New guidance on where, when and how to get tests

As daily COVID-19 cases soar and tests remain in short supply, Santa Clara County health officials Friday issued new guidance on when and where residents should seek a test and what kind.

For starters, the officials emphasized that patients of private health care providers like Kaiser Permanente or Palo Alto Medical Foundation should get tested through them instead of the county Public Health Department.

A county health order issued in September 2020 requires large health care providers to have tests available for patients who either show symptoms or have been exposed to someone with COVID-19 within 24 hours of inquiring. However, some patients are reporting that testing appointments are taking longer than a week.

County Counsel James Williams

said his department is prepared to start fining private providers who do not step up and wants patients to report difficulties in obtaining tests to scccovidconcerns.org.

“The data is pretty clear that the large systems are not proportionately providing the testing,” Williams said, “but we really need individual information from folks who are having challenges.”

According to its data, the health department typically serves about 15% of the county’s residents but has been conducting more than 20% of the COVID-19 tests countywide. In contrast, Kaiser serves about 30% of the county’s population but has conducted only 12% of tests, and the Palo Alto Medical Foundation serves 16.5% but has performed only 2.4% of the tests, Williams said.

A spokesperson for Sutter Health, which Palo Alto Medical Foundation is a part of, said in a

written statement that the provider doubled its testing capacity over the past three weeks in an effort to meet the increased demand but acknowledged that appointments still were limited.

“We really do need all of the large health care systems in the county to do their part so the burden isn’t solely on the county,” Williams said.

In a statement Friday afternoon, Kaiser said it was “baffled” by the county’s suggestion that it was holding back.

“We object to any suggestion that our front-line health care workers are not doing their fair share,” the statement read. “The last 24 months of this pandemic have been an incredibly challenging and stressful time to work on the front lines of health care. And yet our staff and physicians continue to show their commitment to providing care and service, every day. Their work right now and throughout the COVID-19 pandemic has been nothing

short of inspiring.”

Santa Clara County is not the only public health department applying the heat after almost two years of shouldering a disproportionate share of testing and vaccination efforts.

San Francisco public health officials earlier this week demanded that private health care providers in the city submit weekly proof that they are providing testing appointments within 24 hours and results within 48 hours for 90% of their patients who have symptoms or were exposed to someone with the virus. San Francisco’s order applies to urgent care clinics, offices, acute care hospitals and medical groups with at least 100 doctors, nurses or other medical staffers.

“It’s not about punishments; it’s about doing their part,” San Francisco Mayor London Breed said during a Wednesday news briefing.

In Alameda County, public health officials are also urging those with medical insurance to contact their doctor or healthcare provider for testing before turning to county clinics.

“We call for support and expansion from pharmacies,

private providers or labs, doctors’ offices, and health care systems across Alameda County while our community sites remain focused on free, low barrier testing in priority neighborhoods most impacted by COVID-19,” Alameda County Public Health Department spokesperson Neetu Balram wrote in an emailed statement Friday.

As for when individuals should get tested, Santa Clara County Health Officer Sara Cody provided some new guidelines Friday in hopes of clearing up confusion.

Both PCR tests and athome antigen tests can be used to determine whether someone has contracted the virus.

Those who test positive through an at-home test should consider those results valid and not seek a follow-up PCR test at a health care or county facility, according to Cody.

At-home antigen tests, rather than PCR tests, should be used for purposes of shortening isolation or quarantine periods for those who have tested positive or been exposed to

a person with COVID-19, Cody said.

People who have tested positive within the past 90 days should not get tested again during that time frame unless they have new symptoms. In that case, they should use an antigen test rather than a PCR test, Cody said.

With COVID-19 tests so hard to get, Cody said it’s even more important to

“double down” on the other layers of prevention, such as isolating if showing symptoms or having been exposed, avoiding large events and wearing masks in public.

“If you have symptoms of COVID, isolate yourself right away,” she said. “We know how prevalent COVID is, so that’s the most important step you can take.”

And for those who might consider going to an emergency room to get tested, Cody pleaded against that, saying it’s solely for those who need emergency care.

The county’s new guidelines follow the framework released by the federal Centers of Disease Control and Prevention earlier this week.

The CDC guidelines recommend that people get a COVID-19 test when they’re experiencing symptoms of the virus or five days after a known close contact with someone who has tested positive, even if you’re not experiencing symptoms. The agency does not say a negative COVID-19 test is necessary to end an isolation period.