The study that prompted the first county-wide shutdown in the U.S. (plus California’s testing backlog)



It was a bit surprising when a group of six counties in the Bay Area announced a “shelter in place” order back on March 16. Santa Clara county in particular was the first to do so in the nation. Today the San Francisco Chronicle describes the small study of just a couple hundred people that prompted the Santa Clara order:

The county identified its first likely community-acquired case — meaning that the source of the individual’s infection could not be determined — on Feb. 27. More community cases were reported over the next few days, which prompted local, state and federal public health officials to start a study help define how widespread the virus was…

The Santa Clara County surveillance study was small and took place over a few days, from March 5 to March 14, due to the lack of testing supplies.

Overall, 226 patients were included in the study, all of them Santa Clara County residents from four urgent care centers where they had reported respiratory symptoms. Of those patients, 23% tested positive for the flu. A representative sample of the remaining patients were then tested for the coronavirus, and 11% of them — nine people — tested positive.

Nine people who had gone to urgent care with breathing problems and tested positive showed the virus was spreading and prompted a shutdown that impacted millions of people just two days after the study ended. The entire state of California followed three days later, becoming the first state to do so.

California has one of the highest number of cases of any state (11,277 as of today), but that’s still substantially lower than New York which surpassed 100,000 cases today. However, all is not well with the testing system in California. Nearly two-thirds of all tests, almost 60,000 of them, are still waiting to be processed by a lab:

About 92,500 tests had been conducted in California as of Wednesday, according to the state Department of Public Health. Roughly 33,000 results have been received and 59,500 are pending — 64%. Although only four other states report their backlogs — Florida, New Hampshire, Hawaii and Nebraska — the next worst on the list, Florida, has only 1,280 pending results, or 1.6% of tests conducted…

Part of the backlog appears to be tied to one major commercial lab, Quest Diagnostics, which is struggling to process an influx of tests quickly. The company said Wednesday it has 12 labs with 115,000 tests pending — including tests from around the country. Quest declined to say how many of those are California tests.

CNN reported yesterday that the backlog at Quest is actually down from a high of 160,000 which existed late last month.

New Jersey-based Quest Diagnostics had about 160,000 coronavirus test orders waiting to be processed on March 25, which amounted to about half of the 320,000 total orders for the tests the company had received up to that date, according to Quest internal materials obtained by CNN…

A spokesperson for Quest, Wendy Bost, told CNN the backlog for coronavirus tests has begun to shrink in recent days as the company has expanded its capacity, which now amounts to more than 30,000 tests a day and an average turnaround time of four to five days.

“Much of the backlog was due to huge demand in the early days of testing when we were primarily offering a lab-developed test we developed at a single laboratory,” Bost said. “In recent days, our capacity has exceeded our demand, allowing us to reduce the backlog.”

Gov. Newsom announced a new task force on testing Thursday which he promised would deliver “best in class” testing in the state. But for now, California is stuck waiting for the backlog to shrink.





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