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Frustrated by the continued lack of widespread testing for COVID-19, mayors from every city in Santa Clara County co-signed a letter to county leaders this week offering their assistance in new testing sites.
The letter submitted by the Cities Association of Santa Clara County reflects a growing concern among local officials about the county’s slow ramp up in testing capacity, even as shelter-at-home rules are starting to loosen and city leaders are formulating strategies for reopening business. Testing in the county remains largely limited to people with symptoms, health care professionals and other frontline workers. Even as other jurisdictions have made testing more available for the general population (Los Angeles announced Wednesday that any resident who needs a test can get one for free), the county has been testing about 600 people per day over the past month, a fraction of what officials believe is needed to safely reopen the economy.
The numbers have been slowing climbing. County had conducted an average of 898 tests daily over the past seven days, an improvement from mid-April, when there were fewer than 400 tests conducted on some days, according to the county’s dashboard. But city leaders and some members of the Board of Supervisors underscored this week that much more needs to be done.
“Our businesses and schools must have some certainty for their plans to reopen, which appears directly tied to the availability and the amount of testing,” states the letter that is signed by 15 mayors, including Adrian Fine of Palo Alto and Margaret Abe-Koga of Mountain View. “It’s not clear how much testing is sufficient, and that is of concern to us.”
The letter addressed to the Board of Supervisors, County Executive Jeff Smith and Health Officer Dr. Sara Cody requests that the county compile and publicize a comprehensive list of testing sites; create partnerships with cities to create more testing sites; and make sure all government, medical and food-distribution workers have testing readily available.
The letter also pointed to a recent request from Gov. Gavin Newsom’s COVID-19 Testing Task Force that communities create partnerships and more testing sites.
“But information on how we get there is not forthcoming,” the letter states. “It may be timely to form a Santa Clara County Testing Task Force. Without testing … we do not reopen our county.”
County and state officials have consistently maintained that testing capacity is a critical factor in loosening stay-at-home rules and reopening the economy. On Wednesday, Cody listed key indicators that are guiding her decisions on loosening shelter-in-place rules. These include the county’s ability to meet its need for testing residents who are in vulnerable populations or in high-risk settings or occupations.
County officials had noted in recent meetings that their ability to test is hampered by shortages of reagents (chemicals used to analyze tests) and key equipment, as well as the fact that most of the tests are conducted by hospitals and academic institutions. Their rough estimate is that testing capacity will need to get to about 4,000 per day, which Cody said amounts to roughly two tests per 1,000 people per day per population.
Smith cited at the Wednesday meeting of the county’s Health and Hospital Committee a number of factors that have contributed to the lack of widespread testing, many of which he said are beyond the county’s control. These include supply shortages in reagent, the complex approval process for tests and the fact that the tests that the Centers for Disease Control and prevention had initially provided were ineffective. These factors, Smith said, have “put us behind the eight ball.”
“And then we have many parts of the country that are doing much worse that we are, so they are sucking up the capacity,” Smith said.
Even so, the slow progress remains a topic of significant concern, both for county officials and city leaders. In Palo Alto, Councilwoman Liz Kniss has been a leading proponent of greatly expanding testing. Kniss, a former nurse, made the case at recent meetings that the city and the county need to do much more to ramp up testing. She and others pointed to examples in other cities and counties of drive-thru testing stations that are available for the broader populations – not just frontline workers and people with symptoms.
Kniss argued at the April 20 City Council meeting that testing today is woefully insufficient, particularly in the north end of the county.
“I just know we’re not doing sufficient testing,” Kniss said. “And we actually should be testing people who do not have symptoms, especially if you go to work in some places like a nursing home or grocery store — where you’re going to be in close contact with people on a regular basis.”
Palo Alto City Manager Ed Shikada said at the April 20 meeting that unlike Fremont and Hayward, which have instituted drive-thru testing sites, his city has opted not to be an “active player” in pursuing more testing. It has, however, initiated a conversation with the county.
“If there is a role for cities, we in Palo Alto are ready and interested in participating in any appropriate role,” Shikada said.
Supervisor Joe Simitian, whose district includes Palo Alto and who serves on the Health and Hospital Committee, said at the Wednesday meeting that he thinks the letter signed by the mayors is “on point.” He also said that he would like to use the committee to make testing “dramatically more robust.”
“It’s time to test. I think it’s past time to test,” Simitian said.
Simitian said he has spoken to Shikada about a possible partnership and had also been in discussions with El Camino Hospital CEO Dan Woods, who has expressed a willingness to not only partner with the county but to provide physical space for testing.
While Simitian acknowledged the limitations cited by Smith, he said the county has to look at those as “challenges we need to overcome, not impediments that we simply accept.”
One of the fundamental challenges, he said, is the fact that no one at the federal, state, county or city government level has taken responsibility for testing. The county, he said, needs to step up and take initiative to see what it can do to “dramatically increase the number of tests.”
“I think it’s pretty clear at this point that if we wait for someone who has control to show up on our doorstep and start offering tests in some great number, we can be waiting a while,” Simitian said.
Find comprehensive coverage on the Midpeninsula’s response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.
Why does Donald Trump continue to say there is plenty of testing capacity when local officials keep complaining about the lack of testing capacity? Is there some secret place we are supposed to go to get tested?
Palo Alto seems to be a risky hotspot. Wish we regular taxpayers could get a test. I say this respectfully, meaning after first responders and front line workers, of course. But yet, we hear all LA residents offered a test….places like SF cater to homeless, undocumented…but regular taxpayers footing the bill for EVERYTHING can’t be tested….in Silicon Valley. I really think such testing is highly justified!
Oh, today in Trump’s press conference, he blurted at some mid-point that he doesn’t wear a mask, everyone who comes to visit his office gets a rapid test (Abbott Labs test, I think he said). They’re incredible. Yeah. So many tests are wasted on visitors to cater to Trump who refuses to wear a mask. And we regular folks in a pretty high risk area get NONE.
Moaning about lack of leadership in accelerating testing is not productive.
– “His city has opted not to be an “active player” in pursuing more testing.” City Manager Ed Shikada said
– “It’s not clear how much testing is sufficient, and that is of concern to us.” – Mayor Fine
– “I just know we’re not doing sufficient testing,” Kniss said.
These are laments and excuses, not solutions. Real leadership is building a program to implement testing asap. Palo Alto has abundant resources – let’s put them to work.
John, the city does not have abundant resources. Take a look at projected revenue streams based on current impacts of Covid. Check the facts.
Unprecedented budget cuts are in our near-term future.
Why does Donald Trump continue to say there is plenty of testing capacity when local officials keep complaining about the lack of testing capacity?
answer: Why? Because he knows he is in hot water with the American public and will lie his way throug to November hoping we are too stupid to notice that he is not a leader, not compassionate and no capable of being POTUS. By now we have all heard his ludicrous musings about injecting disinfectant, later dismissed by him as sarcasm, he does not have the intellect to be sarcastic.
Not clear how more testing sites will help.
There are 5 large tents set up for testing located at the corner of Galvez and Campus on the Stanford campus. I have yet to see more than one vehicle there (beyond staff).
Glad the curve was flattened successfully. Now that the goalposts have been moved (more testing) my heart goes out to those fortunate among us. The unemployed, the small business owners, the furloughed healthcare works, etc.
With two million people residing in Santa Clara County, and a very low Covid-19 infection rate—longtime political people like Liz Kniss should be pressed to provide exact numbers about as to how much testing she believes should be performed on a daily basis—and just who should be tested.
There are now two kinds of tests—diagnostic and surveillance. Diagnostic tests indicate whether a person is actively infected, or not. Surveillance (serological) indicate whether a person has antibodies, indicating a previous infection. Positive surveillance tests do not insure immunity from re-infection. Negative diagnostic tests do not prevent a person from testing positive at a later time.
So, just how many tests should our elected leaders expect to be performed daily, by whom, on whom and who should pay for these tests so that people like Ms. Kniss won’t be inclined to opine about things that she probably is not qualified to criticize?
@ Don’t-Test-Me–Test-The-Man-Behind-The-Tree
In the article, Sara Cody says we need 4,000 tests/per day. What’s not clear to me is whether that means we need to have the capacity for 4,000 tests (and if we’re able to figure out what our capacity is without doing the tests) or if we need to actually have doctors referring 4,000 people/day for tests. I do wonder if doctors are referring fewer people for testing because fewer people are contracting any viruses, Covid or otherwise, since we’ve all been at home for so long. I regularly think about how one interesting part of being at home is that I pretty much know my kids won’t get any viruses right now — usually with them at school and activities you never know if they’ll wake up sick one day (or night). But right now it’s hard to imagine how they could catch anything since we only go out for walks in the neighborhood with masks and wash hands as soon as we get back. So I am wondering the extent to which we don’t have a lot of testing going on because there aren’t enough people with symptoms to refer.
So, maybe it’s that we just aren’t able to do more than the ~800 tests we’re doing right now per day (which seem to have about a 1-2% positive test result rate currently). But it’s not clear to me whether we’re only doing 800 because we don’t have the capacity to do more, if it’s because doctors are constrained from referring more people for testing because of requirements of specific symptoms (e.g., fevers or shortness of breath only, not just plain coughs), or if it’s because we don’t have a program in place where we test more than just people that have specific symptoms.
Diagnostic testing in the US has been ramping up quickly. Since early March, the US has tested over 6M people. According to the White House, testing is proceeding at 1M tests a day. Recent announcements by the nation’s leading pharmacies and labs, indicates that hundreds of new test sites will be opened soon.
A recent article in FierceBiotech reports on how testing capacity in the private sector is increasing–
“Weeks after launching their own COVID-19 molecular testing initiatives, lab giants Quest Diagnostics and LabCorp have begun offering antibody tests nationwide for the next phase of the coronavirus pandemic.
Quest is now allowing individuals to order the immune response test for themselves online through the company’s direct-to-consumer portal. Previously, its antibody test service was made available for healthcare providers to order on behalf of their patients. After requesting and purchasing the test, people can set an appointment for a blood draw at one of Quest’s service centers.”
Los Angeles is now offering free testing to anyone—not just people demonstrating CDC symptoms:
https://www.washingtonpost.com/nation/2020/04/30/los-angeles-coronavirus-test/
“On Wednesday, Garcetti expressed confidence that there would be enough tests for anyone who wants one, despite the county being home to roughly 10 million people — a belief echoed by Los Angeles Deputy Mayor Jeff Gorell, who is helping to lead the city’s outbreak response.”
“Meanwhile, Garcetti stressed during his announcement Wednesday that people showing symptoms will still be prioritized at city-run sites. The city has the capacity to test 18,000 people a day, Garcetti said, noting that Los Angeles is one of the first major cities in the United States to roll out such an effort. Earlier this month, Houston launched a similar plan that allows any city resident access to one free test.”
With a stated capacity of 18,000 tests a day—LA will add over 500,000 tests a month to the nation’s testing capacity. With the expanded commercial testing, LA’s testing and the growing testing efforts of the States – it’s hard to believe that the Conronavirus Task Force’s estimates about sufficient testing capacity will not prove true with a couple months.
The Santa Clara County Coronavirus Dashboard contains information about testing within the County:
https://www.sccgov.org/sites/covid19/Pages/dashboard.aspx
Updated on 05/01/20, the testing section indicates that about 30,000 people have been tested. It states that the County Lab, academic labs and commercial labs are evaluating the test sames.
There is nothing in the dashboard that provides any sense of total lab capacity within the County, or how much of that capacity is being utilized on a daily basis.
Why would Shikada say Palo Alto does not want to be an “active player” in testing?
Jean,
That’s not what he said.
Quoting:
“If there is a role for cities, we in Palo Alto are ready and interested in participating in any appropriate role,” Shikada said.
As far a testing strategy, what about the proposal from Cornell:
https://www.forbes.com/sites/kotlikoff/2020/05/03/dr-fauci-heres-a-way-to-contain-covid-19-and-reopen-the-economy-in-as-little-as-one-month/#73035901c7a0
Perhaps we can start with a smaller SCC scale testing and opening strategy following the same spirit as this article, since I see little/no hope at the federal level.