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County, Hospitals Expand Coronavirus Testing As Demand Falls Short Of Expectations

 April 21, 2020 at 11:17 AM PDT

Speaker 1: 00:00 While antibody testing is being slowly expanded, officials are now saying that testing for the virus itself is being underused in San Diego. CDC guidelines plus the initial scarcity of the tests made hospitals and doctors cautious about who could get the test for covert 19 now the number of tests have increased along with testing analysis and San Diego health officials are reexamining. The criteria about who can get tested. Joining me is KPBS health reporter Taran mento Taryn, welcome to the program. Thanks so much. Marine CDC guidelines really put a limit on who should get tested for covert 19 what are those guidelines? Speaker 2: 00:41 There are three tiers of priority. Number one is hospitalized patients with severe respiratory illness and health care facility workers with symptoms. And again the symptoms of COBIT 19 are fever, cough and shortness of breath and that's the top tier. The second priority group, um, are people who had, are higher risk of complication. I'm from a coven, 19 infection and those are people in longterm care facilities with symptoms, patients who are 65 years or older with symptoms, underlying conditions with symptoms and first responders with symptoms. And then at the bottom they know there's a health care facility, workers and first responders overall because they are at a higher risk, but also individuals with mild symptoms in communities that may have high numbers of coven 19 hospitalizations. So it's broken down into three different tiers of priority. Speaker 1: 01:32 But that's just a recommendation, right? It's just a guideline. Could it be expanded? Speaker 2: 01:36 Correct. It's a guideline to help hospitals and laboratories are physicians who are able to order these tests, kind of figure out how to best use early on very scarce testing abilities. And it does say in the guidance that still we defer to the expertise of clinicians and County health officials that really know their communities and their needs best. Speaker 1: 01:57 What are local hospitals saying about how tests and testing capacity are being used here in San Diego? Speaker 2: 02:03 So we found that some hospitals, you know, had the ability to test up to 950 maybe even 1600 tests a day, but we're really only using [inaudible] a couple of hundred like 300 and that's because, you know, early on they really needed to pay attention to the needs of the very sick people in their hospitals. And some hospitals only had the ability to run six tests early on. And so they were able to accelerate their testing at a much quicker rate than their inpatient needs grew. So now they're slowly starting to look at these other groups of patients that they can test that may not necessarily have symptoms. So sharp is looking at testing women who are coming in for labors, people who are receiving cancer treatment and people who may be about to undergo a procedure or an operation. Speaker 1: 02:52 So the, some of the hospitals themselves are expanding the criteria of who gets tested. Can the County come up with its own testing guidelines? Speaker 2: 03:01 Right. So the County says that they do follow the CDC guidelines, but Wilma Wooten, dr Wilma Luton, the County public health officer last week did acknowledge that, you know, hospitals are not using all of the capacity they have largely due to following guidelines for the very, very sick, which was intended to limit or to better utilize the very limited test. We at the beginning, so earlier today at as County board of supervisors meeting, BOMA Wooten said they have a task force that is looking at how to better utilize our [inaudible] regions testing capacity. And that would include expanding it to, uh, those who are infected with HIV testing, uh, people who are in low income communities and also some people, members of certain racial groups, including native and native Americans. So they're, they're working on coming up with that plan to expand it to those more vulnerable populations. But we just don't know when that will be announced or implemented. So we're waiting on those details. Speaker 1: 03:56 Now. Last week, governor Newsome outlined to six indicators the state will look at, in deciding whether or not to modify the statewide stay at home order. One of those concerns, testing capabilities do we know of San Diego County has adequate testing available to meet the governor's mandate? Speaker 2: 04:13 So during Wilma Wootens update to the kind of board of supervisors this morning, she said that this point they're in progress on, they're working on with the task force, how they can make sure that they meet the governor's criteria and the white house criteria to be able to have robust testing capabilities to test whoever needs it and whoever their close contacts are to make sure that we have a full picture of what's going on. So that is in progress and what the task force is working on. Speaker 1: 04:40 Now there have been areas where testing has been expanded to people without symptoms. Tell us what's happening at the convention center. Speaker 2: 04:46 Right. So the convention center is housing hundreds of homeless individuals and bringing more as well in on the city of San Diego is bringing more in. And so the lucky duck foundation and family health centers of San Diego have teamed up to test all individuals at the convention center regardless of symptoms. And so far at last update yesterday, supervisor Nathan Fletcher said 116 tests of individuals in staff have been done, 113 of them came back negative three we're unclear of the results. And so those individuals are going to be retested. We'll expect another update this afternoon on that. Speaker 1: 05:21 And is testing also being expanded to first responders? Speaker 2: 05:25 So you CSD did say that because of their excess capacity they are working with other entities to take on their testing needs. And so one of those is testing first responders within the city of San Diego. Speaker 1: 05:39 Well one of the obvious questions is if we have more capacity to test and to analyze those tests than we've been using, why not expand testing to anyone who wants it in the County. Speaker 2: 05:50 Even though we do have X access capacity, you know, based on who we're testing right now it's, you know, a couple hundred extra tests is still not enough to test anyone who wants it, you know, in a County our size. So it would really overwhelm the capability and even people who are saying we need to test more people. They are saying we need to be strategic about it because we're not just ready to test everyone. And another official or another source that I spoke to at sharp did say that, you know, because we do have a low prevalence of the virus, even though more than 2000 people have tested positive, it's still a low prevalence. And when you do widespread testing in an area where there is low prevalence, you run the risk of getting false positives or false results. And that's not something that we want to go telling people who are positive that they're negative or people who are negative, that they're positive cause that can change their behaviors and caused them to maybe not take as many precautions to not contract the virus and that would further spread the illness. Speaker 1: 06:48 And there's also a financial consideration to some hospitals though. So the testing really does need to be expanded to some degree, doesn't it? Speaker 2: 06:57 Correct. I mean if you invest in rapidly expanding your testing capabilities, that's money that you're spending to be able to test more. But you're not utilizing those resources you invested in. That means you're not able to get back the money that you put into it. And so financially that's a big issue for hospitals and healthcare centers and anyone in the medical field right now because we do know that fewer people are going to the hospital because of stay at home orders, some positive signs there. Also Cubs to some current, some concerns. People might be a little too scared to go into a medical facility. Um, so that just creates more of a financial issue at a time when we're dealing with a widespread economic crisis. Speaker 1: 07:35 Is there any timeline as to when we might hear from this new County task force on testing? Speaker 2: 07:41 We get a daily update from the County. We'll have one again this afternoon. I suspect, I know I'll be asking questions about it. I suspect others will be as well as testing is a really big point of criteria that we need to look at in terms of reopening accounting. Speaker 1: 07:55 I've been speaking with KPBS health reporter Taren mento. We'll be looking forward to that answer. Thank you very much, Taryn. Speaker 2: 08:01 Thank you.

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As testing abilities increased more quickly than needs, some hospitals are loosening their criteria to test more people while county officials are launching a task force to better utilize the excess capacity.
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