The testing paradox

Rebecca Neipp

News Review Staff Writer

The testing paradoxCounties that report dramatic increases in positivity rates for COVID-19 infection are subject to closures and restrictions in order to help contain outbreaks. But new guidelines for screening, in light of a nationwide shortage of test kits, mean that only those presenting symptoms will qualify for prioritized testing.

“That is going to be a major challenge in improving our statistics if we are only testing symptomatic patients,” said Ridgecrest Regional Hospital CEO Jim Suver. “When we had our free drive-through clinics, we generated a lot of negative test results.

“Under the new guidelines, it could create a false increase in our positivity rate that is not really reflective of our population.”

The paradox is just one of the many challenges community leaders are facing in their attempts to help restore operations and services that have been compromised by COVID-19 outbreaks and precautions.

Toward the beginning of the crisis, the hospital was struggling to capture an appropriate sample size to provide insight into our positive cases and risks of infection. In May, the hospital partnered with Kern County to provide free drive-through testing that allowed individuals to be tested with no screening criteria.

The hospital quickly went from less than 300 tests to more than 3,000 (including some 2,400 from the free clinic). At press time, 82 results had come back positive, with 465 results still pending.

The data proved useful in clearing travelers and other individuals to return to work, and also helped manage some of the outbreaks that cropped up in organizations whose employees had come into contact with known carriers.

In early July, the high demand for processing across the state had stretched wait for results to as long as 16 days. At the same time, test kits among hospitals and clinics were beginning to dwindle.

Last week, Gov. Gavin Newsom worked with the state department of public health to revise testing guidelines to prioritize residents and staff of nursing homes and patients who presented symptoms for COVID-19.

Suver noted that one positive outcome of this is that the hospital has subsequently been able to work through some of its growing backlog of test samples, and that turnaround for results is back down to 3-4 days.

The drawback is that RRH is down to an extremely limited supply of test kits, as well as the reagents that can be analyzed by in-house testing equipment.

“So we are prioritizing in-patient and emergency-room cases, and for that we have an adequate supply,” he said.

“But the services we were able to provide with the drive-through clinics, which helped our workforce return to their jobs, are no longer possible.”

Suver also commented that he believes the community can manage to safely return to most normal operations — so long as masks, distancing and other common-sense precautions are upheld.

“We are completely different from the Bakersfield community. But the reality is that we had increased numbers in Kern County because of noncompliance — there is no way around that conclusion.”

So far, Ridgecrest has not seen the tax on hospital capacity the way West Kern communities have, he said.

“I am also very supportive of getting our kids back into a regular school program, and will do everything I can to support Superintendent Ostash’s efforts on that,” said Suver.

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The hospital is anticipating their testing supply to be replenished Aug. 10. Hopefully, said Suver, that will help facilitate a safe return to schools once Kern County campuses have been cleared to reopen.

Pictured: Estefania Castro, RRH medical lab assistant, with a biofire machine, used for limited processing. — Photo by Laura Austin

Story First Published: 2020-07-24