Name: San Diego County dropped from state COVID-19 watchlist
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San Diego County dropped from state COVID-19 watchlist

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Copyright © 2022, The San Diego Union-Tribune | | AdvertisementAdvertisement As expected, state officials announced that they removed San Diego County from the state’s COVID-19 watchlist Tuesday, a move that was telegraphed one day earlier by local leaders.The action, which came as local doctors were adjusting to new testing guidance from the county, starts a 14-day countdown during which the region must avoid crossing any of six thresholds that, if they persisted for three days in a row, would land the region back on the list. Provided San Diego’s daily COVID-19 numbers remain below state-set maximums for two weeks, K-12 schools would be able to resume in-person instruction at the discretion of local school boards.But getting off the list does not mean businesses, churches and other organizations forced to operate outdoors for weeks can suddenly move back indoors. Additional state approval is necessary for an indoor migration, and so far, Sacramento has been silent on when it will give the go-ahead.State monitoring categories include: the average number of tests a region is able to perform per day, the case rate per 100,000 residents, the percentage of positive tests returned, significant changes in the number of hospitalized patients, the percentage of intensive care unit beds available and the percentage of mechanical ventilators available.AdvertisementThe only threshold the county has crossed so far is the state’s limit of no more than 100 cases per 100,000 residents, which, according to the state’s calculations, fell below the level of concern on Saturday.The number continued to fall in Tuesday’s regular COVID-19 tracking report, hitting 88.4 five points lower than the 89.8 calculated Monday.An additional 202 positive test results were added to the outbreak total Tuesday, and the region’s 14-day test positivity rate was 4.1 percent. After two days reporting no additional COVID-related deaths, the county reported seven Tuesday, bringing the total to 633. Two women and five men, all age 60 or older, were included in the total. They died between Aug. 14 and Aug. 16.San Diego is the second county in the state to be removed from the state’s watchlist, with Santa Cruz County leading the way late last week.Dr. Mark Ghaly, secretary of the state health and human services agency, said the two early exits have done well in controlling the spread of the virus by increasing the local use of face coverings, increasing disease investigation capacity and supporting people who are sick in order to help them isolate themselves from others.“Santa Cruz, San Diego, some others that are nearing coming off the county data monitoring list, they have likely been at some of these efforts potentially a little longer,” Ghaly said. “They have been able to work with skilled nursing facilities, jails and prisons and other congregate facilities, their essential workplaces in the agricultural and the textile and the poultry and meat packing areas, in different ways. So all of those strategies are additive and together can help a specific county improve its trajectory.”San Diego County is also working to fine-tune its local testing protocols.New COVID-19 released Monday by the county health department seek to help health care providers decide who should get tested and to prioritize which patients get tested first when shortages appear.The new set of tiered recommendations revise a dated Apr. 23. Top priority is still given to hospitalized patients, and “high risk” individuals with COVID-19 symptoms such as those who reside in congregate living facilities, seniors, those with underlying health conditions and people considered vulnerable due to challenges such as homelessness. Persons identified during public health investigations, especially outbreak investigations, also receive top priority for testing whether or not they have symptoms.A second tier includes people with symptoms, including health care workers and first responders, who are not members of a high risk group. Also in this tier are patients without symptoms checking in for hospital stays or for surgical procedures.The third tier includes people without symptoms who are in “high risk settings” such as employees of congregate living facilities, homeless shelters, substance abuse disorder residential facilities, correctional facilities and detention centers. Also at this level are close contacts of people who have tested positive but who exhibit no symptoms themselves.Asymptomatic health care workers are included in a fourth tier with priority given to health care workers and first responders, those in vulnerable populations, those in essential jobs, older adults, and caregivers of older adults with underlying medical problems.Health care workers with symptoms were previously listed in the top tier of priority in federal, state and local lists, but they have been moved down a notch to tier 2.Dr. Ghazala Sharieff, chief medical officer of clinical excellence and experience at Scripps Health, was involved in the working group that pulled together the new guidelines. She said Monday that moving health care workers down one spot made sense because anyone with symptoms is advised to call in sick and remain self isolated until their infection resolves.At times when there are not enough tests to go around, she said, it makes sense to prioritize on those who are at the highest risk of severe medical consequences.“Everybody is trying to focus testing on the categories that make the most sense, that will get the most immediate benefit,” Sharieff said.Dr. Jeannette L. Aldous, clinical director of infectious disease for San Ysidro Health, was also involved in the formation of the new guidelines and actually implemented similar prioritization for her own organization in early June.She said a more hard-and-fast priority list puts doctors on firmer ground when deciding who to order tests for and when. “We have needed testing guidance since the beginning,” Aldous said. “Even if you had infinite testing available, you still need to know when to use it.”Testing of the asymptomatic — those without symptoms who may have been exposed to the virus, or who might just be curious about their infection status — has been the grayest area for testing.The most tried-and-true novel coronavirus diagnostic works best between five and seven days after infection when the pathogen has had enough time to replicate itself in the body and develop a significant presence in the nose. Collect samples too early, and there is not enough virus yet present to make the test show positive, potentially missing an active infection.New guidelines emphasize waiting until five to seven days after the suspected exposure date before ordering a test for the best chances of accuracy. The “testing too early” problem, Aldous said, connects directly to quarantine, which is required of anyone who is exposed to a person who tests positive for the virus.In some cases, she said, a person will be advised to self quarantine for two weeks, but will immediately get tested. When the test comes back negative, some will assume they’re good to go and resume their normal activities. The new guidelines, Aldous said, can help doctors make sure that their patients self quarantine for the full two weeks.“If you get tested and it’s negative, it doesn’t mean you can’t get COVID the very next day,” Aldous said. “You still have to quarantine as directed for the entire period.”Recently, the nationwide health care system was forced to become more careful about testing the population often called the “worried well” after massive demand created shortages of supplies including the swabs, pipettes and chemicals used to collect and process samples. After waiting in long lines at drive-up testing centers, many anxiously waited for weeks for their results to arrive.On Monday, county health officials said that tests performed locally, either by hospital labs, county public health labs or by Helix, a local company contracted with the county to process up to 2,000 samples per day, have short turnarounds.From Aug. 9 through Aug. 15, said Dr. Wilma Wooten, the county’s public health officer, public health labs, Helix, and Family Health Centers of San Diego, the region’s largest community clinic network, are generally able to return results in a day or two with hospital labs able to get the work done in a day or less. Commercial labs, the doctor said, averaged between seven and 10 days.Wooten said the continued lag from commercial labs was vexing because it slows the pace of investigation. Case investigators don’t begin interviewing subjects until they know they have tested positive.Reached by email Tuesday for comment, representatives of Quest Diagnostics and LabCorp Inc., two of the largest testing firms used widely by San Diego health providers, said they have recently resolved testing delays.Quest said in a statement that its turnaround time is now down to 1 to 2 days but was higher than that through the end of last week due to the time it took to clear a backlog of specimens that built up when testing demand peaked. LabCorp, which said it has now performed more than 10 million COVID-19 tests, pegged its current average turnaround time at 1 to 3 days, though it added that results for some patients, such as those living or working in nursing homes, are given a higher priority. 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Copyright © 2022, The San Diego Union-Tribune | | AdvertisementAdvertisement As expected, state officials announced that they removed San Diego County from the state’s COVID-19 watchlist Tuesday, a move that was telegraphed one day earlier by local leaders.The action, which came as local doctors were adjusting to new testing guidance from the county, starts a 14-day countdown during which the region must avoid crossing any of six thresholds that, if they persisted for three days in a row, would land the region back on the list. Provided San Diego’s daily COVID-19 numbers remain below...

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San Diego County dropped from state COVID-19 watchlist

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