California Governor Gavin Newsom, under increasing pressure to launch a shaky COVID-19 vaccination of vaccines, sent to Los Angeles on January 15 to unveil a massive new vaccination site at Dodger Stadium that expected to eventually vaccinate 12,000 people a day.
The city was the largest COVID test site in the US and during its nearly eight months of operation, it administered more than 1 million tests – and more than 10,000 per day during the recent boom. Its redeployment to the cause of vaccination, Newsom explained, provides a world-class extraordinary site for a world-class logistics operation. ‘
The attempt comes with a compromise: when the city of Los Angeles ended COVID tests at Dodger Stadium and closed another test site to help the new vaccination center, it at least temporarily removed about one-third of all government enterprises. test in Los Angeles County – the country’s largest province, with a population of 10 million, and one of the largest COVID hotspots.
Sites operated by the city, county or state account for just over a third of all COVID tests in LA County, said Dr. Clemens Hong, who heads the province’s testing operations.
Reduced testing ability can lead to longer waits for appointments, which means that infected people may be exposed for longer before they learn they have the virus.
But LA Mayor Eric Garcetti said that has not happened so far. In what he calls an example of “perfect timing,” infection rates in LA County have declined since Dodger Stadium switched to vaccinations, and demand for tests has dropped by half to two-thirds, the mayor said Thursday. “We provide for the need – surpass the need.”
Yet he admits that the conversion of the stadium was a risk – one that the city took because ‘the vaccines will prevent and cure it and eventually resolve it’.
Many health experts agree that the right step is to prioritize vaccination over testing.
“The best way to get out of our current crisis is masks, little contact per day and vaccines. So it makes sense to create more access points for vaccinations, even if it means a little less testing,” said Dr. Bob Kocher, a senior fellow, said. at USC’s Schaeffer Center for Health Policy & Economics and a former member of the state’s COVID-19 Testing Task Force.
But with COVID effects still high despite their recent drop in peak levels and mutant strains of the virus threatening to provoke new outbreaks, some senior public health officials say testing is an equally important part of the pandemic effort to contain – and ultimately to suppress. .
And it could become even more important in the coming months as the vaccination campaign gets steamy, as the tests could be a valuable tool in determining how well the vaccines work.
“It’s hard to say now, given how many people are sick with COVID, that the vaccine is more important,” Hong said. “It’s hard to balance the two, because we just need a lot of both.”
Balancing vaccinations with testing and other COVID-related tasks is a major challenge for public health officials across California and the country, as these functions use many of the same resources – especially the staff needed for administration and record keeping.
On vaccination sites, good record keeping is essential to plan from day to day how many doses you should take out of the freezer.
“It has to be done right, otherwise you can get it right when the second dose is,” said dr. George Rutherford, an epidemiologist at UC San Francisco, said.
Sara Bosse, Madera County’s director of public health, noted that in the current fiscal year, provinces across the state of Newsom have asked for $ 400 million to cover the cost of setting up vaccination sites, including facility costs, security, staffing and import clinics. data, to help cover. give the shots and note adverse side effects. They are also seeking $ 280 million for COVID testing and $ 440 million for contact detection and non-group housing to protect COVID vulnerable residents.
“I think a lot of provinces prioritize vaccination, and based on the resources they have, they may come from different parts of the COVID response, such as contact detection or testing,” Bosse said. The funding, she said, would help avoid health officials in the province “the difficult decisions from which we must draw one part of the COVID response to advance the next.”
Federal aid could also be on the way: President Biden has announced plans to establish 100 federally supported vaccination centers and allocate $ 50 billion to extend the test.
In Madera County, a poor rural area of 160,000 people stretching from the Central Valley to the Sierra Nevada, the state has largely taken over COVID testing and enabled the province to focus its resources on vaccinations, Bosse said.
The big challenge at the front, she said, is to have enough trained health personnel to manage the vaccination sites. The province recently heard from 85 trained clinicians who are willing to volunteer for the vaccination, “which is going to be a game changer for us,” Bosse said.
In Los Angeles, the city has the means to add testing capability elsewhere and sharpen mobile testing, Garcetti said. The mayor has considered a test site at Pierce College in the San Fernando Valley, which does not seem to need to be opened.
The city, county and state are also discussing the possibility of a partnership to expand testing at Exposition Park in South LA
In San Diego County, health officials expect to face a challenge due to competition for staff between vaccinations and testing, and they hire to meet the need, said Sarah Sweeney, a spokeswoman for the health and safety agency. human services, said. The province has not yet converted test sites to vaccination sites, but expects to do so after the supply of vaccines increased, she said.
San Bernardino Province health officials are committed to maintaining testing at current volumes, even as they increase vaccinations, said Corwin Porter, the director of public health. But he conceded that it was a struggle to do both at the same time because “we do not have enough vaccine and not enough staff.”
The province holds rental events each week and works with multiple partners to find additional resources, “because we try not to pull anything out of the test or contact detection,” Porter said.
In addition to the question of resources, another major challenge faces health officials: “There’s an issue of divided attention,” LA County’s Hong said. ‘Now we have two big things to do – three if you include contact tracking. I think we will have to be considerate about our strategy. ”
After a broad section of the population is vaccinated, which can take many months, the test volume is likely to drop sharply, Rutherford of UCSF said.
“I do not see hundreds of thousands of tests a day once we get vaccinated,” he said. “You will test thousands of people to track down dozens of cases.”
In the meantime, LA County is likely to ask questions at its test appointments website to ask people about their vaccination status, Hong said. “That way, we can track down what happens to people who are vaccinated.”
Continuous COVID outbreaks may require increased testing, especially in poorer color communities, which have been hit hardest by the pandemic – and where the hesitation to be vaccinated is likely to be more widespread, Hong said. “The bottom line is that the test does not go away.”
This story was produced by KHN (Kaiser Health News), which publishes California Healthline, an editorial independent service of the California Health Care Foundation. KHN is not affiliated with Kaiser Permanente.