While coronavirus testing continuing to be in short supply statewide, Orange County has reported numbers that appear to put it significantly behind its southern neighbor.

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As of Tuesday evening, OC reported about 3,500 tests per million residents, while San Diego County has reported about 6,000, and Los Angeles County about 5,000. Other California counties, like Santa Clara County, also have reported more than 5,000 tests per million residents.

San Diego County, in particular, has a similar population size to Orange County – with about 4 percent more residents than OC – while reporting about 80 percent more COVID tests (20,336 versus 11,307, as of Tuesday evening).

In an interview, Orange County’s director public health services cautioned San Diego County’s numbers could be higher because of cruise passengers and crew that disembarked at San Diego’s port. Another reason they could be higher is San Diego County’s testing totals include residents and non-residents, while OC only includes residents in its total, he said.

“I think what’s important to focus on here…is that there is not enough testing capacity here in Orange County [and statewide],” said David Souleles, OC’s director of public health services, in the interview Tuesday with Voice of OC.

He noted Gov. Gavin Newsom announced over the weekend he was convening a statewide task force to get more testing rolled out more quickly, with a goal of five-fold increase in testing by the end of the month.

“There is a lack of widespread testing availability. There has been a relatively small number of test runs statewide, and county by county, to really meet the demand of the moment,” Souleles said.

But San Diego County says “almost all” of their 20,336 reported tests were from county residents and less than 100 were from cruise ships.

“The only cruise ship testing in our numbers are the symptomatic crew still on board. (less than 100 at best),” said Michael Workman, San Diego County’s communications director, in an email response Wednesday to Voice of OC.

“To be clear, the people who disembarked here and flew home were NOT tested,” he added.

Asked how many of the 20,336 total tests are of San Diego County residents, Workman said: “Almost all. We dropped the out of towners a few weeks ago. The only exception are crew in port on the ships,” which he said are fewer than 100.

Other counties apparently have moved to make testing accessible in ways it currently is not in Orange County.

On Tuesday, officials announced that any LA County resident can now request to get tested if they want to, and can do so at one of 11 or more testing sites throughout the county.

Such open access to testing is not known to be available in OC, where individual doctors decide who should get tested. Orange County generally focuses testing on people who are seriously ill, health care workers, first responders, and people in congregate living situations like skilled nursing facilities.

Overall, about 0.3 percent of all people in Orange County’s population have been tested for COVID-19, which is similar to the statewide rate. That’s about 1 in every 285 people have been tested in Orange County, as of Tuesday.

Because of the shortage in testing and supplies, officials say the actual number of people with COVID-19 in OC is almost certainly many times more than the 931 known cases as of Tuesday.

At a county supervisors’ meeting Tuesday and in the interview, Souleles said the bottleneck for testing in OC continues to be a shortage of supplies. He said officials stand ready to expand testing once more supplies are flowing in.

“Out goal, if commercial labs and the [Orange County] public health lab all had access to the testing kits, to the extraction kits, to the collection kits, swabs – everything we needed to do unlimited testing – we would be doing it today,” Souleles said in the interview.

“There are bigger supply chain issues than any one county can fix,” he added. “Hopefully the system gets fixed in a way that testing becomes available and it’s not the pinch point that it’s being right now.”

Public health authorities say testing is crucial to understanding the scale of the epidemic, and that for each positive COVID test in the U.S., it’s likely that many times more people have the contagious disease.

Between 25 percent and 50 percent of people with COVID are estimated to have no symptoms at all yet are still contagious, according to the nation’s top infectious disease expert. That high rate of being infectious without symptoms has been a driving factor between the recent guidance and orders for workers and others to wear face coverings in public and at essential businesses.

Most of the testing in the U.S. – and about 90 percent of the tests in Orange County – are done by private laboratories, mainly those run nationwide by Quest Diagnostics and Lab Corp.

About 800 new test results are being reported per day in Orange County. Of those, about 80 per day are being conducted by Orange County’s public health laboratory, with the rest performed by private labs.

In an effort to help with the testing shortage, OC officials said they tried to get approval for the county Crime Lab to do COVID tests. That request was rejected by the U.S. Food and Drug Administration, but the crime lab’s equipment could be useful for COVID testing at OC’s public health lab, Sheriff Don Barnes said Tuesday at the county Board of Supervisors meeting.

“Our [crime lab] scientists, and the devices they use, could be easily relocated to the public health lab and help bolster the numbers of [tests] that could be processed,” Sheriff Don Barnes said at Tuesday’s Board of Supervisors meeting. “They can do the COVID-19 [testing] with a little bit of novel training.”

Nick Gerda covers county government for Voice of OC. You can contact him at ngerda@voiceofoc.org.

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