Santa Clara County’s COVID-19 testing continues to lag

Santa Clara County public health managers have gained significant ground in controlling the coronavirus among vulnerable populations and the public in general, they told the Board of Supervisors on Tuesday, June 2. But while the county has met a state goal for testing, a key indicator for reopening the economy, it still struggles to meet its own separate testing goal, they said. In large part, that’s because some hospitals and clinics are lagging behind, the chief manager of the county’s testing program said.

The county has reached a state indicator goal of 150 tests per 100,000 people per day — about 2,880 — which is recommended by California health leaders, said Dr. Marty Fenstersheib, head of the county COVID-19 testing task force. Reaching that milestone has allowed the county to further relax restrictions on businesses and public movement under the state’s Phase 2 guidelines. The county has met the goal at least twice, but not consistently. It expects it will reach those numbers again once the latest data on tests per day are tallied.

Santa Clara County’s self-imposed goal was a minimum of 4,000 nasal-swab tests per day by the end of May, Fenstersheib said. He and County Executive Jeff Smith previously stated they were confident they would meet the goal, a minimum they said they needed to reach to feel confident about easing more restrictions. That number is far from the 15,000 to 16,000 tests per day they have said the county needs to be fully testing enough people.

Fenstersheib indicated that despite the county’s failure to reach the end-of-May goal, the county has seen a significant drop in the number of positive cases of coronavirus. The county now has about a 1% positivity rate in most areas and a 3% positivity rate in hot spots, far lower than they have previously seen. He said health officers are quite happy with the results, a strong indication the stay-at-home order and other measures are working.

Health Officer Dr. Sara Cody said the county has contained the COVID-19 outbreaks in skilled nursing facilities, which have been hard hit by the disease. She cautioned the public should continue to stay at home and wear masks in public to help prevent a second wave of infections, however.

It’s unlikely the stay-at-home order will completely be lifted anytime soon. The Public Health Department continually monitors for any signs of a resurgence and will adjust the order as needed. Health officers won’t know for three weeks what effect relaxing restrictions has had on the number of cases, she said.

“Testing continues to be key to control,” she told the supervisors. “This virus is a sneaky virus. Once it takes off in a community, it’s very challenging to put it back in the bottle.”

County supervisors questioned why there’s been such limited progress on performing tests. Fenstersheib said the Regional Medical Center of San Jose (Good Samaritan), Kaiser Permanente and Palo Alto Medical Foundation have not had good testing numbers.

“They could be doing more,” he said, although he did not state the number of tests that have been done at those facilities. The reasons are varied: missing reagents for the tests, costliness and perhaps even a lack of will, he said.

“It’s not my intent to shame them,” Fenstersheib said.

Supervisor Joe Simitian thought staff should push harder, however.

“If this is an all-hands-on-deck operation, then I don’t think it’s inappropriate to say ‘all hands on deck.’ It’s totally appropriate to say ‘Let’s step it up,'” he said.

Health officers continue to focus on hot spots and vulnerable populations, including at skilled nursing facilities, among first responders and “essential” lower-income workers who must interact with the public at their jobs. People of color have also been disproportionately affected by the coronavirus. Simitian said he wants countywide testing so they can have a full picture of the virus’ spread.

The county is making some progress on its attempts to identify and trace contacts of people who test positive for the coronavirus. Evelyn Ho, a senior community health planner for Santa Clara County, told supervisors the county’s case investigation and trace contacts program has 94 people trained and 85 in training. By Monday, they expect to have all 179 people trained.

The number is far from the 1,000 people they want to have trained by July 27. Ho said the testing task force has identified 301 county employees who can be reassigned and has asked the state for 500 of its workers to join the contact-tracing team. Those numbers would put the county near its goal. The number of contact tracers would not need to be trained and deployed all at once. Instead, they would be phased in as needed. Staff has a goal to train 100 to 150 people each week, she said.

Cody said they are working to scale up the workforce faster than the virus will grow so they will have a better handle on where it is spreading and to keep it controlled. Staff said they would have more data during the Thursday, June 4, update to the board’s Health and Hospital Committee.

Find comprehensive coverage of the Midpeninsula’s response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.