Santa Clara County's Board of Supervisors is seeking to make free at-home COVID-19 tests widely available to residents as new cases spike to new heights and the availability of testing appointments plummets.

Supervisors agreed at their Tuesday meeting to expand a strategy of using at-home kits to diagnose infections amid an unprecedented wave largely caused by the infectious omicron variant of the virus.

Nearly 1 in every 5 positive cases of COVID-19 since the start of the pandemic have occurred since Dec. 20, according to county data.

Testing data shows that the number of tests being administered in the county have hovered at around 25,000 per day and only expanded last week, with appointments becoming increasingly difficult to secure on short notice. County Supervisor Joe Simitian said his office tried to book an appointment on Jan. 3 and couldn't find broadly available spots until Jan. 9.

And while the number of tests may be constrained, the positivity rate has soared to the highest levels since March 2020. Positive tests now make up more than 15% of all tests administered by the county, compared to about 1.5% early last month. Turnaround times for results appear largely unaffected.

The most striking results came on Jan. 3, when the county hit a record-breaking 6,582 new COVID-19 cases in a single day — more than double the highest number recorded during the surge, in January 2021. That wave overwhelmed hospitals and killed hundreds.

The extraordinary rise in positivity rates have been slightly lower in north county cities. County data shows that Palo Alto residents have taken 7,472 tests since Dec. 26 with 599 testing positive, a rate of 8%. Mountain View residents have taken 7,068 COVID-19 tests and have had 731 positive cases, for a positivity rate of 10.3%. Both are significantly lower than San Jose (17.3%) and Gilroy (20%) over the same period.

With testing capacity once again in constrained, Simitian proposed that the county find immediate ways to "significantly expand" the acquisition and distribution of at-home COVID-19 tests that would be available free of charge. While places like CVS and Walgreens sell tests, Simitian said they can be pricey and are currently in short supply.

Simitian said the county could emulate an at-home testing program in Colorado, which delivers BinaxNOW-brand tests directly to residents through an online request form. Alternatively, Washington, D.C. provides tests that are free for pick up at 36 locations.

"Right now, at-home testing is one of the few tools available to slow the spread of the virus," Simitian wrote in his proposal. "But it is almost unavailable to the vast majority of county residents. The county is well-situated to address this issue, and it should do so."

There has already been some progress in providing publicly accessible at-home tests. The county's Public Health Department has received over 90,000 tests from the state of California and has been distributing antigen tests to places like skilled nursing facilities, homeless shelters, acute care hospitals and vulnerable communities. School districts also are operating their own COVID-19 testing with kits allocated directly by the state.

City leaders from throughout the county came out in support of distributing more at-home testing kits. Saratoga Mayor Tina Walia said testing appointments are "extremely limited" and that expanded self-use tests would go a long way toward slowing the spread of COVID-19. Monte Sereno City Council member Liz Lawler said the county should put personal health back in the hands of residents and that it shouldn't wait to make sure the federal government reimburses the costs of buying and distributing tests.

"Time is of the essence. We have the kits now; let's get them out to the public," Lawler said. "We shouldn't wait for the federal government to follow through on delivery."