="https://www.bls.gov/opub/reports/race-and-ethnicity/2018/home.htm" target="_blank">higher percentages of black people</a> work in the service, transportation, production and shipping industries than other groups.“We
 put these factors together and it leads to blacks being more exposed,” 
Ray said. “We also know that black Americans are more likely to be in 
these new ‘essential service’ jobs.”Overall, Kansas needs to 
obtain and provide more demographic information when it comes to 
coronavirus testing, Ray said, including gender, age and location.“We
 need to collect more data,” he said, “then be able to funnel resources,
 testing and triage centers to predominantly black neighborhoods that 
are under-resourced.”Nomin Ujiyediin reports on criminal 
justice and social welfare for KCUR and the Kansas News Service. You can
 follow her on Twitter <a href="https://twitter.com/nominuj" target="_blank">@NominUJ</a>.

Black Kansans much more likely to die from virus than white Kansans

SEDGWICK COUNTY— Law enforcement authorities are investigating an April 23, fatal shooting that took the life of 30-year-old Blake Mayes of Wichita and have reported two arrests.

Police are asking the public for help locating&nbsp; 28-year-old Jesse Sweeney of Wichita, in connection with the shooting. 

On Saturday, authorities reported the arrest of&nbsp;51-year-old William Moore of Wichita. Sunday police reported&nbsp;36-year-old Bobbie Williams-Cox of Topeka was also in custody. They are both being held&nbsp; on a requested charge of first-degree murder.

Moore is also facing charges that include domestic battery and criminal possession of a weapon by a felon, according to the Sedgwick County arrest report.

Just after 7 p.m. Thursday, police responded to a shooting call at a home in the 200 block of North Charles in Wichita, according to officer Charley Davidson.&nbsp;

Upon arrival, police found Mayes on the front porch of the home with a gunshot wound to his body.&nbsp; EMS transported him to an area hospital where he died.

Police on the scene of Thursday's fatal shooting -<a href="https://www.kwch.com/content/news/Man-critically-injured-in-W-Wichita-shooting-569911421.html">photo courtesy KWCH</a>

The investigation revealed a disturbance occurred at the home between Mayes and three other known individuals.&nbsp; During the disturbance, Mayes was shot one time, causing his fatal injuries.

Police released no additional details Friday afternoon.

SEDGWICK COUNTY— Law enforcement authorities are investigating a fatal shooting and have identified the victim as 30-year-old Blake Mayes of Wichita.

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/4/1587762685888.png" alt="" />
 <figcaption></figcaption>
 </figure>SweeneySEDGWICK COUNTY— Law enforcement authorities are investigating an April 23, fatal shooting that took the life of 30-year-old Blake Mayes of Wichita and have reported two arrests.Police are asking the public for help locating&nbsp; 28-year-old Jesse Sweeney of Wichita, in connection with the shooting. <figure>
 <img src="https://media.eaglewebservices.com/public/2020/4/1587900733026.png" alt="Williams" />
 <figcaption>Williams</figcaption>
 </figure>On Saturday, authorities reported the arrest of&nbsp;51-year-old William Moore of Wichita. Sunday police reported&nbsp;36-year-old Bobbie Williams-Cox of Topeka was also in custody. They are both being held&nbsp; on a requested charge of first-degree murder.Moore is also facing charges that include domestic battery and criminal possession of a weapon by a felon, according to the Sedgwick County arrest report.<figure>
 <img src="https://media.eaglewebservices.com/public/2020/4/1587856746805.png" alt="Moore" />
 <figcaption>Moore</figcaption>
 </figure>Just after 7 p.m. Thursday, police responded to a shooting call at a home in the 200 block of North Charles in Wichita, according to officer Charley Davidson.&nbsp;Upon arrival, police found Mayes on the front porch of the home with a gunshot wound to his body.&nbsp; EMS transported him to an area hospital where he died.<figure>
 <img src="https://media.eaglewebservices.com/public/2020/4/1587752049994.png" alt="" />
 <figcaption></figcaption>
 </figure>Police on the scene of Thursday's fatal shooting -<a href="https://www.kwch.com/content/news/Man-critically-injured-in-W-Wichita-shooting-569911421.html">photo courtesy KWCH</a>The investigation revealed a disturbance occurred at the home between Mayes and three other known individuals.&nbsp; During the disturbance, Mayes was shot one time, causing his fatal injuries.Police released no additional details Friday afternoon.-------SEDGWICK COUNTY— Law enforcement authorities are investigating a fatal shooting and have identified the victim as 30-year-old Blake Mayes of Wichita.Just after 7 p.m. Thursday, police responded to a shooting call at a home in the 200 block of North Charles in Wichita, according to officer Charley Davidson.&nbsp;Upon arrival, police found Mayes on the front porch of the home with a gunshot wound to his body.&nbsp; EMS transported him to an area hospital where he died.The investigation revealed a disturbance occurred at the home between Mayes and three other known individuals.&nbsp; During the disturbance, Mayes was shot one time, causing his fatal injuries.

2 in custody, search continues for suspect in fatal Kan. shooting

By CELIA LLOPIS-JEPSEN <a href="https://www.kcur.org/news/2020-04-24/new-federal-laws-may-not-protect-uninsured-coronavirus-patients-as-hoped">Kansas News Service</a>

The small crew of health care workers at Guadalupe Clinic in Wichita —
 aided by dozens more who volunteer there — sees nearly 2,000 people a 
year.

Every one of them is uninsured, and all visits are free.

<a href="https://guadalupeclinic.org/" target="_blank">Guadalupe</a>
 can’t yet check patients for COVID-19. But emergency federal 
legislation might help the nonprofit roll out that service to the 
low-income neighborhoods it serves.

“Our patients live in small 
apartments, small houses,” where COVID-19 can spread quickly, executive 
director J.V. Johnston said. “So testing would be important for us.”

Stimulus funds promise to cover coronavirus testing and treatment for the uninsured.

Still, benefits for the <a href="https://www.khi.org/assets/uploads/news/14956/khi-health-insurance-info-2018-web.pdf" target="_blank">250,000 people</a> without health insurance in Kansas remain unclear. Experts see potential <a href="http://chirblog.org/expanded-coverage-for-covid-19-testing/" target="_blank">loopholes</a>
 in the new federal laws and policies that could risk leaving people on 
the hook for hundreds, even tens of thousands, of dollars for hospital 
stays.

And while the Trump administration says the offer to help 
will stop when funding runs out, it has yet to say how much money it’ll 
spend.

The confusion could keep many sick people from seeking care. At the same time, the uninsured often work essential jobs that don’t give them the luxury of hiding from the virus at home.

“This
 crisis is exposing big gaping holes in our health care system,” said 
Sabrina Corlette, a professor at the Georgetown University Center on 
Health Insurance Reforms. “When we have a public health crisis like this
 … the last thing you want is someone to hesitate to get tested and 
treated.”

The <a href="https://www.kff.org/uninsured/issue-brief/estimated-cost-of-treating-the-uninsured-hospitalized-with-covid-19/?utm_campaign=KFF-2020-Uninsured&amp;utm_source=hs_email&amp;utm_medium=email&amp;utm_content=2&amp;_hsenc=p2ANqtz-_a29TEiXmBg8w1NSN1RHzrL0AkB3b_c4oM2hMy5UgzCOCHSGxOjD-D1JifL7SXWGLjLy73365xrpw86-gHFg1k_gKuWw&amp;_hsmi=2" target="_blank">Kaiser Family Foundation</a> estimates coronavirus could put between 670,000 and 2 million uninsured people in the hospital nationwide.

The uninsured may <a href="https://www.kff.org/uninsured/fact-sheet/what-issues-will-uninsured-people-face-with-testing-and-treatment-for-covid-19/" target="_blank">face a higher risk</a> of contracting the novel coronavirus because so many work face-to-face jobs, such as cashiering and housekeeping.

Two stimulus bills passed by Congress in March should benefit people without health coverage.

The Families First Coronavirus Response Act gives states the option of covering <a href="https://www.healthaffairs.org/do/10.1377/hblog20200413.783118/full/" target="_blank">COVID-19 testing</a> for the uninsured through Medicaid. That would include both the lab work and the office visit for the patient.

But it wouldn’t help with coronavirus treatment,
 which can total daunting sums. Kaiser and the Peterson Center on 
Healthcare estimate inpatient bills for a serious case of COVID-19 <a href="https://www.healthsystemtracker.org/brief/potential-costs-of-coronavirus-treatment-for-people-with-employer-coverage/" target="_blank">could top $20,000</a> even when people do have job-based health plans that negotiate down the prices.

The
 Trump administration came under fire to act. It has declined to reopen 
access to the Obamacare exchange but vowed instead to use money in 
another stimulus bill, the CARES Act, to reimburse hospitals at Medicare
 rates for treating the uninsured.

Kaiser initially estimated that could use up <a href="https://www.kff.org/uninsured/issue-brief/estimated-cost-of-treating-the-uninsured-hospitalized-with-covid-19/?utm_campaign=KFF-2020-Uninsured&amp;utm_source=hs_email&amp;utm_medium=email&amp;utm_content=2&amp;_hsenc=p2ANqtz-_a29TEiXmBg8w1NSN1RHzrL0AkB3b_c4oM2hMy5UgzCOCHSGxOjD-D1JifL7SXWGLjLy73365xrpw86-gHFg1k_gKuWw&amp;_hsmi=2" target="_blank">between $13.9 billion and $41.8 billion</a>
 of a $100 billion portion of the CARES Act meant to help hospitals cope
 with the pandemic. Now that the Trump administration has said the money
 would also go for care beyond hospital admissions, Kaiser says the plan
 could use up <a href="https://www.kff.org/coronavirus-policy-watch/update-on-covid-19-funding-for-hospitals-and-other-providers/" target="_blank">even more funds</a>.

This
 has sparked some controversy among health care providers worried the 
dollars won’t stretch, Kaiser senior fellow Karyn Schwartz says.

“That’s less money that’s available to help them buy protective equipment for their staff,” she said.

The
 White House and Congress have since agreed to add $75 billion for 
health care providers to weather the storm. But the administration has 
yet to say how much CARES money it will set aside for the uninsured — 
while making clear that help will stop if that unspecified amount of 
money runs out.

The typical 
patient at Guadalupe cobbles together paychecks from various part-time 
jobs that don’t offer health coverage, said Johnston, the clinic’s 
executive director.

As the pandemic costs people their jobs, he expects more will likely need help.

“If they have no income,” he said, “they're going to buy food and pay their rent before they pay their health insurance.”

Johnston
 is eager to learn how reimbursement for testing will work, and whether 
Guadalupe can participate. The money will flow through state Medicaid 
programs, and his donation-funded clinic has never billed Medicaid 
before because it only sees the uninsured.

“So it’s (up) in the air now,” he said, “but hopefully that’s the case.”

Like other states, Kansas is still working out the kinks of this unprecedented use of its Medicaid program.

As
 of late April, the Centers for Medicare and Medicaid Services said it 
had only approved two states to cover coronavirus testing for the 
uninsured.

Once Kansas clears that same hurdle, CMS said in an 
email, Medicaid could kick in retroactively, for tests conducted no 
earlier than March 18 (when the new law <a href="https://www.congress.gov/bill/116th-congress/house-bill/6201/text" target="_blank">took effect</a>).

Even bigger questions remain about how billing will work for the far costlier treatment of COVID-19.

The CARES Act contains provisions meant to <a href="https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html" target="_blank">prevent “surprise bills”</a> — when a hospital or a doctor charges patients for more money directly beyond what health plans pay.

But
 several health insurance experts studying the act expressed concern 
that it shields uninsured patients from hospital charges without 
protecting them against independent billers under the same roof, such as
 anesthetists or emergency department staff.

They have similar 
concerns about how billing will shake out when someone tests negative 
after treatment has begun. And what if, they wonder, the patient can’t 
get a coronavirus test at all and is given one for the flu instead?

“We
 know due to the lack of testing capacity,” Georgetown’s Corlette said, 
“that many, if not a majority, of people who present with covid-19 
symptoms are turned away without a test. But they’re still charged for 
the visit.”

The complexity of it all — and lack of clarity — doesn’t surprise 
Katherine Hempstead, a health insurance expert at the Robert Wood 
Johnson Foundation.

“We have a very complicated, highly segmented 
health care system,” she said, and now a pandemic has sent the country 
scrambling for fixes to help millions of Americans get testing and 
treatment. “You can kind of see all these little patches that we’re 
trying to erect.”

In Kansas, if those patches don’t work well — 
hampering efforts to control the coronavirus or leaving patients saddled
 with the kind of massive medical bills that drive mounting public 
frustration with American health care — it could fuel the political push
 to extend full Medicaid coverage to more low-income adults.

That includes Derby resident Melissa Dodge.

She fears what <a href="https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html" target="_blank">the novel coronavirus</a>
 would mean for her 9-year-old daughter with heart and lung problems. Or
 the danger it could pose for her mother, who is over 60.

But she has another worry: As a single mother caring for her four children while working part-time, she has no health insurance.

“My
 anxiety was always high because I knew the financial risks” of being 
uninsured, Dodge said. “Add a new global pandemic on top of that, and 
it’s terrifying.”

Dodge takes every precaution she can. When the 
pandemic hit, her employer agreed to move her shift later in the 
evenings and let her spend more of it stocking shelves — two things that
 reduce her exposure to other people.

When she gets home past 
midnight, she peels off a face mask, scrubs her hands and changes 
clothes before so much as sitting down.

Though she doesn’t qualify
 for Medicaid, her children do. She has driven to Topeka before to beg 
lawmakers to give people like her the same benefit.

“It's a 
lifesaver for my family,” Dodge said. Her 9-year-old has had multiple 
heart surgeries. Another of her children is autistic.

But if she needs care for herself, Dodge struggles with what that debt would do to her family.

“The financial aspect of COVID,” she said, “is probably one of the most unspoken scary parts of it.”

Celia Llopis-Jepsen reports on consumer health and education for the Kansas News Service. You can follow her on Twitter <a href="https://twitter.com/Celia_LJ" target="_blank">@celia_LJ</a>
 or email her at celia@kcur.org. The Kansas News Service is a
 collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public
 Radio focused on health, the social determinants of health and their 
connection to public policy.

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/4/1587758501245.png" alt="Face masks that Derby resident Melissa Dodge uses to protect herself at her grocery store job. Dodge has no health insurance. Melissa Dodge / Submitted" />
 <figcaption>Face masks that Derby resident Melissa Dodge uses to protect herself at her grocery store job. Dodge has no health insurance. Melissa Dodge / Submitted</figcaption>
 </figure>By CELIA LLOPIS-JEPSEN <a href="https://www.kcur.org/news/2020-04-24/new-federal-laws-may-not-protect-uninsured-coronavirus-patients-as-hoped">Kansas News Service</a>The small crew of health care workers at Guadalupe Clinic in Wichita —
 aided by dozens more who volunteer there — sees nearly 2,000 people a 
year.Every one of them is uninsured, and all visits are free.<a href="https://guadalupeclinic.org/" target="_blank">Guadalupe</a>
 can’t yet check patients for COVID-19. But emergency federal 
legislation might help the nonprofit roll out that service to the 
low-income neighborhoods it serves.“Our patients live in small 
apartments, small houses,” where COVID-19 can spread quickly, executive 
director J.V. Johnston said. “So testing would be important for us.”Stimulus funds promise to cover coronavirus testing and treatment for the uninsured.Still, benefits for the <a href="https://www.khi.org/assets/uploads/news/14956/khi-health-insurance-info-2018-web.pdf" target="_blank">250,000 people</a> without health insurance in Kansas remain unclear. Experts see potential <a href="http://chirblog.org/expanded-coverage-for-covid-19-testing/" target="_blank">loopholes</a>
 in the new federal laws and policies that could risk leaving people on 
the hook for hundreds, even tens of thousands, of dollars for hospital 
stays.And while the Trump administration says the offer to help 
will stop when funding runs out, it has yet to say how much money it’ll 
spend.The confusion could keep many sick people from seeking care. At the same time, the uninsured often work essential jobs that don’t give them the luxury of hiding from the virus at home.“This
 crisis is exposing big gaping holes in our health care system,” said 
Sabrina Corlette, a professor at the Georgetown University Center on 
Health Insurance Reforms. “When we have a public health crisis like this
 … the last thing you want is someone to hesitate to get tested and 
treated.”<h2>Help on the way</h2>The <a href="https://www.kff.org/uninsured/issue-brief/estimated-cost-of-treating-the-uninsured-hospitalized-with-covid-19/?utm_campaign=KFF-2020-Uninsured&amp;utm_source=hs_email&amp;utm_medium=email&amp;utm_content=2&amp;_hsenc=p2ANqtz-_a29TEiXmBg8w1NSN1RHzrL0AkB3b_c4oM2hMy5UgzCOCHSGxOjD-D1JifL7SXWGLjLy73365xrpw86-gHFg1k_gKuWw&amp;_hsmi=2" target="_blank">Kaiser Family Foundation</a> estimates coronavirus could put between 670,000 and 2 million uninsured people in the hospital nationwide.The uninsured may <a href="https://www.kff.org/uninsured/fact-sheet/what-issues-will-uninsured-people-face-with-testing-and-treatment-for-covid-19/" target="_blank">face a higher risk</a> of contracting the novel coronavirus because so many work face-to-face jobs, such as cashiering and housekeeping.Two stimulus bills passed by Congress in March should benefit people without health coverage.The Families First Coronavirus Response Act gives states the option of covering <a href="https://www.healthaffairs.org/do/10.1377/hblog20200413.783118/full/" target="_blank">COVID-19 testing</a> for the uninsured through Medicaid. That would include both the lab work and the office visit for the patient.But it wouldn’t help with coronavirus treatment,
 which can total daunting sums. Kaiser and the Peterson Center on 
Healthcare estimate inpatient bills for a serious case of COVID-19 <a href="https://www.healthsystemtracker.org/brief/potential-costs-of-coronavirus-treatment-for-people-with-employer-coverage/" target="_blank">could top $20,000</a> even when people do have job-based health plans that negotiate down the prices.The
 Trump administration came under fire to act. It has declined to reopen 
access to the Obamacare exchange but vowed instead to use money in 
another stimulus bill, the CARES Act, to reimburse hospitals at Medicare
 rates for treating the uninsured.Kaiser initially estimated that could use up <a href="https://www.kff.org/uninsured/issue-brief/estimated-cost-of-treating-the-uninsured-hospitalized-with-covid-19/?utm_campaign=KFF-2020-Uninsured&amp;utm_source=hs_email&amp;utm_medium=email&amp;utm_content=2&amp;_hsenc=p2ANqtz-_a29TEiXmBg8w1NSN1RHzrL0AkB3b_c4oM2hMy5UgzCOCHSGxOjD-D1JifL7SXWGLjLy73365xrpw86-gHFg1k_gKuWw&amp;_hsmi=2" target="_blank">between $13.9 billion and $41.8 billion</a>
 of a $100 billion portion of the CARES Act meant to help hospitals cope
 with the pandemic. Now that the Trump administration has said the money
 would also go for care beyond hospital admissions, Kaiser says the plan
 could use up <a href="https://www.kff.org/coronavirus-policy-watch/update-on-covid-19-funding-for-hospitals-and-other-providers/" target="_blank">even more funds</a>.This
 has sparked some controversy among health care providers worried the 
dollars won’t stretch, Kaiser senior fellow Karyn Schwartz says.“That’s less money that’s available to help them buy protective equipment for their staff,” she said.The
 White House and Congress have since agreed to add $75 billion for 
health care providers to weather the storm. But the administration has 
yet to say how much CARES money it will set aside for the uninsured — 
while making clear that help will stop if that unspecified amount of 
money runs out.<h2>Waiting to hear more</h2>The typical 
patient at Guadalupe cobbles together paychecks from various part-time 
jobs that don’t offer health coverage, said Johnston, the clinic’s 
executive director.As the pandemic costs people their jobs, he expects more will likely need help.“If they have no income,” he said, “they're going to buy food and pay their rent before they pay their health insurance.”Johnston
 is eager to learn how reimbursement for testing will work, and whether 
Guadalupe can participate. The money will flow through state Medicaid 
programs, and his donation-funded clinic has never billed Medicaid 
before because it only sees the uninsured.“So it’s (up) in the air now,” he said, “but hopefully that’s the case.”Like other states, Kansas is still working out the kinks of this unprecedented use of its Medicaid program.As
 of late April, the Centers for Medicare and Medicaid Services said it 
had only approved two states to cover coronavirus testing for the 
uninsured.Once Kansas clears that same hurdle, CMS said in an 
email, Medicaid could kick in retroactively, for tests conducted no 
earlier than March 18 (when the new law <a href="https://www.congress.gov/bill/116th-congress/house-bill/6201/text" target="_blank">took effect</a>).<h2>Risk for surprise bills</h2>Even bigger questions remain about how billing will work for the far costlier treatment of COVID-19.The CARES Act contains provisions meant to <a href="https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html" target="_blank">prevent “surprise bills”</a> — when a hospital or a doctor charges patients for more money directly beyond what health plans pay.But
 several health insurance experts studying the act expressed concern 
that it shields uninsured patients from hospital charges without 
protecting them against independent billers under the same roof, such as
 anesthetists or emergency department staff.They have similar 
concerns about how billing will shake out when someone tests negative 
after treatment has begun. And what if, they wonder, the patient can’t 
get a coronavirus test at all and is given one for the flu instead?“We
 know due to the lack of testing capacity,” Georgetown’s Corlette said, 
“that many, if not a majority, of people who present with covid-19 
symptoms are turned away without a test. But they’re still charged for 
the visit.”<figure>
 <img src="https://media.eaglewebservices.com/public/2020/4/1587758579320.png" alt="Derby resident Melissa Dodge doesn't qualify for Medicaid, but the program does cover her children's health care." />
 <figcaption>Derby resident Melissa Dodge doesn't qualify for Medicaid, but the program does cover her children's health care.</figcaption>
 </figure>The complexity of it all — and lack of clarity — doesn’t surprise 
Katherine Hempstead, a health insurance expert at the Robert Wood 
Johnson Foundation.“We have a very complicated, highly segmented 
health care system,” she said, and now a pandemic has sent the country 
scrambling for fixes to help millions of Americans get testing and 
treatment. “You can kind of see all these little patches that we’re 
trying to erect.”In Kansas, if those patches don’t work well — 
hampering efforts to control the coronavirus or leaving patients saddled
 with the kind of massive medical bills that drive mounting public 
frustration with American health care — it could fuel the political push
 to extend full Medicaid coverage to more low-income adults.<h2>‘A lifesaver’</h2>That includes Derby resident Melissa Dodge.She fears what <a href="https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html" target="_blank">the novel coronavirus</a>
 would mean for her 9-year-old daughter with heart and lung problems. Or
 the danger it could pose for her mother, who is over 60.But she has another worry: As a single mother caring for her four children while working part-time, she has no health insurance.“My
 anxiety was always high because I knew the financial risks” of being 
uninsured, Dodge said. “Add a new global pandemic on top of that, and 
it’s terrifying.”Dodge takes every precaution she can. When the 
pandemic hit, her employer agreed to move her shift later in the 
evenings and let her spend more of it stocking shelves — two things that
 reduce her exposure to other people.When she gets home past 
midnight, she peels off a face mask, scrubs her hands and changes 
clothes before so much as sitting down.Though she doesn’t qualify
 for Medicaid, her children do. She has driven to Topeka before to beg 
lawmakers to give people like her the same benefit.“It's a 
lifesaver for my family,” Dodge said. Her 9-year-old has had multiple 
heart surgeries. Another of her children is autistic.But if she needs care for herself, Dodge struggles with what that debt would do to her family.“The financial aspect of COVID,” she said, “is probably one of the most unspoken scary parts of it.”Celia Llopis-Jepsen reports on consumer health and education for the Kansas News Service. You can follow her on Twitter <a href="https://twitter.com/Celia_LJ" target="_blank">@celia_LJ</a>
 or email her at celia@kcur.org. The Kansas News Service is a
 collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public
 Radio focused on health, the social determinants of health and their 
connection to public policy.

New laws may not protect uninsured coronavirus patients as hoped 

SEDGWICK COUNTY — Law enforcement authorities are investigating a shooting that wounded a Kansas man.

Just before 10p.m. Thursday, police proactively patrolling and focusing on an increase in drive-by shootings heard several shots being fired in the area of 3800 E. Ross Parkway in Wichita, according to officer Charley Davidson.&nbsp; 

Then officers were alerted by 911 to a shooting at that location.&nbsp;

Upon arrival, officers located blood evidence and a shell casing on Ross Parkway street.&nbsp; A 25-year-old male victim was then located at a business at 31st&nbsp;and Hillside with a gunshot wound to his body, according to Davidson.&nbsp; He was transported to an area hospital for treatment of non-life-threatening injuries.

The investigation revealed the 25-year-old man met two women on a dating app, and he agreed to meet them along with his 25-year-old friend in the 3800 block of East Ross Parkway to engage in drug activity.

As the victim was standing outside of his vehicle, he was approached by an unknown suspect who pushed him and then fired a shot, striking him.&nbsp; The suspect fled, and the victim and his friend drove to the business at 31st&nbsp;and Hillside.

Police have not reported an arrest. Davidson did say, "using dating apps can be positive. However, there could also be potential dangers.&nbsp; WPD wants to remind citizens of some steps you can take when meeting someone you don’t know:

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Avoid sharing a lot of personal information;

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Arrange for your own transportation to a location;

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Meet in a public place;

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Meet with a trusted person; and

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Share your location with a family member or friend and have them check-in.

SEDGWICK COUNTY — Law enforcement authorities are investigating a shooting that wounded a Kansas man.Just before 10p.m. Thursday, police proactively patrolling and focusing on an increase in drive-by shootings heard several shots being fired in the area of 3800 E. Ross Parkway in Wichita, according to officer Charley Davidson.&nbsp; Then officers were alerted by 911 to a shooting at that location.&nbsp;Upon arrival, officers located blood evidence and a shell casing on Ross Parkway street.&nbsp; A 25-year-old male victim was then located at a business at 31st&nbsp;and Hillside with a gunshot wound to his body, according to Davidson.&nbsp; He was transported to an area hospital for treatment of non-life-threatening injuries.The investigation revealed the 25-year-old man met two women on a dating app, and he agreed to meet them along with his 25-year-old friend in the 3800 block of East Ross Parkway to engage in drug activity.As the victim was standing outside of his vehicle, he was approached by an unknown suspect who pushed him and then fired a shot, striking him.&nbsp; The suspect fled, and the victim and his friend drove to the business at 31st&nbsp;and Hillside.Police have not reported an arrest. Davidson did say, "using dating apps can be positive. However, there could also be potential dangers.&nbsp; WPD wants to remind citizens of some steps you can take when meeting someone you don’t know:·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Avoid sharing a lot of personal information;·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Arrange for your own transportation to a location;·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Meet in a public place;·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Meet with a trusted person; and·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Share your location with a family member or friend and have them check-in.

Kan. man shot after lured to robbery on dating app

By DEE-ANN DURBIN and PAUL WISEMAN, Associated Press

The days of standing shoulder-to-shoulder at a bar or sharing a meal at a table for 10 are gone for now — and could take a long time to return even after the coronavirus pandemic ends.

By DEE-ANN DURBIN and PAUL WISEMAN, Associated PressThe days of standing shoulder-to-shoulder at a bar or sharing a meal at a table for 10 are gone for now — and could take a long time to return even after the coronavirus pandemic ends.U.S. restaurants are thinking ahead to a time when their dining room doors reopen to a changed world. Owners say there may be physical differences, like masked waiters, disposable menus or fewer tables so patrons can sit farther apart. There will be signs explaining cleaning procedures and glass dividers to protect cashiers. Disinfectant wipes might sit next to napkin dispensers.“The pivot with my restaurants doesn’t anticipate a return to exactly what was,” said Dan Simons, the owner of Farmers Restaurant Group, which owns six restaurants, a bakery and a distillery in the Washington area and a restaurant in Pennsylvania.Restaurants that have reopened in Asia provide a blueprint. In Hong Kong, public gatherings are limited to four people, and restaurants must keep tables nearly 5 feet apart. Customers’ temperatures are taken at the door, and they are required to wear masks unless they’re eating or drinking.In Hefei, China, the La Ma Restaurant reopened March 17 but still checks diners’ temperatures and disinfects the premises every two to three hours, said employee Yang Gui. Business is down by half compared with before the outbreak, Yang said. As few as a dozen diners come some days; two-thirds of the staff have yet to return to work.That’s changing the experience for diners. Rae Elloso, a teacher in Hong Kong, eats out occasionally because she feels it’s important to have social contact. Dining out is more peaceful now, she said, but also a little uncomfortable when some seating areas are blocked off.“When restaurants tape up chairs and tables, the impression I get as a diner is that they don’t want me there, even though I know this is not the case,” Elloso said.David Siu, who also lives in Hong Kong, has noticed that restaurants try to turn the tables over more quickly because they have less capacity.Delivery is also accelerating in China, indicating many people still want to eat at home. Spending on food at restaurants, convenience stores and other outlets dropped 30% in China in January and February, but delivery spending was up 10% in that period, according to NPD Group, a data and consulting firm.Takeout and delivery were already gaining in popularity in the U.S. before the pandemic with the introduction of apps like UberEats; that may accelerate if shell-shocked consumers stay home. Menus will likely be pared down, with more focus on food that travels well.John Gordon, founder of San Diego-based Pacific Management Consulting Group, which advises restaurants, thinks U.S. restaurants — like Asia’s — will have to follow local guidelines when they reopen. Earlier this week, California Gov. Gavin Newsom suggested the state might require temperature checks and more distance between tables.Gordon says regulations about density will affect restaurants differently. Sit-down restaurants like Cheesecake Factory are designed to bring in a certain amount of money per square foot, so they would see their profitability drop. Fast food chains generally don’t have a lot of business in their dining rooms, so they may not feel as much impact.But with business down as much as 80% in the sector right now, Gordon said, most restaurants aren’t yet focused on the impact of potential regulations.“They’re just trying to survive to get to whatever the other side of this is,” he said.While they wait, some restaurants are already experimenting. Simons added fresh produce and other grocery items to his Founding Farmers restaurants this month. It was a big success. Simons has rehired 175 of his 1,100 staff members, and he’s making 60% of pre-virus sales at one location and 80% at another between takeout and groceries.Simons expects to continue grocery sales once his dining rooms reopen. He’s also considering other ideas, like renting out the dining space for events.Even before the pandemic, Simons said restaurants were struggling with the popularity of takeout and delivery, high labor costs and lower alcohol consumption among younger patrons.Overall traffic at U.S. restaurants was flat last year, according to NPD Group. But digital orders for takeout were up 33%, while digital orders for delivery rose 16%.With those numbers in mind, many restaurants were already shifting away from big dining rooms. In December, Applebee’s opened its first takeout- and delivery-focused restaurant in Mobile, Alabama. The store is half the size of a traditional Applebee’s, and all the food is packaged to go.Bent Hansen, the owner of Los Gringos Locos, a Mexican restaurant near Pasadena, California, says it will be up to restaurants to make diners feel comfortable. That will likely mean visible cleaning, fewer tables, touchless ordering and lots of hand sanitizer. He’s also thinking of hiring his own delivery drivers so he can make sure cars are sanitized and the food is protected until it’s delivered.Restaurants will eventually bounce back, predicts Henry Pertman, director of operations at Total Image Creative, a Maryland-based hospitality consulting firm.“If you think this is going to make people want to cook their own meals while surfing the Food Channel, you’re wrong. You can only burn so many pot roasts,” he said.But some restaurants just can’t make the math work right now. The Downtowner in Lafayette, Indiana, closed its dining room in mid-March and quickly abandoned takeout after getting only a handful of orders. Now the 69-year-old restaurant is shuttered until the crisis passes. Its six full-time employees are signing up for unemployment benefits.Still, Manager Yolanda Timmons said she’s optimistic that the restaurant will reopen when the outbreak recedes.“We’re going to have the biggest party when we can all get out,” Timmons said.___