Santa Clara County looks to ramp up at-home testing as COVID-19 cases surge

Santa Clara County supervisors are seeking to make free at-home COVID-19 tests widely available to county residents as cases spike to new heights and the availability of testing appointments plummets.

Supervisors agreed at the Jan. 11 meeting to pivot from testing at county-run facilities and expand the use of at-home kits amid an unprecedented wave of new cases, largely caused by the infectious omicron variant of the virus. Nearly one in every five 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 have only recently 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.

We are currently seeing a dramatic and really breathtaking explosion of cases.

Sara Cody, Santa Clara County health officer

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 test 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 cases in a single day — more than double the highest recorded during the surge in January 2021 that overwhelmed hospitals and killed hundreds.

“We are currently seeing a dramatic and really breathtaking explosion of cases,” said Santa Clara County Health Officer Sara Cody at the Jan. 11 Board of Supervisors meeting.

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

With testing once again in short supply, Simitian proposed that the county find immediate ways to “significantly expand” the acquisition and distribution of at-home COVID 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 what are called “BinaxNOW” 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 are also operating their own COVID-19 testing with kits allocated directly by the state.

Cody stressed that the county’s high number of COVID-19 cases are still an undercount, noting that more and more residents are turning to at-home tests rather than going to county-operated testing sites. The positive results people receive at home are not getting added to the county’s data, and would likely paint an even grimmer picture. She said the expectation is that omicron will peak by the end of this month or early next month, and warned that the next few weeks will be difficult.

City officials from throughout the county came out in support of 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 towards slowing the spread of COVID-19. Monte Sereno Councilwoman 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.”