Health Experts Cautiously Optimistic on California’s Reopening Plan

People sit on the sand in Huntington Beach, Calif., on April 26. (AP Photo/Marcio Jose Sanchez)

(CN) — Health experts told California lawmakers Wednesday the state is on track to test 80,000 residents daily for Covid-19 and deploy thousands of investigators to track viral spread but that supply shortages and inequitable access to testing has exposed problems in the pandemic response that must be addressed before flu season arrives.

The California Senate’s Special Committee on Pandemic Emergency Response is tasked with tracking the expansion to testing access and the distribution of supplies to health departments fighting the coronavirus outbreak.

Kiran Savage-Sangwan, director of the California Pan-Ethnic Health Network, told lawmakers the state is falling short of its goal to provide equitable access to testing.

“California is currently not collecting racial and ethnic data in its testing process,” Savage-Sangwan said. “This leaves a hole in our understanding of who’s impacted.”

As the state increases the number of test sites, it needs to remove barriers to testing that make access difficult for vulnerable populations such as low-income and undocumented residents.

A committee report released prior to the hearing acknowledged the health disparities – including the higher rates of death in Latinos, blacks, Native Hawaiians and Pacific Islanders – but said the state is collecting racial and ethnic data in testing.

“Data on infection rates, hospitalizations and deaths is being collected and reported in California by race and ethnicity,” the report said. “However, there are other demographic categories who are believed to be impacted by health disparities, such as the LGBTQ community and for whom, we are not currently collecting and reporting data.”

Madera County Public Health director Sara Bosse told lawmakers the state’s rural counties face shortages in staff and other resources for executing public health measures.

“In California’s small rural counties, it’s not easy to get rapid testing machines, which is a prerequisite to reopening and relaxing restrictions,” Bosse said. “We need the support of the state. We need to put locally flexible measures in place to protect against the next health threat.”

California health officials announced Wednesday 58,815 residents have tested positive for Covid-19 and 2,412 have died from the respiratory disease.

Rates of new infections have stabilized while hospitalizations and ICU admittance fell in the last 24 hours, according to state health data.

California Gov. Gavin Newsom has said reopening state parks and beaches and kick starting economic activity will take place in phases and will be based on guidance from public health officials.

Remain-at-home orders and restrictions on large gatherings will be lifted as the state deploys contact tracers, or workers who investigate the spread of the respiratory disease by tracking contacts of people who’ve tested positive for the virus.

Newsom said Wednesday the state has hired approximately 10,000 people for contact tracing and plans to employ at least 20,000 total by June.

California Department of Public Health official Susan Fanelli told committee members the state currently has 800 contact tracers and will eventually redirect 10,000 state employees to train for the effort.

Fanelli said contact tracers will be trained in health care privacy and cultural competency and must demonstrate a general understanding about public health before they’re deployed.

“Contact tracing is about building quick relationships with someone so you can gain info you need, explain why you need it, how you will keep their information private and how to protect yourself and your family so we can mitigate the spread of this disease,” said Fanelli, CDPH chief deputy director of policy and programs.

Committee co-chair Senator Patricia Bates, R-Laguna Niguel, said lawmakers will need assurances their privacy rights won’t be violated by any digital apps that help contact tracers track cases and contact residents.

Fanelli told Bates the apps don’t track individuals’ movement and that privacy rights are part of the state’s strategy on contact tracing.

“The apps we want to use are for data management and the private information is left to local contact tracers doing outreach,” Fanelli said. “Protecting everyone’s privacy is in all of our interest. We are not looking at how people are moving as in the Google apps.”

Senator Hannah-Beth Jackson, D-Santa Barbara, asked whether health experts agreed that the state should dive into phase two of its reopening plan given the issues with testing access and supply.

“How is it that with the number of tests and the delay with [test] results we feel we can move toward containment?” Jackson asked.

Charity Dean, CDPH assistant director, said at the hearing the state is on track to ramp up daily testing to 80,000 but that reliable stream of critical supplies and capacity issues have hampered efforts.

“There have been challenges in the supply chain,” Dean said, adding that testing sites lack enough cartridges for testing machines and the proper quantity of specimen collection kits.

Alan Wu, San Francisco General Hospital chief of clinical chemistry and toxicology, told the committee his hospital is short on its supply of special swabs used for antibody testing.

Wu said an Abbott Laboratories testing device in the hospital can only accept samples collected with swabs manufactured by Abbott.

“We need to set aside supplies in case of a second wave, even if it means not all people who want to get tested and know the result can’t know,” Wu said.

While state and local government have embraced antibody testing as a prerequisite for softening of remain-in-place policies, Dean told lawmakers health officials are “cautiously optimistic” about leaning too heavily on the serological tests.

“We don’t know if the antibodies provide immunity to reinfection,” Dean said. “We don’t know how sensitive or specific the tests are. They’re good at telling you the prevalence of infection, or how many people were infected at some point. But they’re not good at diagnosing individual immunity.”

Dean said California has administered at least 50,000 serological tests and will eclipse 80,000 tests soon.

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