Napa, Solano and Sonoma counties say they have met the testing benchmark set by Gov. Gavin Newsom — 150 tests per 100,000 people each day, the number Harvard researchers estimate will capture most positive cases in a community.
The remaining six counties, which collectively set a more aggressive goal of 200 daily tests per 100,000 people, have yet to meet the benchmark. None have met the lower, state-set benchmark of 150 tests per 100,000 people, either. Yet all are starting to relax restrictions on restaurants, retailers and residents.
Testing is a critical component of reopening so that infected people can isolate to prevent spreading the disease to others, and so health officials can trace the contacts of each person who tests positive and have them isolate, as well. This is how public health officials can slow or stop transmission before it gets out of control.
County health officials cite three main reasons for why they haven’t met their testing goals:
• They have set up too few test sites in areas that need it the most, such as low-income neighborhoods. Researchers believe these residents need testing the most because their jobs often require them to work away from home, and they are more likely to contract the virus.
• Even when they have set up testing sites in such areas, many people don’t get tested because they lack health insurance or a regular doctor, don’t realize that testing can be free, or they face language barriers.
• People without symptoms assume they don’t need to be tested. But some counties recommend that all essential workers, such as first responders and employees of grocery stores and pharmacies, get tested once a month.
Despite the lag in meeting testing goals, health officials generally agree that if counties move cautiously and gradually to reopen — and closely monitor progress on testing and other indicators like hospitalizations — it is reasonable to phase in some activities like curbside pickup, outdoor sports and manufacturing.
“We’re not exactly where we’d like to be, but we know it’s a constant balance to really try and think about the need to re-engage our society, reopen our businesses and consider that aspect of things,” said Dr. Susan Philip, deputy health officer at the San Francisco Department of Public Health. “The reason we’re doing things so gradually is to be able to see how things go. … It’s not flipping a switch, we really are adjusting a dimmer.”
San Francisco has made the most progress out of the six Bay Area counties in moving toward the local testing benchmark. The city is more than halfway there, testing about 122 people per 100,000 residents, according to the city’s latest COVID-19 data. Philip said testing supplies and lab capacity are much better now than a month or two ago, though there is no guarantee the supply chain will be adequate beyond the next two to three weeks.
“We have a ways to go to get there, but we’re stabilizing,” Philip said. “We’re able to do more than we were a few weeks ago, certainly a month ago. It’s all a work in progress.”
Officials are trying to course-correct. In Santa Clara County, 40% of coronavirus cases have come from East San Jose, even though only 20% of the county’s testing has been conducted there, said Dr. Marty Fenstersheib, head of the county’s testing task force.
“We’re under-testing people from East San Jose,” he said. “We want the community, especially those that are workers that are going to be at higher risk to come out and be tested. I’m not so worried about the (overall testing) numbers, I’m more concerned about where we’re testing.”
So the county this week opened up two new test sites, at the Police Activities League Stadium and at the county fairgrounds, and is setting up a mobile testing unit that will go into neighborhoods to test residents. Similarly, San Francisco this week announced three new test sites in the Tenderloin, Bayview-Hunters Point and at City College. The health department is also testing all residents and staff at the city’s 20 skilled nursing facilities.
Many residents are simply unaware they can get tested, or don’t know where to go. Counties are increasing outreach efforts, posting signs for free testing in neighborhoods and announcing testing sites as they open. But not everyone has access to the Internet, or reads the news constantly.
The halting progress marks an evolution of the testing problems that have plagued the U.S. since the beginning of the pandemic. Initially, it was almost impossible for anyone to get a test anywhere unless they were already sick enough with COVID-19 symptoms to be hospitalized. By early April, after counties, cities, health care providers and private companies set up dozens of testing sites across the state, many more people were able to get tested more easily. The problem shifted to that of uneven distribution of testing.
Verily, a division of Google’s parent company Alphabet, is operating the two new Santa Clara County sites. They can only expand testing there if enough people show up to the sites to get tested, and the county can justify investing more resources to expand testing, officials said.
“We will increase our capability as the demand increases,” Fenstersheib said. “We want to get the demand going so people get out there and get tested.”