Notes from the Governor’s COVID-19 Testing Task Force Update
May 7, 2020, 2:45 pm – Note from CA League of Cities
** Information transcribed and truncated for audience;
notes may not fully capture all information provided **
Dr. Charity Dean, MD, MPH, Assistant Director of the California Department of Public Health
- California was doing about 2,000 tests per-day in March;
- Wanted to reach 25,000 per-day by the end of April;
- Average actuals for April 28th—May 2nd show us doing 30,900 tests per-day;
- Actions to increase test volumes:
- Increase capacity for existing labs to process testing;
- Increase number of specimens collected for possession; and
- Assess and deploy new tests (ex: point of care and serology).
Paul Markovich, President and CEO of Blue Shield of California
- Additional sites are being established to provide equitable access across the state;
- We have been asking ourselves: How do we ensure that everyone in California who needs access to a test is able to do so?
- Want to make sure access is ubiquitous and equitable;
- This is something we want to accomplish/work towards this month;
- Have identified sites statewide for testing;
- Created a map where you can find testing near you;
- Surveyed the state and found a lot of gaps in testing;
- Tried to ensure that 95% of California’s population could access testing sites by strategically deploying 86 OptumServe sites;
- 64 of the 86 sites are operational right now;
- There have been bumps in the road, we have been working through those;
- This is a partnership, with the state putting forward funding for these sites, and ensuring they are professional and appropriately managed;
- Localities determine where these sites will be located, and to get the word out to the public;
- Want to ensure these testing sites are utilized to the maximum capacity;
- There are some counties that are fully booked for two weeks for testing;
- Here, there is potential to expand and increase the capacity of these sites;
- Criteria for recommendation of additional sites:
- Ensure access to testing in underserved communities;
- Ensure a collection site within approximately 30 minutes driving time in urban areas and within approximately 60 mins in rural areas; and
- Ensure there is sufficient capacity at each site to handle projected volume.
Dr. Christina Kong, Vice Chair and Medical Director of Pathology & Clinical Lab, Stanford University
- Common question is how to use serology testing;
- Just uploaded a document yesterday on serology testing indications, which tells you what this type of testing should be used for;
- It is important when using serology testing to ensure it has a strong performance criteria, should have great specificity, over 95%; and
- We are working to update our serology performance criteria document to add further clarity on this.
Question and Answer
- Q: Where is PCR testing being done? A lot of labs can do PCR testing, but are not in use, why?
- A: We’ve surveyed all of the labs in the state, and have a good sense of the equipment capacity labs have to perform PCR tests. At the moment that is not the issue. They have the capacity, but they need specimens. As we get more testing capability, we could potentially use additional labs. For right now, we have enough lab capacity. We will continue to see if there are other ways to expand that.
- Q: Can someone obtain a test in their doctor’s office?
- A: Yes, they absolutely can. One of the goals in setting up the additional 86 OptumServe sites was to help protect the health care system and preserve personal protective equipment, so individuals do not feel like they need to go to the doctor’s office or the emergency room to be tested. But you can be tested there, just as any other test would be conducted.
- Q: What is the number of OptumServe sites that are currently open or are planned to be opened?
- A: Map of these sites is available on the website. As of this morning, 64 sites are up and functional. There will be 74 of these sites operating by Monday, and an additional six are to be determined. We are tracking this progress regularly.
- Q: Is California’s testing in line with guidance from the Center for Disease Control, (CDC) or are we more stringent?
- A: This is important as we expand our testing capacity in the state. We have updated guidance for individuals working or living in congregate facilitates to be tested even if they are asymptomatic. California’s testing guidance differs slightly from the CDC’s, it is more expansive. Right now, virtually anyone in California who wants a test can get one. More information on testing criteria can be found on our website. Asymptomatic individuals have access to testing. You don’t have to have the same stringent criteria of symptoms that you needed before. We have also been testing blood supply for COVID-19, only found one positive so far. There are no studies that show that COVID-19 can be transmitted by blood, but based on screening so far, it is uncommon to find it in blood samples. At the local level, local leaders know their jurisdictions best, we defer to them as to the prioritization of populations within their jurisdictions that need access to testing.
- Q: Napa County is opening testing to the public. How frequently might we need to retest?
- A: Good question, we are asking this too. Working with researchers on this. We are looking at wastewater monitoring too, and temperature monitory that can help identify early symptoms. There is not a perfect answer yet, but we are looking into it.
- Q: The Governor mentioned surveillance studies. Are there similar studies going on now to show a larger picture of COVID-19?
- A: Yes, a lot of surveillance studies are being conducted. For example, one study at Stanford is taking samples of the population and health care workers using serology and PCR testing to understand prevalence and to track them to see what happens over time. There are similar studies taking place throughout the state as well.
- Q: Can you share the difference between drive through testing sites and the OptumServe sites discussed here?
- A: All of the OptumServe sights are in buildings because of weather restrictions. Last thing you want to do is wait outside for your test when you are sick. Beyond that, there are a number of local sites that are drive through. There is nothing clinically different between drive through testing or testing in a building. Logistically, for OptumServe, it just made more sense to have them indoors rather than outdoors. There can also be challenges for people who do not have cars, and how to access drive through testing without at car. So those communities know what is best for their population.
- Q: Ensuring that tribes are also receiving testing?
- A: Goes back efforts of trying to ensure equitable across the entire state for all populations. We are working on this and looking into solutions. There are places in the state where the population is so sparse and spread apart it can be very difficult to determine testing sites. There is the possibility of mobile testing. A month ago, it was very difficult to get tested in California, so at the local level it is important to communicate needs.
- Q: Is it a good idea to do serology tests at same time as PCR tests to see if someone who has COVID-19 had COVID-19 before?
- A: Some see value in that, especially as more people become exposed. There is not agreement in doing both tests at the same time. Some feel strongly that serology tests should only be used for surveying to see prevalence, and since you don’t do anything survey wise when doing both tests at the same time, there isn’t importance in doing so. There has been talk of using serology tests for returning to work, and that is not appropriate for serology. It does not tell you that you are protected from future COVID-19.
- Q: Can you talk about the intake process when administering a test, what data is collected? Personal information collected?
- A: There are different reporting requirements for the state of California. Some information is mandatory, and some is voluntary. For example, race and sexual orientation is voluntary information. Geographic information, on the other hand, is important to pinpoint health disparities in the state.
- Q: How are you working towards the sustainability of these sites?
- A: We wish we knew how long specimen collection will continue. We know this will last at least the next few months and even beyond that. We are aware we need to have a long term plan, and we are looking at that. We believe that we will have enough testing capability to last through the end of 2020. What is unknown is if new testing strategies could be developed. The field is still changing, and we are evaluating that.
- Q: Will pharmacies be able to have the capability to do testing?
- A: As of right now, that is not the case. We are open to anything that we think will achieve testing goals effectively. Main challenge is that testing in a pharmacy requires a specific license.