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Orange County Coronavirus

Orange County Continues to Face Shortages of Coronavirus Tests and Contact Tracing

JULIE LEOPO, Voice of OC

Signs outside a coronavirus testing site in Garden Grove on May 18, 2020.

By Nick Gerda Nick Gerda | July 14, 2020
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Months into the coronavirus pandemic, Orange County is among many regions facing shortages of two key components to slowing the virus’ spread – testing and contact tracing – with some residents having to wait more than a week to get tested and results often taking several more days to come in.


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When it comes to contact tracing, the County of Orange is way behind, with fewer than half the contact tracers recommended by state health officials.

When the county applied to the state in May to re-open more types of businesses, county officials attested to having enough contact tracers. The application said there should be at least 15 contact tracers per 100,000 residents, which for a county of OC’s size is 480 contact tracing staff.

As of Friday, Orange County had fewer than 185 contact tracers, officials said, with not enough resources to contact everyone who tests positive.

Orange County Health Care Agency officials acknowledged the challenge and said they’re doing their best with the resources they have.

“The number of staff doing [contact tracing] work and the number of cases investigated varies day to day. The OC Health Care Agency (HCA) has approximately 185 staff working nearly full time on COVID-19 activities and those resources are used to meet the most pressing needs for public health response first (i.e. Skilled Nursing Facility outbreaks) and staff shift from one activity to another to make the best use of available resources at all times,” said the county’s  acting director of public health services, Marc Meulman, in a written response to questions.

“Given the high volume of cases and public health activities more critical than [contact tracing], there are not adequate resources to make contact with all cases. We monitor cases regularly to adjust priorities as disease transmission shifts.”

Over the past decade, Orange County supervisors have cut nearly $20 million in unrestricted tax dollars from the county Health Care Agency’s budget while more than doubling such spending on the Sheriff’s Department, mostly for pay raises for deputies whose union is the supervisors’ largest campaign spender.

On testing, officials said the wait at some test sites is more than a week, with some labs having backlogs of more than a week as well in processing tests.

“We are aware that it is taking more than a week to get an appointment at some test sites and that many of the major labs are backed up over a week as well,” Muelman said.

“Demand outstrips the capacity of the entire system both in-terms of appointments and lab processing time due to increases in disease, requirements for testing from employers, increased unnecessary exposures due to loosening of social restrictions and personal behavior.”

In one sign of the growing community spread of coronavirus, more people are now getting tested but the share of OC residents testing positive has doubled from 7 percent to 14 percent in the last month.

With testing capturing only a small share of actual infections, contact tracing is less effective, according to county health officials, who are urging the public to help slow the spread by practicing physical distancing and wear face coverings to help slow the spread.

“The Centers for Disease Control and Prevention now estimates that for every confirmed case, there are 10 that are not confirmed. [Contact tracing] can help slow the spread; however, when only fewer than 10% of cases are diagnosed and for the remaining there is no ability to follow-up, even [contact tracing] at its best cannot slow transmission enough,” Meulman said.

“In addition to the small fraction of cases that are confirmed, other factors such as testing delays and reporting delays limits how effective [contact tracing] interventions can be,” he added.

“Because of this reality, it is critical that all members of the community practice behaviors that prevent transmission including staying home as much as possible, especially when sick, isolating when infected, quarantining if exposed, social distancing, wearing face coverings, washing hands frequently, and disinfecting frequently touched surfaces.”

Andrew Noymer, an epidemiologist at UC Irvine, credited the county for being transparent about the challenge with testing and contact tracing, which many communities outside Orange County are facing as well.

“That’s a candid acknowledgement of how hard contact tracing is when we’re in that sort of context, of 1,000 [new] cases a day. Contact tracing is difficult…in an expanding epidemic. And it’s good to see their candor, because I think honesty is the best policy,” Noymer said.

“I do support them trying to get the resources so that they can try to turn that around” through expanding access to testing and contact tracing, he said.

“The whole idea of this thing is to basically try to slow things down until we get to a vaccine, or until we get to herd immunity,” said Dr. Thomas Cesario, an infectious disease doctor and former dean of the UC Irvine School of Medicine.

“And so what we’re trying to do is contain the rapidity with which it spreads. And the way to do that is…to try to make sure that we get people who have the disease away from others whom they’re likely to spread it to. so by identifying people [through testing who have coronavirus], contact tracing them, and putting them in isolation, the intention is to keep infected people out of circulation and hence prevent them from [infecting] others, which of course slows the rate” of the spread.

Testing and contact tracing are each “one more weapon in the battle…that we use to slow this [disease spread] down,” Cesario added, saying they’re among the “foundations” of public health.

Test results for hospital patients generally have a turnaround time within 24 hours, with an initial test result back in a couple of hours, he said. But for people who aren’t hospitalized, it can be a several-day wait before the next appointment and it’s not uncommon for it to take another four or five days for results come back, Cesario said.

Meanwhile, Orange County continues to not disclose which workplaces have had coronavirus outbreaks, while that info is available in neighboring Los Angeles County.

School officials like Mike Matsuda, superintendent of the Anaheim Union High School District, have been calling for more testing and contact tracing to help prevent outbreaks in local communities.

Asked if there’s a need for more capacity on testing and contact tracing, Matsuda said, “Yes. with capital letters.”

He credited the county for partnering with the nonprofit Latino Health Access to add 500 daily tests at two sites in the hard-hit communities of Anaheim and Santa Ana, which filled up quickly. But more is needed, he said.

Dr. Daniel Chow, an assistant professor at UC Irvine, also noted the increasing delays in test results being reported, making it tougher to determine where outbreaks are happening.

“When you have these kinds of lags, it makes it more difficult to do contact tracing, because right away you wanna call that person,” Chow said. “They may have exposed other people three or four days ago.”

Spencer Custodio contributed reporting to this article.

How can I sign up for a vaccine?

For full details on the COVID-19 vaccine in Orange County view our Voice of OC vaccine page that is constantly updated and has links of where to register for an appointment: http://bit.ly/occovidvaccine.

What is COVID-19? Do I have it?

INFORMATION View the CDC website. View OC's website. View the latest OC case counts.

TRANSLATIONS See the county's guides in non-English languages. Learn key Coronavirus facts in Vietnamese and Spanish via VietRise. See VietRISE guides in Spanish and Vietnamese.

PROTECTION To limit exposure, the CDC recommends: wash your hands often, avoid close contact with others, cover your mouth and nose with a cloth mask when around others, cover coughs and sneezes, clean and disinfect frequently touched surfaces.

SYMPTOMS The CDC identifies these key symptoms that can occur any time between 2 and 14 days after exposure: Fever or chills, cough and shortness of breath or difficulty breathing, fatigue, muscle or body aches,  headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting or diarrhea. If you suspect Coronavirus, CALL your primary medical provider.

EMERGENCY SYMPTOMS If you display any of the following emergency warning signs, seek immediate medical attention: difficulty breathing or shortness of breath, persistent pain or pressure in the chest, new confusion or inability to arouse, or bluish lips or face.

RISK The CDC identifies people most at risk for serious illness: Older adults, and people who have serious chronic medical conditions such as heart disease, diabetes and lung disease.

What is open?

RESIDENTS The County of Orange offers a list of notices and news on what guidance is given for families and persons.

SCHOOLS The latest information for the county is available from the Orange County Board of Education.

STATE GUIDE TO WHAT IS OPEN A full list of statewide guidelines for what is open and what is closed.

SOCIAL DISTANCING Staying away from other people is called "social distancing." The aim is to SLOW the spread of Coronavirus so as to not overwhelm the nation's health care systems and so that people in need can get help. The Washington Post explains: "The spread (of COVID-19) can be slowed, public health professionals say, if people practice "social distancing" by avoiding public spaces and generally limiting their movement."

What support is available?

STRESS & ANXIETY Stress and anxiety can be triggered by the situation and resources are available to help from the Anxiety and Depression Association of America and from the American Psychology Association. Concern over this new virus can make children and families anxious, here are tips on talking with children about COVID-19.

MENTAL HEALTH The County of Orange offers a list of available mental health support services.

FIRST RESPONDERS The County of Orange offers these support services for first responders and health care workers.

BUSINESSES & ORGANIZATIONS The County of Orange offers a list of up-to-date guidelines for business and faith-based/community organizations.

FOOD ASSISTANCE Voice of OC offers a weekly list of available food pantries in Orange County. You can also apply for food benefits over the phone through the CalFresh program at 800-281-9799 or online.

PUBLIC TRANSPORTATION Buses and trains still offer service, but routes have been reduced so make sure to check your route ahead of time.

HOMELESSNESS The County of Orange offers a list of available shelter beds and other resources.

GENERAL FINANCIAL HELP Here are some services:

  •   • Find information on unemployment and disability benefits.
  •   • The Orange County Social Services Agency, despite closing its lobby, is processing online filings for assistance programs. This includes emergency cash assistance for immediate needs like rent or medical bills. The phone line has averaged a 30 minute wait time and offers a callback service, but people are encouraged to apply for benefits online.
  •   • Residents can apply for any of these programs by calling 800-281-9799.

RESTAURANT OWNERS & EMPLOYEES You can find a detailed list of resources available to restaurant owners and employees

How can I help?

VOLUNTEERING A statewide guide offers examples of ways to volunteer safely during Coronavirus. Options include, but are not limited to: donating plasma, making cloth face masks and supporting local food banks. Orange County's Second Harvest Food Bank lists support options online.

DONATIONS An Orange County Community Resilience Fund has been started through the OC Community Foundation to raise money for local nonprofits and volunteer organizations.

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SUBTOPICS:
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  • contact tracing
  • coronavirus testing
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