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Community Clinic Seeing High Rate Of Positive Coronavirus Tests

Dr. Christian Ramers of Family Health Centers of San Diego stands in front of the clinic's administrative offices, July 22, 2020.
Matthew Bowler
Dr. Christian Ramers of Family Health Centers of San Diego stands in front of the clinic's administrative offices, July 22, 2020.

San Diego County’s rate of positive coronavirus tests is slowly coming back down after a prolonged surge in new daily cases.

A local community clinic that serves vulnerable populations, however, reports its positivity rate is consistently higher than the countywide figure.

The nonprofit Family Health Centers of San Diego serves patients, many of whom are uninsured, in the region’s low-income communities. Chief of Population Health Dr. Christian Ramers said the community clinic’s monthly positivity rate in July reached 15%. The county’s rolling average has only ever reached 8.3%, which was back in late March.

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“We feel like we’re actually reaching communities that are really in need of testing," Ramers said. “I think that’s evident in our test positivity rate.”

The community clinic’s overall monthly positivity rate in March was 10.7%, dropped to 8.7% in April, then climbed to 12.5% in May and 13.1% in June, he said.

The county’s 14-day rolling average dipped from its peak in March to its lowest point of 2.5% in mid-June and has since curved back up to 5.3% the first of this month, according to the county’s data dashboard.

Video: Community Clinic Seeing High Rate Of Positive Coronavirus Tests

Testing availability and criteria have changed across the county. Health care providers and labs, including the county’s public health lab, significantly scaled up its capacity since resources were limited in the pandemic’s early days. The county loosened its testing guidelines after the first few months but put those back in place in mid-July when supply shortages returned and some labs saw major delays in turnaround.

The state last month also implemented testing and processing guidelines to prioritize sick or high-risk patients.

The Family Health Centers’ lab worked to expand its testing capacity as well and now processes up to 500 tests a day to provide results in 48 hours, but he said the high positivity rate among its patients means more testing is needed, Ramers said.

“To do a fully saturated testing effort we really should be reaching 5% positivity rates or lower,” he said, referencing the World Health Organization’s recommendations.

High positivity rates indicate testing may only be concentrated among the very ill, while a lower rate suggests a jurisdiction has enough capacity to more adequately capture the virus’s presence, according to the Johns Hopkins University’s Coronavirus Resource Center.

Family Health Center’s positivity rates are even higher when isolated by walk-up testing sites that the clinic launched in late June in southeastern San Diego (14.4%), Chula Vista (14.8%), Spring Valley (14.9%), and city of San Diego’s Logan Heights neighborhood (16.8%), Ramers said. Family Health Centers has also offered walk-up testing at temporary or limited pop-up sites around the county, including in El Cajon and North Park.

“We feel this very big conflicting feeling that the state’s criteria are designed to restrict a little bit of some of the unnecessary testing and yet we’re seeing in our communities, especially in the South Bay, very high positivity rates telling us we should be doing more of what we’re doing,” he said.

A spokesman said patients tested in clinics are done so under a physician order, mostly to maintain safety by limiting unnecessary in-person visits, while anyone regardless of symptoms can go to a walk-up site.