White House has a message for L.A.

CDC is asked to look into region’s spread of coronavirus, as feds imply city’s stay-home orders are unlawful.

Los Angeles Mayor Eric Garcetti sought to fend off criticism from federal officials Friday over his handling of coronavirus stay-athome orders, even as he announced the lifting of various restrictions over this Memorial Day weekend.

Earlier in the day, the White House’s coronavirus response coordinator singled out Los Angeles as one of three regions where persistent spread remains a significant concern as the holiday weekend posed another test of whether the novel coronavirus can be slowed even with loosened stay-at-home rules.

Then, the U.S. Department of Justice sent a warning letter to the mayor saying it was concerned the city was pursuing “an arbitrary and heavy-handed approach” to stay-at-home orders.

Eric S. Dreiband, assistant attorney general for the department’s Civil Rights Division, pointed to what he said were public comments by Garcetti and Barbara Ferrer, Los Angeles County’s director of public health, suggesting that stay-athome orders could be extended several months.

“Reports of your recent public statements indicate that you suggested the possibility of long-term lockdown of the residents in the city and county of Los Angeles, regardless of the legal justification for such restrictions,” Dreiband wrote. “Any such approach may be both arbitrary and unlawful.”

Garcetti responded at an evening press conference, saying, “Look, we’re not guided by politics in this, we are guided by science. We are guided by collaboration. So talking to industry and talking to business owners and talking to employees

County facilities, health officials announced a new plan to test everyone in an effort to turn the tide.

The point of testing everyone is to catch people who are infected but show no symptoms — including employees, who often work at multiple nursing homes and could spread the disease from facility to facility.

But as of Monday, county officials had managed to test everyone at only 141 skilled nursing facilities, health officials acknowledged.

That’s about a third of the nearly 400 facilities in the county.

All of the facilities where everyone has been tested have had outbreaks, according to county officials.

Facilities with no known cases of COVID-19 have been instructed to test 10% of residents every week, in the hope that will be sufficient to catch and control an outbreak before it gets out of hand.

“I think this was a wise move. It really was meant to allow us to do as much as possible as quickly as possible,” county health director Barbara Ferrer said at her daily briefing Thursday. She added that everybody would be tested at any nursing home if a case turned up in the sample.

Ferrer promised the first round of universal testing would be complete at homes with known outbreaks by next week.

Wasserman, who is also medical director at a nursing home in Reseda, said the new approach doesn’t make sense.

“Let’s say you have 100 people in a facility and you test everyone and find that five are positive. Well, you can do something about that,” Wasserman said. Residents would get quarantined, and employees would get sent home or assigned to work only with residents who have also tested positive.

But if you test only a small sample of residents and don’t bother to test staff, you are bound to miss positive cases, Wasserman said. Staff members with the virus will “keep coming to work and you are going to have a big outbreak on your hands,” Wasserman said.

Charlene Harrington, a professor emeritus at UC San Francisco’s School of Nursing who has studied nursing homes since the 1980s, said: “It is not good just to test those where there is an outbreak because it is too late by then — the virus will have spread throughout the facility.”

The county “needs to mandate testing twice a week in all homes that don’t have the outbreak, too, in order to isolate the employees and residents before it spreads.”

It’s not clear why the county changed its approach. Experts say fear of bad publicity and the cost of the tests could have been factors.

The first round of testing all staff and residents is being conducted by the county at no cost to the nursing homes, according to the letter. The facilities were advised to contract with commercial laboratories for ongoing testing — presumably at the nursing home’s expense.

That’s a concern for facility owners. Tests cost about $150 each, according to a recent estimate by American Health Care Assn., which represents nursing homes. It would cost $36 million to test more than 240,000 nursing home residents and staff in California, the group said.

Dr. Manuel Eskildsen, who teaches in the Division of Geriatrics at UCLA and works as a clinician for a network of nursing homes, said there has been noticeable progress in testing even in the last week.

Nursing home operators were initially concerned about the stigma of discovering a COVID-19 case and winding up on the county’s list of outbreaks.

A single, asymptomatic case could get a home branded as a COVID-19 facility, which upset family members and made employees anxious. It also hurt business. “I have one facility in mind that had a really tough time with referrals after they turned up four or five positives,” Eskildsen said.

That’s actually “a triumph,” Eskildsen said, because it allowed the home to isolate the cases and control what could have been a huge outbreak without the testing. “But they still had that whiff about them,” Eskildsen said, referring to potential negative publicity.

The hesitance of nursing home operators to perform testing, and of public health officials to demand it, has left advocates for the elderly pleading for swifter action.

“It’s disgraceful that the county would take a step backward on testing at a time when dozens of nursing home residents are dying from the coronavirus almost every day,” said Michael Connors, a spokesman for California Advocates for Nursing Home Reform. “Without universal testing, the virus will continue to rage through nursing facilities and kill many more residents.”

‘It is not good just to test those where there is an outbreak because it is too late by then — the virus will have spread.’ — Charlene Harrington, professor emeritus at UC San Francisco’s School of Nursing