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Free coronavirus testing to all in Los Angeles - Printable Version

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Free coronavirus testing to all in Los Angeles - BostonCard - 04-29-2020

https://www.latimes.com/california/story/2020-04-29/all-l-a-residents-can-how-get-coronavirus-test-garcetti-says

The point is to try to detect asymptomatic clusters to aid contact tracing.  Priority is still being given to those with symptoms and healthcare workers, but this is a good development (because it will enable contact tracing and because it means tests are finally available enough that they don't have to be limited).

BC

RE: Free coronavirus testing to all in Los Angeles - dabigv13 - 04-29-2020

This is great news. The more testing the better, full stop.

I am somewhat skeptical of the accuracy of the county run tests; they give a swab to the patient and tell them to rub it around their throat in their car themselves. Limits HCP exposure, not exactly the double nasopharyngeal/oropharyngeal swab technique that is recommended. I think the spit in a cup saliva testing may give better results with less false negatives.

Also, test result times from the county are decent now, 1 to 2 days for positive tests, 3 to 5 for negative. The person I know who had one had to wait 3 days, was negative.

RE: Free coronavirus testing to all in Los Angeles - M T - 04-30-2020

Promising 10M free tests might be as great as promising free lunches, but is this by 2023 or what?


Sounds like they're still not able to handle their current load:  "Public Health Department Director Barbara Ferrer announced 1,541 new confirmed COVID-19 cases, nearly 1,000 more than what was reported the previous day. The large increase is mostly the result of a boost in testing as well as a lag in weekend reporting,"

As of about a week ago (most recent full numbers), LA County has been testing up to about 5,000 per day.  At that rate, it will take 2000 days (5.5 years) to get through everyone once.  At their current COVID-19 death rate of 47 a day (over past week), .... well, you can do the math.

LA County reports 46% of its deaths are in institutional settings.  (SCC 46/107 = 43%)

RE: Free coronavirus testing to all in Los Angeles - Goose - 04-30-2020

(04-30-2020, 03:41 AM)M T Wrote:  Promising 10M free tests might be as great as promising free lunches, but is this by 2023 or what?Sounds like they're still not able to handle their current load:  "Public Health Department Director Barbara Ferrer announced 1,541 new confirmed COVID-19 cases, nearly 1,000 more than what was reported the previous day. The large increase is mostly the result of a boost in testing as well as a lag in weekend reporting,"

I really have no idea what the testing capacity available in Los Angeles county.  The delay through the system does not reflect necessarily on capacity. The "large" testing machines run batches of a thousand or so. Preparing the samples takes the most time. However, they don't want to run them half full so probably they queue up samples and do one run a day. If they had enough samples doing three runs a day would be easily possible. I have previously pointed out that University of Washington advertises a capacity of 3000 tests per day but has (at that date) never run anything close to capacity. So, what is the truth? Are they capacity limited or demand limited?
Quote:As of about a week ago (most recent full numbers), LA County has been testing up to about 5,000 per day.  At that rate, it will take 2000 days (5.5 years) to get through everyone once.  At their current COVID-19 death rate of 47 a day (over past week), .... well, you can do the math.
True. Offering more tests, in fact a lot more tests, seem to imply they think they can do well more than 5000 a day and just haven't been ask to do so.

RE: Free coronavirus testing to all in Los Angeles - Snorlax94 - 04-30-2020

(04-30-2020, 12:16 PM)Goose Wrote:  True. Offering more tests, in fact a lot more tests, seem to imply they think they can do well more than 5000 a day and just haven't been ask to do so.
This is what I imagine has been happening: First, the US had no tests. Then, the US had way too few tests, so they sort of covered this up and prioritized scarce resources by making the bar to get tested ridiculously high -- even if you were dying, if you hadn't recently flown back from Wuhan, you couldn't get tested. Even at the beginning of the lockdown, they still had few tests -- when my friend was ill in mid-to-late March in Santa Clara County, she could not get tested for flu-like symptoms. She had to beg because she had an elderly family member in her household, was rejected everywhere she tried, and finally someone suggested she try Stanford, and they could do it, so she got tested, and tested positive. Her workmate, who works next to her all day in the same indoor room, then requested a test. Despite being close to a known, confirmed positive, she was rejected everywhere. She finally tried Stanford, and after explaining her close contact with a confirmed case, was able to get a test (and tested negative). 

My sense is, now they're finally able to test more. Newsom's goal was 25,000 tests/day by the end of April and it looks like we've hit it. But he said the lab capacity, if every lab was perfectly maxed out every day, could process 95,000 tests day. But even 10 days ago, bottle neck was supplies, mostly swabs.

CA has now been getting more swabs with the help of the federal government. My sense is, everyone has been so conditioned that they can't get tested unless they're extremely ill that they have the reverse problem -- CA has the capacity to run more tests, and finally has supplies, and we could contain outbreaks better, but now people don't even try because they think it's futile. So some mayors encourage everyone with symptoms to get tested, still the numbers are low.

So now, LA is advertising that ANYONE can get tested. I don't think that's really the case. I looked at the signup website and everyone is put into priority buckets -- very ill, healthcare workers and first responders, people with symptoms, others. My guess is that they're just trying not to waste their total capacity -- if on a given day, there are so many very ill people and healthcare workers being tested, then no one else would get tested. But on another day, maybe a lot of capacity is going to waste, so why not process some people in the lowest priority bucket. 

All the buzz about the policy could encourage people with more mild symptoms to get tested. Maybe there is a spouse of a Costco clerk out there in LA who has mild cold-like symptoms, and this news could encourage them to go out and get tested when otherwise they might not.

RE: Free coronavirus testing to all in Los Angeles - Goose - 04-30-2020

(04-30-2020, 01:08 PM)Snorlax94 Wrote:  All the buzz about the policy could encourage people with more mild symptoms to get tested. Maybe there is a spouse of a Costco clerk out there in LA who has mild cold-like symptoms, and this news could encourage them to go out and get tested when otherwise they might not.

I basically agree with all you said. I would add that there was a period of time early on when there was probably adequate testing capability but the health care community wasn't really sure that was so and wanted to err on the side of caution. Also, in many cases it doesn't matter if a patient is positive, they have to be treated as if they are because even if they tested negative, you couldn't be sure they wouldn't go positive tomorrow. So, no benefit by testing, be conservative, don't do it.

The spouse of the Costco clerk above also has to weigh the practical benefit of being tested against the perceived danger of actually catching COVID-19 because you went out to be tested. I don't think many people who aren't very sick will bother to get tested unless they have a particularly vulnerable person in their household. No real benefit and their is some risk.

RE: Free coronavirus testing to all in Los Angeles - Farm93 - 04-30-2020

A person would have to weigh the benefit of the information against the logistics of getting tested and the possibility of get exposed to COVID19 at the test facility.   It would be great to know in case you were worried about exposing family members or perhaps you had interactions with a number of people in the days before symptoms.  

Hopefully LA county will be able to introduce a plan to start systematic testing of essential workers and announce the plans on contact tracing too.  Seems like LA county might start something like that in the next few days for nursing care facilities, which is helpful.

Since LA county is home to a large number of CA hospitalization and deaths, it will be hard for CA to move through the different restrictions stages unless LA is ready to test and trace.  So it is great news.  If feels a bit like the Pac-12's chances for football hinge on LA's COVID recovery, so anything on this topic is good for the citizens of CA and the fans of Pac-12 sports. 

I am personally more interested in antibody testing, so hopefully that will become available to the masses soon.

RE: Free coronavirus testing to all in Los Angeles - Goose - 04-30-2020

(04-30-2020, 03:41 PM)Farm93 Wrote:  Hopefully LA county will be able to introduce a plan to start systematic testing of essential workers and announce the plans on contact tracing too.

Contact tracing is a real key, because it can reduce R0 much better than anything else we have. I would really like all counties to report in on what they plan to do and when they can actually do it. If they have been sitting on their hands for the last 40 days, I will not be happy.

Regarding voluntary testing, there is another issue that we will have to face soon. People who test positive are going to be quarantined, period. They aren't going to work for at least a couple of weeks. All the members of their household will also be quarantined, even if they aren't sick (yet). That's how contact tracing works. Sadly, lots of people will try to avoid the quarantine, possibly by not getting tested even (or especially) when they believe it is probable they are positive.. Are we all ready for what it will take to make this approach work? It would be real nice if that dialog started sooner rather than later.

RE: Free coronavirus testing to all in Los Angeles - dabigv13 - 04-30-2020

Regarding risk of exposure at the test site, its basically nil. You drive up in your car, slide your window down part way, and they give you the swab to do and bag yourself.

RE: Free coronavirus testing to all in Los Angeles - BostonCard - 04-30-2020

The other potential big testing news is the devleopment of a rapid antigen test.  This is like the rapid flu test.

https://www.npr.org/sections/health-shots/2020/04/30/847416695/a-next-generation-coronavirus-test-raises-hopes-and-concerns

The upshot is that it will be able to give results in near real time.  So you can imagine a number of use cases, such as healthcare providers who may have been exposed.

The downside is that like the rapid strep test or the rapid flu test, a negative test wouldn't truly rule out COVID-19, especially in the presymptomatic period.  So my guess is that the use case is as a screening test where your prior probability of having COVID-19 is pretty low to begin with (no known exposures, no symptoms, no temperature, and a negative RAT means you can go to work).  On the other hand, if you have a high suspicion (symptoms or known contact), the test would only be useful to rule someone in, but would need to be confirmed with PCR if initially negative.

BC

RE: Free coronavirus testing to all in Los Angeles - Goose - 04-30-2020

(04-30-2020, 05:05 PM)dabigv13 Wrote:  Regarding risk of exposure at the test site, its basically nil. You drive up in your car, slide your window down part way, and they give you the swab to do and bag yourself.
I know that, you know that, but how others feel will be the issue.