LINCOLN — The Utah group behind Nebraska’s and Iowa’s multimillion-dollar ventures to increase COVID-19 testing was dreaming big after it developed what it calls its “crisis response service.”
On the same day in March when the group inked its first contract to provide coronavirus testing in Utah, one of the firms in the group registered web addresses similar to TestUtah.com for 47 other states.
A few days later, URLs were registered for Puerto Rico and some Canadian provinces.
Today, most of the sites redirect you to crushthecurve.com, another site registered by Domo, of American Fork, Utah. Crushthecurve.com provides a marketing pitch for states to sign up for the Utah group’s services.
Whether the aggressive web registrations by the Utah group were just good business or are an example of attempted profiteering during a crisis sparked a debate between those who back Nebraska’s $27 million contract with the group led by Nomi Health and those who question the wisdom of entering into the hastily arranged, no-bid deal.
One state senator, who has been involved in Internet startup firms and has questioned the transparency of the TestNebraska contract, said it looks like the Utah group found a good idea and, like a lot of high-tech startups, decided to shoot for the moon with only a couple weeks of experience.
“It’s opportunism at its worst,” said State Sen. Megan Hunt of Omaha. “And we fell for it.”
A spokeswoman for Domo said the numerous registrations were made “early” in case other states signed up for the same testing program provided to Utah. So far, only Nebraska and Iowa, which signed a $26 million contract just before Nebraska, have taken up the offer.
Domo spokeswoman Julie Kehoe would not say how many states were offered contracts by the firm.
Gov. Pete Ricketts, who has touted TestNebraska as the way to expand testing and return the state to normal, said it was only “a few.”
The Republican governor, who had been trying without success to obtain COVID-19 tests elsewhere, made it clear last week that Nebraska needed to sign up, or it would lose an opportunity to increase testing dramatically, from 600 to 800 a day to eventually 3,000 a day.
“Every state was out there trying to find ways to expand testing, and they still are looking,” Ricketts said. “We found a consortium of companies that had access to all of these (testing) materials that was able to set up very, very quickly.”
Kehoe did not respond to a question about whether the Utah companies were cashing in on a crisis but said there was “no correlation” between the more than 50 URLs registered and the number of states and provinces contacted.
Indeed, a spokeswoman for Montana Gov. Steve Bullock said several companies selling coronavirus testing had contacted her state, but she didn’t recall the Utah firms.
Marissa Perry, the spokeswoman, said Montana successfully obtained its testing materials by working with the federal government and private vendors.
Taylor Gage, a spokesman for Ricketts, said it was his understanding that the Utah group could work with only a “limited number” of states because of constraints on the supplies it could obtain.
Crushthecurve.com makes it clear that the group is looking for more states.
“Join the nationwide Crush-the-Curve movement,” it says, displaying a U.S. map with Utah, Nebraska and Iowa highlighted and maintaining that its “crisis response service” will “increase the rate of COVID-19 testing, save lives, and restore normalcy.”
Hunt is not alone in questioning the program.
Last week, four state lawmakers, led by Sen. Machaela Cavanaugh of Omaha, called on the governor to cancel the contract and instead work with Nebraska providers.
Ricketts called that request “ludicrous” and said the senators didn’t realize how hard it is to find someone who could deliver so many tests so quickly. While there have been some glitches, he said, they’ve been addressed. And meanwhile, TestNebraska has provided two weeks’ of tests.
“We rushed this to get it out as quickly as possible,” Ricketts said. “We certainly could have spent a month or two testing this, but we thought the better deal here was to make sure we had more testing.”
The governor signed the first of three contracts for TestNebraska.com on April 19 and announced the launch of the testing program two days later — the same day Iowa launched its program.
One key was that the Utah group pledged provide 540,000 COVID-19 test kits — kits that were in short supply — and promised to ramp up to 3,000 tests a day by the end of May.
The launch of TestNebraska.com has had bumps. The website initially did not recognize that health care providers should be given priority to schedule a test, and, until last week, test result data was not being provided to local health districts. But those problems have been fixed.
Gage said Saturday that one of the four high-tech polymerase chain reaction (PCR) machines used to analyze the tests that was provided to TestNebraska broke down, but it has been replaced. That did not harm the quality of test results, he said.
And it appears that Nomi Health has honored its pledge to deliver test kits. The company, in a statement Friday, said it had already delivered 200,000 test kits each to Nebraska and Iowa. That is ahead of contract deadlines and above the 180,000 that were scheduled to be delivered.
“These states told us what they needed in the midst of a crisis and we delivered,” the company said.
Still, the test programs have drawn criticism in Utah and Iowa, as well as Nebraska.
In Nebraska and Utah, the tests done by the Nomi Health group produce far fewer “positive” tests than testing done by other labs in those states. Failure of analytical machines in Iowa has delayed test results. And early on, questions were raised about ties the CEO of Nomi Health has with a company that stockpiled hydroxychloroquine, an antimalarial drug once touted by President Donald Trump as a possible coronavirus treatment. A question about the drug that was initially on the TestNebraska.com assessment was removed shortly after questions were raised.
The drug has been shown to be ineffective, and even harmful, in some early trials.
Hunt said that she’s not opposed to public-private partnerships but that the speed at which the Utah firms ramped up and signed up Utah, Iowa and Nebraska reminded her a lot of high-tech startups that “overpromise” and then figure out the details later.
“My concerns are about accountability and transparency,” the senator said.
The Nebraska contract with Nomi calls only for COVID-19 tests that produce “accurate results a majority of the time.” Hunt said medical professionals tell her that is “as good as no test.”
“That could give people a false sense of security,” she said. “I’d rather people get bad news than be misled.”
The World-Herald reviewed dozens of pages of emails, documents and text messages released by the Governor’s Office to get a flavor of the steps taken in inking the contracts with Nomi Health, Domo, Qualtrics, and the Utah-based test manufacturer, Co-Diagnostics.
They portray a rush to sign up with the Utah firms, based on a recommendation from Utah Gov. Gary Herbert. Iowa Gov. Kim Reynolds has said the TestUtah group was recommended to her by actor Ashton Kutcher, a native Iowan and a friend of Ryan Smith, the CEO of Qualtrics.
By April 15 — four days before the first TestNebraska contract, with Nomi Health, was signed — the Cornhusker State had received a copy of the TestIowa contract.
“Amara, start reading this,” said an email from Doug Carlson, the chief procurement officer for the State of Nebraska to Amara Block, the legal counsel for the Nebraska Department of Administrative Services, the agency that deals with state contracts.
Several email exchanges followed, including one from the state asking that the contract stipulate a 36-hour turnaround on results after tests are administered. (After Ricketts initially indicated that TestNebraska was supposed to provide test results in 48 hours, the TestNebraska site now pledges to have them in 72 hours. But he said last week that the “average” turnaround time for TestNebraska was 1.8 days, which was faster than the state’s labs.)
Block, in an email the morning of April 19, emphasized that “time is of the essence” and said she was “comfortable” that Nomi Health could deliver the test kits it promised, which were 180,000 by 5 p.m. May 19 and 540,000 total.
But she added, “I’m not certain how to ensure quality control or accuracy” because the CDC-approved tests would be administered by workers hired by the State of Nebraska, which so far have been CHI Health employees.
By 12:10 p.m. on April 19, a Sunday, a “final draft” was in the hands of Nebraska officials, and less than two hours later, a signed contract with Nomi Health was in hand.
But that was just the start of contract discussions.
The emails indicate that a contract with Domo wasn’t signed until 3:30 p.m. April 21, a few minutes after the governor announced the launch of TestNebraska.com at his daily coronavirus briefing. The contract with Qualtrics, a Utah firm that has done work for the University of Nebraska-Lincoln, wasn’t signed until two days later, and only after Nebraska insisted on adding an extra clause to block the use of the information provided by residents to TestNebraska.com from any private use.
The emails released included requests from the Governor’s Office to well-known Nebraskans including Husker football coach Scott Frost and University of Nebraska President Ted Carter to use social media to encourage people to sign up for testing.
There was optimism about TestNebraska, but also concerns expressed, in some emails.
Dr. John Vann, a pediatrician from Omaha, sent an email to the Governor’s Office saying he was happy about the testing but asking about “the sensitivity and specificity” of the tests being used. The records released by the Ricketts administration did not include a response to that email.
The accuracy of COVID-19 tests is vital, to ensure that infected people don’t spread the virus after being cleared by false negative test results. Also, there have been questions raised about whether certain coronavirus tests are sensitive enough to glean results from a small sample of the virus.
In one email, Michael Harvey, a hospital administrator in Syracuse, Nebraska, said “many of the hospital laboratory directors across the state are very frustrated at the state’s approach” with TestNebraska. The concern, he said, was that the state program would gobble up the hard-to-obtain materials to conduct COVID-19 testing, leaving smaller hospitals without any.
Jerel Katen, the lab director at the hospital, Syracuse Area Health, also complained in an email that the state was deploying testing kits to a small hospital in Osmond but not to a hospital in Hastings, where the coronavirus was spreading rapidly.
Gage said that states are vying with one another for testing materials but that the Ricketts administration has tried to work with local hospitals and labs. The Utah group, he added, uses supply chains to which the state doesn’t have access.
“(It) doesn’t compete with the other testing supply chains we’re using,” he said.
Gage added that testing performed by the TestNebraska lab set up at St. Elizabeth Hospital in Lincoln was validated before the launch of testing two weeks ago, and has been validated twice since then. The state is working with the Nebraska Public Health Lab to “ensure the integrity” of the test results, he said.
Hunt, the state senator, said she’s still not convinced. Sure, she said, Nebraska needed to move fast, but she sees no evidence that the state’s authorities on pandemics were consulted before signing up with a group of Utah firms that had no prior medical experience. Meanwhile, there’s too many stories across the country of companies promising COVID-19 supplies and services that never delivered, she said.
“I’d like to be wrong (about TestNebraska), but show me that I’m wrong,” Hunt said.