MAY 4 — Marin has rolled out its first free coronavirus testing clinic in San Rafael’s Canal area, one of 80 state-funded sites aimed at increasing testing in underserved communities, while a New Jersey-based lab with offices in Strawberry is now offering antibody testing for about $130.
Meanwhile, California Gov. Gavin Newsom said this week the state’s stay-at-home rules will begin to relax on May 8, but state health officials separately clarified the final stage of the order won’t be lifted until a vaccine is in place — which could take 12-18 months. At the same time, a Center for Infectious Disease Research and Policy report issued last week suggested global herd immunity won’t be reached for 18-24 months.
The global COVID-19 case total surpassed 3 million last week, the U.S. total passed 1 million and California’s total passed 50,000, while global deaths passed 200,000 and California deaths passed 2,000.
Marin: 240 confirmed cases, 13 deaths, per the Marin Department of Health and Human Services as of May 3. Up from 224 cases, 12 death the previous week.
California: 54,937 confirmed cases, 2,254 deaths, per the California Department of Public Health as of May 3. Up from 43,464 cases, 1,755 deaths the previous week.
U.S.: 1,152,372 cases, 67,456 deaths, per the U.S. Centers for Disease Control and Prevention as of 1 p.m. May 4. Up from 957,875 cases and 53,922 deaths the previous week.
World: 3,435,894 cases and 239,604 deaths, per the World Health Organization as of 1 a.m. May 4. Up from 2,878,196 cases and 198,668 deaths the previous week.
Four stages to reopen state
As Marin County public-health officials joined others from around the Bay Area to extend the regional shelter-in-place order through the end of May, Newsom on May 4 announced California will separately begin to enter the next phase of relaxed state rules within days and “will allow retail to start operating across the spectrum.”
Newsom said the rules will be gradual and only apply to certain industries, including bookstores, clothing shops, florists and sporting-goods stores, but no shopping malls.
However, the Bay Area’s shelter-in-place order runs through May 31 and, at least for now, remains more strict than the state rules to be introduced.
Of Newsom’s four stages, California is currently in Stage 1, he said, with the state building testing and contact tracing while preparing for a potential hospital surge.
In addition to some retail, Stage 2 would allow schools, summer programs, child-care facilities and low-risk outdoor businesses to reopen with modifications, similar to the loosening of rules seen in Marin beginning this week. Some retail could reopen with curbside pickup, along with manufacturing and offices where telework isn’t possible, plus more open spaces.
Newsom last week suggested schools may need to start sooner — in July or August — to make up for lost learning, though that announcement took many school districts by surprise. Some superintendents have said the opposite, that they may push the start of school later to give students the best chance at normalcy.
Getting to the second stage has required stabilizing hospitalization trends and preparedness for a hospital surge, with sufficient testing capacity and contact tracing.
Stage 3 would allow for the reopening of higher-risk environments, such as hair and nail salons and gyms, movie theaters, sports without in-person audiences and religious services like churches and weddings.
Only once “therapeutics” have been developed to treat patients infected with coronavirus will California enter Stage 4, the end of the shelter order and the resumption of mass gatherings, such as concerts, live sports and conventions.
“Therapeutics” does not necessarily mean a vaccine, which experts say is still 12-18 months away. However, the director of the state’s Department of Public Health later said the order will only be fully lifted once a vaccine has been developed.
That news came as the Center for Infectious Disease Research and Policy at the University of Minnesota issued a report April 30 suggesting the COVID-19 outbreak won’t end until 60-70 percent of the global population is immune, which could take 18-24 months. The researchers’ worst-case scenario predicts a second, larger wave of infections this fall and winter.
Marin Recovers business strategy
County Administrator Matthew Hymel last week announced the creation of Marin Recovers, an industry-advisers group that will bring together leaders from across 11 business sectors with members of government and public-health officials to develop standards to safely get back to work.
Hymel said the advisers will include representatives of “restaurants, retail, construction, parks and outdoor activities, general office space, summer camp and youth opportunities, transportation, hotels/motels, as well as personal services.”
“The goal of this effort is to inform how will these industries modify activity over time to reduce the risk of COVID-19, and so that we can provide guidance to those industries as they get into a position to reopen, and so they can plan for the future months ahead,” Hymel told the Marin Board of Supervisors at its April 28 meeting.
He said the county will create a website with more information in the coming weeks.
Community testing in San Rafael
One of California’s 80 new state-funded community testing sites targeting underserved communities will be set up in San Rafael’s Canal area and will offer free testing by appointment.
While the site will serve all Marin County residents, priority will be given to essential workers, those experiencing COVID-19 symptoms and Canal residents. Multilingual staff are also available to help with booking and testing.
“The state is making good on the promise to support our testing capacity,” Willis said in a May 1 press release. “This site will help reach residents who’ve had limited access to health care and COVID-19 tests up until now. We need to match any changes to our shelter-in-place order with the ability to widely test. This is an important step in that direction.”
The site will have the ability to test 132 people per day, which would nearly double Marin’s current capacity of 150 tests per day. Willis has said the goal is to test 500 people per day across the county.
To date, the county has tested about 3,900 of its roughly 250,000 residents, or about 1.5 percent of all residents.
To schedule an appointment at the San Rafael facility, visit lhi.care/covidtesting.
Quest labs rolls out antibody testing
Quest Diagnostics, which has a location at 23 Reed Blvd. in Strawberry, last week announced “consumer initiated” antibody testing for all for $129 after fees.
The blood-draw antibody test intends to show who has been exposed to the coronavirus and recovered from an infection, potentially indicating who has immunity and can return to normal life and work. However, more than 150 antibody tests have hit the market under loosened FDA emergency-use authorizations, and they have varying degrees of accuracy. At the same time, it’s still unclear whether or how long those with antibodies will have enough effective antibodies to fight off reinfection.
The WHO does not yet recommend the results of antibody tests dictate public-health policies or guide individual behavior, a sentiment echoed by Willis, Marin’s public-health officer — though experts agree it’s likely the tests will eventually be critical to ending the pandemic-related shutdowns. For now, the tests appear to be best used as data points to better understanding of the virus and of test results.
Quest’s Quest Direct service allows patients to answer a series of questions online before scheduling an in-person test. Those interested must not have experienced symptoms for at least 10 days, must wear a face covering at the testing site and must pass a no-contact temperature check. Results are posted online in two to three days.
The test is based on those from Abbott and Euroimmun, the former of which has received emergency-use authorization from the FDA while the latter is in the process; the authorization does not require FDA verification or certification of the test’s accuracy.
Abbott claims its test has a 100-percent sensitivity, or no false negatives, and a 99.5 percent specificity, or few false positives. Euroimmun was not as forthcoming with its data, but Quest said it reports 98.5-99 percent specificity; Quest did not indicate the Euroimmun test’s sensitivity. All values are self-reported and have not been independently verified.
To sign up for the Quest Direct service, visit questdirect.questdiagnostics.com.
• Marin health officials announced last week that none of the 1,845 tests administered in Bolinas returned positive for an active coronavirus infection. In a privately funded study in cooperation with the University of California at San Francisco, all Bolinas residents were offered both the swab test for an active infection and the finger-prick serology test for antibodies; the antibody results are not yet available. Willis warned that as the swab test only tested for active infections, it doesn’t indicate people won’t be infected in the future.
• In his report to the Marin Board of Supervisors April 28, Willis said he hopes to build his corps of contact-tracing investigators from 30 to 50 by the end of May. Willis said the investigators are necessary to contact people who have tested positive for COVID-19, persuade them to self-isolate and then trace their whereabouts and contacts over the previous several weeks.
• The Board of Supervisors on April 28 approved $5.9 million in additional funding for the county’s Emergency Operations Center, bringing the total to $7.9 million. Of the new allocation, $3 million is for the setup and operation of an alternative-care site to address a potential outbreak in a residential care or skilled nursing facility; the site would house up to 25 patients for two months. Marin has seen 31 patients and 25 staff test positive at such facilities, or roughly a quarter of all of Marin’s cases. At The Ark’s press time there was actively only one positive patient and one positive staff.
• California legislators last week unanimously passed two bills worth $1.1 billion to help the state address the coronavirus. One bill set aside $100 million to help schools play for cleaning. The larger bill immediately gives Newsom considerable leeway in granting access to $500 billion — and potentially $500 billion more — for any funding related to California’s state of emergency.
• Newsom on April 30 announced a new web portal, mychildcare.ca.gov, that seeks to connect parents to “safe, reliable and accessible child-care options.” Parents and caregivers can enter their location to call up a list of local providers that includes health and safety information, age of children accepted, capacity, availability, hours and contact information.
• A federal trial of a drug touted for treating COVID-19 had moderate results that led the FDA to issue a temporary emergency use authorization. A National Institute of Allergy and Infectious Diseases-sponsored trial of 1,063 patients were given remdesivir or a placebo. Recovery time averaged 11 days with the drug, 15 days with the placebo, and no statistically significant difference in the number of deaths. The study has not been peer-reviewed.
Kevin Hessel is The Ark’s executive editor. Reach him at 415-435-2652, on Twitter at @thearknewspaper and on Facebook at fb.me/thearknewspaper.