Image from the CDC.
Shasta County Health and Human Services Public Health Department offers live press briefings that occur 11 a.m Monday, Wednesday and Friday and can be found on their Facebook and YouTube pages. Their COVID-19 specific site, Shasta Ready, addresses the concerns of medical providers and ordinary citizens with resources, prevention tips, and FAQs, as well as a place to report stay-at-home violations.
Regarding COVID-19 testing in Shasta County, the Shasta Ready site reports that medical providers collaborate with the public health department, which will decide if someone needs the test, and that public health follows CDC guidelines to decide who gets tested.
Shasta County Health and Human Services advises medical providers to collect specimens from individuals who meet the CDC’s Tier 1 criteria for COVID-19 testing. Tier 1 includes people who are both symptomatic and either hospitalized, or have had exposure to a confirmed COVID-19 patient, or are an individual living in a congregate living facility, such as a jail, homeless shelter, or long-term care facility.
In other words, to meet CDC Tier 1 criteria, which Shasta County is currently using, a person would have to be both symptomatic and fall into one of the categories above. A SCHHS spokesperson said that private labs can test people in the CDC’s Tier 2 criteria, which includes those above age 65 with significant underlying medical conditions, or anyone a medical provider thinks needs to be tested.
CDC’s Tier 1 testing is already a fairly restrictive metric. But according to the public health department, testing is now even more restricted, not due not to the county’s lack of COVID-19 test kits, but to its lack of the related extraction kits, which allow them to prep the specimen for testing. During the Shasta County HHSA’s April 1 press conference , Dr. Karen Ramstrom, Shasta County Health Officer, said that the county has a very limited number of these extraction kits left.
Exactly how many more patients does Shasta County have the capacity to test? “After today, somewhere in the mid-forties,” she said. That was four days ago.
According to Ramstrom, the county is urgently waiting for additional extraction kits that were expected to have been delivered last week. While they are hopeful more will be delivered in the next few weeks, Ramstrom said she knows Shasta County is in competition for these kits with other counties, some of which have already run out of test kits.
This means that despite the public health department’s March 31 announcement of confirmed community transmission of COVID-19 in Shasta County, local testing for the disease will not be expanding. Ramstrom explained that with so few remaining tests available, those tests are being saved for the highest priority cases, such as a symptomatic individual from a congregate facility like the jail.
Going forward
Shasta County is not alone. Nationwide, because of the lack of test kits, counties lack the ability to stop or slow the pandemic through broad testing. But it’s not the only constraint to stopping the disease. Recently released research indicates that one in four cases of COVID-19 are asymptomatic, meaning that unless everyone is tested, it’s impossible to effectively isolate everyone who’s contagious. Additionally, according to research coming out of China , the false negative rate for COVID-19 testing may be as high as 30 percent, meaning three out out of 10 people who are actually sick with the virus might test negative.
Given the north state’s limited COVID-19 testing capacity, and the possibility of a false negative, even for those who are tested, combined with the likelihood of an asymptomatic infection, the way forward is clear: Shelter in place, wash hands often, and practice good self-care.
