Hospital patients prioritized for COVID testing over essential workers in new California guidelines

Hospitalized people with COVID-19 symptoms will be the first priority for testing under new California guidelines released Tuesday, followed by medical workers in the second tier and teachers and service workers in the third.

The new priority system comes as the state experiences a dramatic rise in coronavirus cases and the state runs low on testing supplies, causing bottlenecks for testing and forcing people to wait longer for results, California Health and Human Services Secretary Dr. Mark Ghaly said.

Under the new guidelines, hospitalized patients and people who have been in close contact with someone who has tested positive will be in the top tier.

Other people with COVID-19 symptoms and workers in group living facilities like homeless shelters, nursing homes and jails will be in the next tier, along with medical workers. Teachers, service workers and food industry workers are in the third tier, while everyone else is in the fourth, according to the guidelines.

The tiers will guide not only who is prioritized for testing, but also whose test results are processed fastest by labs, Ghaly said.

Earlier this month, the Department of Public Health said commercial labs were “becoming overwhelmed with large volumes of specimens, slowing down processing timelines” across the country. As a result, some people who suspected they had COVID-19 were waiting more than a week for results.

The new guidance is part of an overhaul of the state’s testing strategy, which includes a revamped testing task force that will now be led by Kaiser Permanente senior vice president Dr. Bechara Choucair and California Department of Public Health official Dr. Gil Chavez.

They replace Blue Shield CEO Paul Markovich and Dr. Charity Dean, former assistant director of the state Department of Public Health, who stepped down earlier this month.

In the first iteration of the testing task force, nearly half of the leadership positions were filled with executives from insurance company Blue Shield. Beyond the new co-chairs, Ghaly did not say how else the composition of the task force will change.

Ghaly credited the original task force with increasing testing dramatically to a current average of about 105,000 tests per day. The task force expanded testing in part by ensuring that essential supplies like cotton swabs and vials were distributed to the testing sites that needed them, but Ghaly said supply of some of those essential materials is again running low.

Choucair and Chavez’s testing and public health expertise makes them “perfectly suited” to expand testing for vulnerable populations and address supply shortages.

“Our recent surge in cases makes it clear a lot more needs to be done to protect our communities from this unprecedented pandemic, and this requires us to stay on top of emerging trends, evolving science,” Choucair said during the press conference. “A cornerstone of our work going forward must be ensuring that testing is available, testing is affordable, testing is equitable and is reliable.”

Chavez, who serves as deputy director of CDPH’s Center for Infectious Diseases, said testing has been a critical component of the responses he helped develop in other outbreaks, including SARS, H1N1, Zika and Ebola.

“It’s very clear that for us to be effective, we have to have a robust testing system,” he said.

This story was originally published July 14, 2020 at 4:39 PM.