Coronavirus Surge Prompts California Health Leaders To Reevaluate Who Should Get A Test

California has significantly ramped up its COVID-19 testing capacity in recent months, but state officials on Tuesday announced new priority “tiers” to focus testing toward certain groups as some communities hit supply constraints. 

The new guidance harkens back to the early days of the pandemic when limited test kits were strictly reserved for people exhibiting coronavirus symptoms or those who had been exposed to someone who had tested positive. 

No more getting a test just because you want one, it seems. The new guidelines prioritize testing for certain groups: 

1. Hospitalized patients with COVID-19 symptoms, close contacts of people who have tested positive and people who may be linked to outbreaks.
2. All other people with symptoms as well as asymptomatic people who are in high-risk situations, such as health care workers, nursing home residents, correctional facility inmates and workers, or patients being screened for surgery.
3. Other frontline workers in grocery stores, manufacturing, agriculture, child care and public transit. 
4. All other people without symptoms. According to the guidelines, people in this tier will be able to get tested when turnaround for test results is under 48 hours.

The new guidelines also direct labs to prioritize processing tests for those groups.

California’s testing capacity was slow to ramp up, but eventually the state met and began to exceed Gov. Gavin Newsom’s initial goal of 60,000-80,000 tests per day. On Tuesday, the state was averaging more than 107,000 daily tests over a two-week period.

The move represents a more targeted testing approach, which some experts — including UC Davis Health CEO Dr. David Lubarsky — have been calling for. 

“We're testing a lot of the ‘worried-well,’” Lubarsky said. “What we really need to be doing is focusing our testing on those people who really need it first and foremost.” That includes first responders, health care workers, grocery clerks and other essential workers who spend a significant amount of time in public.

A scattershot approach to testing and backlogs piling up at private labs have left some people waiting more than a week for results, “squandering” those tests, Lubarsky said. 

“We really, really need to just rethink entirely what we're doing, not only in the state of California, but in the United States of America,” he said. “We need a focus testing strategy that makes the best use of our current supplies.”

California Health and Human Services Secretary Dr. Mark Ghaly also announced an effort to shift more testing into the health care system by reimbursing insurers and health providers for the cost of tests, which he estimates hovers “just over $100 per test.”

Ghaly hopes that in turn will free up space for underserved communities at the state’s free testing sites.

“That will support a broader set of people having access to testing when they’re symptomatic, when they’ve been exposed [and] when they’ve been at risk of being part of an outbreak,” he said.  
The state is still working to further expand its testing capacity, Ghaly said. He announced two new co-chairs of California’s testing task force: Dr. Gilbert Chavez, the former state epidemiologist, and Dr. Bechera Choucair, chief health officer for Kaiser Permanente.