Santa Clara County announced Wednesday a new public health order forcing local health care providers -- including Kaiser Permanente and Sutter Health -- to provide quick and easy access to COVID-19 testing, following widespread complaints that residents have been wrongly denied tests.
The order, which goes into effect Sept. 25, comes after months of pressure by county officials to get private hospitals to ramp up testing, giving teeth to requirements that have been largely ignored since June.
Essential workers and those who come in contact with a confirmed case of COVID-19 are entitled to a test by any health care provider that has an acute care hospital in Santa Clara County, regardless of whether they show any symptoms. But county officials say those requirements have not been met, and people are routinely being denied a test or are forced to navigate a labyrinthine process to get tested.
Santa Clara County Health Officer Sara Cody said testing must ramp up in order to get a handle on the virus, particularly as schools begin to reopen. About 40% of people with COVID-19 may not show any symptoms at all, she said, making it more important for tests to be easily accessible and widely available.
"if you don't know you have COVID, you can't take measures to protect people in your household or your workplace or anywhere else," Cody said during a virtual press conference announcing the order.
Kaiser Permanente, Stanford, Sutter Health and El Camino Hospital are all included in the public health order. Recent data suggests that all four have not provided enough tests to meet the county's requirements, leaving it up to the county's health care system to pick up the slack.
In the week of Aug. 31 through Sept. 6, Santa Clara County provided 13,072 COVID-19 tests, followed by Kaiser at 4,261 and Stanford at 3,243.
Cody was joined Wednesday by a coalition of 10 mayors across Santa Clara County, including Mountain View Mayor Margaret Abe-Koga and Palo Alto Mayor Adrian Fine. During the Zoom call, Fine said his city is blessed with world-class hospitals that have stepped up to test essential workers, but that more needs to be done to increase capacity. Every time the city hosts a COVID-19 testing site with the county, he said, there is a line around the block.
"I've heard far too many stories that tests are hard to find, hard to get and take too long to get useful results," Fine said.
Under the new order, large health care providers are required to provide immediate testing to any county resident who shows up in person with symptoms of COVID-19, has been exposed to a confirmed case or has been referred for testing by the county's public health department. If residents ask for a test online or by phone, they must be provided a test no later than the following day.
Hospitals are given more flexibility for essential workers, and are obligated to provide a test within three business days. In all cases, test results must be given within three days of the test.
Essential workers eligible for tests include teachers, school staff, grocery store clerks, first responders and health care workers.
The testing order also prohibits any practice that would discourage or delay access to COVID-19 tests, said County Counsel James Williams, which is a direct response to widespread reports that hospitals have made it difficult for residents to get tested. Under the new testing order, hospitals must provide information on testing availability -- consistent with the new county health order -- on websites, in waiting rooms and in promotional materials related to COVID-19.
"Too many people still don't know they can, and have the right, to get tested through their health care providers," Williams said.
Bay Area hospital officials have criticized the county's testing order for being unrealistic, and said that supply chain shortages out of their control have made it difficult to expand testing capacity beyond the patients who need it most. But County Supervisor Joe Simitian said organizations like Kaiser and Sutter have the resources to ramp up testing and finally come into compliance with testing requirements that have technically been in effect since June 10.
"There really is no excuse for large health care systems not to have stepped up and done their fair share and comply with the public health order," Simitian said.
Another incentive for boosting COVID-19 testing is the prospect of more businesses and schools reopening in Santa Clara County. Under the state's new tiered framework, counties that can achieve higher levels of testing are able to open more sectors of the economy -- including indoor dining and other services that have been prohibited since March. San Jose Mayor Sam Liccardo said reopening depends on the county's ability to test, and that it's time for private health care providers to step up.
"The only way we're really going to beat this virus is by having all of our health care providers pushing with us," Liccardo said.
Anyone who believes hospitals are violating the public health order can file a complaint with the county at scccovidconcerns.org. Under a county law passed last month, businesses that violate public health orders can be fined for up to $5,000.