Will California vaccine ramp-up squeeze out COVID-19 testing?



California Gov. Gavin Newsom, below rising stress to jump-start a faltering COVID-19 vaccine rollout, jetted to Los Angeles on Jan. 15 to unveil an enormous new vaccination website at Dodger Stadium that’s anticipated ultimately to inoculate 12,000 individuals a day.

Town-run venue had been the most important COVID testing website within the U.S., administering greater than 1 million checks in its almost eight months of operation — and over 10,000 a day through the current surge. Its redeployment to the reason for vaccination, Newsom declared, offers “a unprecedented world-class website for a world-class logistics operation.”

That effort got here with a trade-off: When the town of Los Angeles ended COVID checks at Dodger Stadium and closed one other testing website to help staff the new vaccination center, it eliminated, at the very least briefly, about one-third of all government-run testing in Los Angeles County — the nation’s largest county, with a inhabitants of 10 million, and one of many greatest COVID scorching spots.

Websites operated by the town, county or state account for simply over one-third of all COVID checks in L.A. County, stated Dr. Clemens Hong, who heads the county’s testing operations.

Diminished testing capability may result in longer waits for appointments, which implies contaminated individuals may doubtlessly expose others for an extended time earlier than studying they’ve the virus.

However L.A. Mayor Eric Garcetti stated that has not occurred thus far. In what he referred to as an occasion of “good timing,” an infection charges in L.A. County have declined since Dodger Stadium switched to vaccinations, and demand for checks has dropped by half to two-thirds, the mayor stated Thursday. “We’re assembly the necessity — truly exceeding the necessity.”

Nonetheless, he acknowledged that changing the stadium had been a threat — one the town took as a result of “the vaccines will forestall and heal and at last resolve this.”

Many well being consultants agree that prioritizing vaccination over testing is the suitable transfer.

“One of the simplest ways out of our present disaster is masks, few contacts per day and vaccines, so it is sensible to create tons extra entry factors for vaccinations even when it means a bit much less testing,” stated Dr. Bob Kocher, a senior fellow at USC’s Schaeffer Heart for Well being Coverage & Economics and a former member of the state’s COVID-19 Testing Task Force.

However with COVID caseloads nonetheless excessive regardless of their current decline from peak ranges, and mutant strains of the virus threatening to gas new outbreaks, some senior public well being officers say testing stays an equally very important a part of the trouble to comprise — and finally suppress — the pandemic.

And it may grow to be much more essential within the coming months, because the inoculation marketing campaign beneficial properties steam, for the reason that checks may show a beneficial device for assessing how properly the vaccines are working.

“It’s onerous to say proper now, given how many individuals are sick with COVID, that vaccine is extra essential,” Hong stated. “It’s onerous to steadiness these two towards one another, as a result of we actually simply want plenty of each.”

Balancing vaccinations with testing and different COVID-related duties is a big problem for public well being officers throughout California and the nation, as a result of these capabilities draw on most of the similar sources — particularly the employees wanted for administration and record-keeping.

At vaccination websites, preserving good information is crucial for planning from daily what number of doses to drag out of the freezer.

“It’s bought to be executed proper, or else you screw up when the second dose is,” stated Dr. George Rutherford, an epidemiologist at UC San Francisco.

Sara Bosse, public well being director of Madera County, famous that counties throughout the state have requested Newsom for $400 million within the present price range yr to assist defray the prices of organising vaccination websites, together with facility prices, safety, information entry staffers and clinicians to offer the photographs and look ahead to opposed negative effects. They’re additionally in search of $280 million for COVID testing and $440 million for contact tracing and non-group housing to guard COVID-vulnerable residents.

“I believe that many counties are prioritizing vaccination, and based mostly on the sources they’ve, they might pull from varied components of the COVID response akin to contact tracing or testing,” Bosse stated. The funding, she stated, would assist county well being officers keep away from “these troublesome selections the place now we have to drag from one a part of the COVID response to prop up the subsequent.”

There is also federal assistance on the best way: President Biden has introduced plans to ascertain 100 federally supported vaccination centers and allocate $50 billion to expand testing.

In Madera County, a poor rural space of 160,000 those that stretches from the Central Valley into the Sierra Nevada, the state has largely taken over COVID testing, permitting the county to focus its sources on vaccinations, Bosse stated.

The large problem on that entrance, she stated, is having sufficient skilled well being personnel to run the vaccination websites. The county lately heard from 85 skilled clinicians prepared to volunteer for the vaccine effort, “which goes to be a game-changer for us,” Bosse stated.

In Los Angeles, the town has the means so as to add testing capability elsewhere and beef up cell testing, Garcetti stated. It had been contemplating a testing website at Pierce School within the San Fernando Valley, “which it appears to be like like we received’t have to open,” the mayor stated.

Town, county and state are additionally discussing the opportunity of a partnership to broaden testing at Exposition Park in South L.A.

In San Diego County, well being officers count on to face a problem because of the competitors for staffing between vaccination and testing, and they’re hiring to fulfill the necessity, stated Sarah Sweeney, a spokeswoman for the county’s Well being and Human Companies Company. The county hasn’t but transformed testing venues to vaccination websites however expects to take action after vaccine provides enhance, she stated.

San Bernardino County well being officers are dedicated to sustaining testing at present volumes at the same time as they ramp up vaccinations, stated Corwin Porter, the director of public well being. However he conceded that doing each on the similar time “is a wrestle” as a result of “we don’t have sufficient vaccine and we don’t have sufficient employees.”

The county is holding hiring occasions each week and dealing with a number of companions to seek out further sources, “as a result of we try to not pull something out of testing or contact tracing,” Porter stated.

Past the useful resource query, one other huge problem confronts well being officers: “There is a matter of divided consideration,” stated L.A. County’s Hong. “Now now we have two huge issues to cope with — three for those who embody contact tracing. I believe we should be considerate about our technique.”

As soon as a broad swath of the inhabitants has been vaccinated, which may take many months, testing quantity will in all probability drop off sharply, stated UCSF’s Rutherford.

“I don’t see a whole lot of hundreds of checks a day anymore, as soon as we get properly up on vaccinations,” he stated. “You’ll be testing hundreds of individuals to seek out tens of instances.”

Within the meantime, L.A. County will in all probability add inquiries to its testing appointment web site asking individuals about their vaccination standing, Hong stated. “That means we are able to observe what’s occurring in people who find themselves vaccinated.”

Ongoing COVID outbreaks might require elevated testing, notably in poorer communities of coloration, which have been hit hardest by the pandemic — and the place hesitancy to be vaccinated is in all probability extra widespread, Hong stated. “So the underside line is that testing is just not going away.”

This story was produced by KHN (Kaiser Well being Information), which publishes California Healthline, an editorially unbiased service of the California Health Care Foundation. KHN is just not affiliated with Kaiser Permanente.