California has received measured and cautiously optimistic praise in the past few days for starting to flatten the curve and thwart the spread of COVID-19, the novel coronavirus. However, the numbers of those infected tend to be deceptively low, not presenting a full picture of the viral spread, on account of insufficient testing statewide and elsewhere in the U.S.
Santa Clara County is no exception. Whereas countries like Germany and South Korea, along with the city of Hong Kong, managed to aggressively flatten their own curves and reduce fatalities through widespread early testing measures, the U.S. has lagged in regard to testing, clouding the numbers and costing lives. Testing is a critical treatment tool since the earlier somebody is diagnosed, the earlier they can be isolated and/or quarantined, as well as subject to treatment to curb a potentially worsening advance of symptoms. In the absence of testing, it’s hard to not only pinpoint where the virus is, but to know how much of it is circulating around us. Deficient testing also has the effect of inflating the known percentage of those who have died as a result of the virus, since in a low-testing environment we are most inclined to get data on people suffering the very worst of symptoms.
Here in Santa Clara County, with a population of 1.94 million people, the public health laboratory is limited in terms of its testing capacity, and has only been testing up to a maximum of 100 people per day for COVID-19.
As the County explains on its website: “Our local public health laboratory, like all public health laboratories, functions as a specialty reference laboratory and as a bridge laboratory to enable testing to occur while other laboratory sectors come on-line. The lab is not structured, physically and otherwise, to scale to commercial-volume testing. As a result, the current focus of the public health laboratory testing is to ensure that hospitalized patients get tested, as well as people who live or work in high risk settings such as long-term care facilities, healthcare professionals, and first responders, while we continue waiting for large-scale testing capacity to come on line through the commercial labs.”
The first-ever test performed inside the county by public officials happened just over a month ago, on February 26. In the meantime, although private companies carry out testing of their own, for the past few weeks only positive results were being reported to the government—to the County Public Health Department. This means we have been subsisting on an unclear sense of the amount of positive cases versus the amount of tests being done overall, though this is rapidly changing (see below).
In general, as indicated above, government-based COVID-19 testing is performed on those exhibiting severe illness and those working in frontline positions, such as in the healthcare profession, and interacting with patients and/or potential patients. As of March 22, Santa Clara officials themselves had only tested 647 individuals. County-based test results usually come back within 24 hours.
As of today, though, the overall picture is fuller. The county reports that 8,246 patients have been tested for COVID-19 through its own resources and by commercial and academic means. Of these Santa Clara County patients, 956 have tested positive. This means that approximately 11.59% of those tested were confirmed to be carrying the illness (it being noted that, with an average time of 2.52 days for results to come in, not all the tests carried out thus far have reached conclusions).
In the meantime, Verily Life Sciences, a research organization owned by Google parent company Alphabet, Inc., has quickly (starting on March 15) launched several area drive-thru testing sites, one of which is at the Santa Clara County Fairgrounds and another of which is at the San Mateo County Event Center. The testing is essentially invite-only; one must first take an online screener survey to learn of their eligibility. Following that, Verily will let them know if they’re eligible for testing, and if they are, direct them to a testing site. However, this research-intensive form of testing should not be confused with outright medical care. Verily’s activity is more devised to help develop a clearer view of the outbreak in California (having initiated its efforts in Santa Clara and San Mateo, followed by more recent expansions to Sacramento and Riverside). They are not focusing on patients with severe COVID-19 symptoms such as fever, cough, and shortness of breath.
In addition, Stanford University and Kaiser Permanente are carrying out drive-thru testing, as well, so long as patients are referred for it by their doctors. Patients exhibiting symptoms and subject to referral are set up for appointments at the drive-thrus. The drive-thru format, given its outdoor nature, is a critical way for the patients and workers involved to avoid viral exposure. The COVID-19 test consists of a swab that enters through the patient’s nose and gets pushed to the back of their throat, where it’s rotated for the collection of viral matter. The mouth is avoided as a port of entry to reduce the risk of false results or contamination.
A higher volume of testing is expected in the days to come.