San Francisco Chronicle - (Sunday)
S.F., as precaution, contracts for another year of virus tests
San Francisco has approved a contract of up to $52 million for coronavirus testing through March 2022 — preparing for the need for detection even after mass vaccination.
As the world fixates on vaccines, public health officials stress that tests are still critical as people continue to contract and die from COVID19. Demand for testing in California dropped as cases plummeted after the winter surge, but some officials worry the decrease is also because of “pandemic fatigue,” leading to more testing availability than demand.
Making sure the city has the resources to test for the virus for the next year doesn’t necessarily mean the pandemic won’t subside. But it acknowledges the likelihood that the coronavirus will stick around to some degree — whether because of vaccine hesitancy, variants, longer waits for children to get vaccinated or the unknown about how long immunity lasts.
“Testing continues to play a central role in the COVID response,” said Dr. Naveena Bobba, deputy director of health at the San Francisco Department of Public Health. “There’s so much uncertainty with this pandemic, we just
want to make sure we’re prepared.”
Moving forward, testing will be important to diagnose remaining cases and target outbreaks as the prevalence of the virus wanes. In the Bay Area, tests are already used to let passengers flying to Hawaii skip a mandatory quarantine and could be used more widely as travel destinations and entertainment venues open.
The Board of Supervisors approved the contract last week with Burlingame firm Color Health, which has provided testing to the city since April 2020. The agreement allows the city to spend up to $52 million, which could be less if demand decreases because of mass vaccination. It also includes the option to extend the contract for two more years, but that would require future approval.
Dr. John Swartzberg, UC Berkeley infectious disease specialist, guessed that “a year from now we’re going to be in much, much better shape,” but the need for testing will remain.
“This virus isn’t going to go away. It’s going to be with us at a level that we can manage and have a normal life again,” he said.
Infectious disease epidemiologist George Lemp said the city is “hedging its bets” with the contract. He predicted the pandemic would last in California for only six more months because of the speed of vaccinations despite “small stubborn outbreaks and cases hanging around.”
Dr. Robert Siegel, Stanford University immunologist, pointed out that “testing is really important even when the prevalence is low.”
Recently, Bay Area cases leveled off after a precipitous drop, worrying some.
“It’s looking more and more like we’re going to have another swell of cases,” Swartzberg said. “We need to do more testing.”
Over the past year, 1.7 million tests have been conducted in San Francisco, 43% of them at city sites. Under the city contract, Color Health can conduct 3,000 tests a day.
Color Health charges the health department $75 per test collected at Embarcadero and Alemany farmers’ market sites and $81 at mobile clinics. Color Health gets reimbursed by insurance companies, retains a 7.5% billing fee and credits the rest back to the health department, which processes the tests.
The city expects $35 million of the contract will be reimbursed by the Federal Emergency Management Agency. The city’s general fund will pay for the remaining $17 million.
Color Health, which also partners with the state health department for school testing, processes tens of thousands of tests a day for the city, state, employers and universities. In Marin County, Color Health runs a statefunded lab, while the county has a contract for testing with Curative through the end of the year. If cases continue to plateau or even increase, Health Officer Matt Willis said the county will promote testing even more.
“It’s critical to us to identify where are those pockets of transmission and where are those outbreaks occurring,” he said.