Santa Clara County revises COVID-19 testing health order

COVID-19 testing requirements are changing in Santa Clara County, but not drastically.

On Monday, county officials announced changes to an ongoing health order allowing health care providers to use antigen testing instead of just PCR testing, and shifting the responsibility of testing and vaccinations back to providers instead of the county.

“The update doesn’t make radical changes,” County Counsel James Williams said. “It does, however, bring the order up to date with what we know about COVID testing.”

Under this health order, health care providers will be required to provide testing, PCR or antigen, to those who have symptoms or exposure to COVID, instead of just those who are considered essential workers. Providers are required to provide testing for those recommended or required to get tested within 24 hours of a request.

Since the pandemic’s start, the county has led in testing efforts, opening multiple sites around Santa Clara County. When COVID infections started to dwindle and the need for mass vaccine sites lessened, the county closed some and shifted to smaller clinics. Private providers helped fill the gaps and were required to provide testing for essential workers. However, the latest surge in omicron cases inundated both county and private testing sites, with many waiting hours to get tested. The county has since made efforts to provide more at-home test kits to residents.

The order outlines recommendations on which test to use. For example, it’s recommended to use antigen and not PCR testing to end isolation early, Williams said. The PCR test is preferred, because it detects RNA—genetic material—specific to the virus within days of infection. Turnaround time, however, can range from 24 hours to three days, due to demand. An antigen home test detects proteins specific to COVID. Results can be reported within 15 minutes and can be less accurate.

Health care providers are not allowed to defer patients to other health care systems or back to the county, but in order to meet the 24-hour deadline they can defer patients to another clinic or site operated by the same provider—as long as it’s in Santa Clara County or 10 miles from home.

Providers are required to return PCR results within 72 hours. If they cannot, they are required to provide an antigen test. If there are delays with results or testing availability, providers are required to inform the county. In addition, providers must update all patients of the new testing rights at their sites and via email, Williams said.

Two years of COVID

The health order changes come as Santa Clara County commemorates the two-year anniversary of its first COVID-19 infection.

Public Health Officer Dr. Sara Cody took time to recognize what the county has lost, learned and gained from the last two years. There have been more than 275,000 COVID infections and more than 2,000 deaths in the county since March 2020.

“Our rates of deaths by COVID are lower than other places in the country,” Cody said. “Nevertheless, it is difficult for me and all of us to imagine that we’ve lost so many people from this pandemic in our community.”

Cody said residents have endured five waves of COVID, with a myriad of fluctuations in things like mask mandates and school and business closures.

The latest surge sparked by the omicron variant is nearing its end, Cody said, as cases are on a downward slope with just under 12% of those tested for COVID getting a positive result—down from 17% at its peak. The seven-day rolling average of new reported infections is 3,312, down from higher numbers in recent weeks.

In addition, 83% of all county residents fully are inoculated. Among those eligible for the booster, 64% have their third shot, Cody said.

Santa Clara County can start preparing for the long-term plans of living with COVID, Cody said, which is why the county updated its health order around testing. It essentially allows health care providers and residents to prepare for the transition in which most vaccinations and testing will be done primarily where people receive most of their medical treatment.

There is no timeline yet for when and if county-run testing sites and clinics will close, but Cody said residents can expect  changes within the next few months.

“The county’s role will over time transition back to our traditional role, which is ensuring access and removing barriers for people who are the most vulnerable in our community,” Cody said.

Contact Jana Kadah at [email protected] or @Jana_Kadah on Twitter.