Orange County supervisors are as eager as any other California officials to relax quarantine restrictions during the COVID-19 pandemic, but in their discussion of the issue Tuesday they made it clear to county staff that ramping up testing will be key.
So far, just 14,977 people have been tested by public and commercial laboratories in Orange County for the coronavirus, 0.47% of Orange County’s 3.2 million population.
David Souleles, a deputy director of the OC Health Care Agency, told supervisors his agency has been struggling with the same problem of scant testing materials that other laboratories across the nation have wrestled with since the coronavirus arrived in the U.S.
The swabs used for polymerase chain reaction tests are in low supply nationally, Souleles said.
Supervisor Don Wagner compared the death rates of the 1918 flu pandemic with coronaviruses SARS and MERS and COVID-19 and said it appears this most recent version of coronaviruses is “less deadly than other modern coronavrisues, so that raises in my mind the question of this exit strategy” of the governor’s.
On Tuesday, Gov. Gavin Newsom outlined what benchmarks the state must meet to begin relaxing his stay-at-home order with testing to help determine who still needs quarantining as a key element.
“You’re the health professional here,” Wagner said to Souleles.
“How will we know when this is over and can in fact lighten those admittedly very draconian regulations we have proposed in the face of a disease that according to your own report pales in comparison to even… SARS and MERS rates?”
Souleles said lifting the state’s restrictions suddenly would likely lead to an “unchecked surge of infections that would overwhelm our hospital system.”
Health officials must do “contact tracing of individuals,” so schools, businesses and other organizations may resume operations with safe social distancing, Souleles added.
“Rather than a light switch, which says on a particular day we go back to pre-COVID activity levels,” Souleles said the plan would involve “backing out over time and slowly lifting restrictions.”
When Wagner asked if warmer weather will help quell the virus, Souleles said, “We’re still learning about that.”
Health officials must focus on getting plans in place to handle a potential second wave before lifting restrictions, Souleles said.
Testing of as many people as possible will help stop the spread of the virus, much like what health officials do to stem a tide of measles, Souleles said.
“I know everyone wants to get back to normal sooner than later, but I think we can take some lessons learned from some of the other countries that have been through the coronavirus crisis and lifted restrictions and now they have a surge of reinfection within their populations,” Supervisor Lisa Bartlett said.
“So I think we need to proceed with caution… We don’t want to infect those that aren’t infected, and we don’t want to overwhelm our healthcare system as well.”
Bartlett advocated for a “ramp-up of testing.”
Bartlett said serological testing, which measures antibodies for the coronavirus developed after they’ve overcome the disease, will help with future quarantining.
“It would be nice to know how large that population is, because they may be more immune at this point,” Bartlett said.
Souleles said the county is “looking at the role that the antibody tests can play.”
The Food and Drug Administration has approved one test.
Antibody tests can show what herd immunity is within the population, but, he added, “as this is a novel virus we are still learning about what kind of immunities our own systems can put upon us once we have been infected. Some viruses we get immunity for life from, but others for a short period of time, and others for a longer period of time.”
Doctors prefer the polymerase chain reaction test, because it involves an extraction of a specimen from a patient and can more accurately diagnose COVID-19.
Supervisor Andrew Do questioned why the county’s health lab isn’t using other types of PCR tests that are available.
Souleles said the various tests require materials that are in short supply.
“There is another PCR test coming online in the next few weeks that should have FDA approval that will run on another piece of equipment that we have in the lab,” Souleles said.
The federal government has “a four-page list of COVID-19” tests, Do questioned.
“Why are we limiting ourselves to just the few that you mentioned?” Do said. “When you look at other jurisdictions like L.A., they reported doing 6,000 tests in one day. We have done what — a total of 12,870 — in the last month and a half. I don’t understand if we are limited by the supplies that we have on hand, first, and why can’t we get more? How come other people can get more and why don’t we explore more tests?”
Souleles said the commercial laboratories are better situated to do mass testing with more frequency.
“The good news is that we’re hearing reports from all of the commercial laboratories about significant backlogs and delays in testing and most have been able to clear the backlogs that they had so they have the capacity to test if we can get samples in the laboratories for testing. We are looking at more drive-through testing sites,” Souleles said.
“We cannot move forward as a county and protect ourselves against the risk as you mentioned earlier of further infections and then of a resurgence of this virus without wider testing,” Do said.
Do asked county health officials to return to the board next week with a plan on increasing testing in the county.