California public health officials announced late Wednesday another major expansion of coronavirus testing, recommending that all people in high-risk settings, including grocery store employees, bus drivers and law enforcement officers, join the ranks of a broadening group of candidates to receive routine screenings for the virus.
Such workers, considered "essential" even amid the shutdown, continue to come into regular contact with the public and, therefore, should be given priority access to testing, even if they don't show symptoms, according to the new guidance by the state Department of Public Health.
The latest change to the state's testing guidelines signals growing confidence among officials that testing capacity at laboratories is increasing enough to handle a bigger share of the state's population.
County officials use their discretion to set restrictions on who can be tested. When a region's testing capacity is limited, the state guidance serves as an advisory tool for deciding which residents to prioritize.
The state's latest announcement follows last week's move to open up priority testing to asymptomatic people who live or work in nursing homes or prisons.
Officials say that monitoring infections of essential workers to prevent the spread of the disease is another step toward lifting stay-at-home orders and reopening the economy. If the state can provide routine testing and timely results for this group, it could provide a model for how to expand testing to California's other industries as asymptomatic people return to workplaces in the future.
"The first step in modifying the stay-at-home order and strengthening the economy is to put in place widespread testing, and the first group you'd want to have access to it is essential workers," said Dr. Bob Kocher, a member of Gov. Gavin Newsom's task force on testing.
"Conceptually, people who have lots and lots of contacts are able to be screened. And we want those people to be tested often," he added. "You want to find out if they're sick before they have symptoms and unknowingly spread it to other people."
The state's new recommendations reflect an overall increase in testing capacity. Major labs have reported sufficient supplies to run more procedures, the public health department said, and the state has averaged more than 20,000 tests per day for the past several days. But asked how many essential workers are active in the state and would presumably need testing, the public health department said it "does not have that information."
Low-risk people who have coronavirus symptoms also remain low on the testing priority list for now.
Adherence to the state's recommendations varies by county. In some areas, such as L.A. County, health clinics and labs appear well-equipped to handle more testing candidates. There, all county residents can get a free swab test, L.A. Mayor Eric Garcetti said Wednesday.
But in other areas, like Bakersfield or Fresno, testing sites can require a long commute. Newsom's team released a state diagram showing testing deserts in parts of the Central Valley and along the borders with Nevada and Oregon, as well as dense urban regions that house large numbers of minorities.
To address the discrepancies, he announced six new testing sites prioritizing "black and brown communities and focusing on rural communities," About 80 others are expected to follow by early May.
In a message to health departments and medical workers, the state health department acknowledged that health officers in some rural regions and high-density neighborhoods may not yet have the infrastructure and supplies to lift local restrictions. Officials said the department's prioritization guidelines should be used "when testing availability is limited" and that the policy "should not supersede the recommendations of a clinician or local health officer."
Eventually, officials said, widespread testing will help public health officials closely track potential cases, one of the essential requirements for California to ease into the next phase of the pandemic response. Such tracking will require an army of at least 10,000 contact tracers, Newsom said.
But the governor has repeatedly emphasized a long, methodical road ahead before easing social restrictions, saying that the spread of the virus will ultimately decide what happens next.
"Politics will not drive our decision-making. Protests won't drive our decision-making. Political pressure will not drive our decision-making," he said in a Tuesday briefing. "Dates don't. But data does."
