Why you may not be able to get a coronavirus test in US

Californians who don’t have symptoms of Covid-19 will probably have a harder time getting tested for the coronavirus, according to new, stricter guidelines state officials unveiled Tuesday.

“It is critical we continue to be deliberate and creative about testing,” Dr. Mark Ghaly, the state’s head of health and human services, said in a statement. “We must do this so that testing is readily available and affordable to those who need it, especially those communities experiencing the worst impacts.”

In a virtual news conference, Ghaly said California was also exploring opportunities for pooled testing, a strategy that could help identify infections in large groups more quickly.

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The shift in testing strategy comes as more states around the country have scrambled to ramp up testing, which has resulted in tighter supply chains and longer turnaround times in California, the nation’s most populous state.

California has contended with an explosion in cases, prompting Gov. Gavin Newsom on Monday to announce the most sweeping rollback yet of reopening plans.

As of Tuesday, California was averaging 8,334 new cases per day over the past week, compared with 3,041 new cases per day on average just a month ago.

Here’s what to know about the changes:

Why are they happening now?

Over the past two weeks, the state reported 107,600 tests per day on average — a huge increase over the past couple of months. But the state’s percentage of tests that have come back positive for the virus has inched upward, as well, to 7.1% on average over the past two weeks.

“Our testing capacity has increased exponentially,” Ghaly said in the statement. “At the same time, new national supply chain challenges and large volumes of specimens sent to commercial laboratories have resulted in growing delays in processing times.”

<strong>What do the new guidelines say?</strong>

Previously, state and local officials had encouraged anyone who wanted to get tested to see if they were eligible, whether or not they had symptoms, as testing capacity ramped up across California and case numbers were less troubling.

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Under the new guidelines, Ghaly said that testing would be much more strategically targeted at people in communities where risks of transmission are higher.

Of course, people who have severe symptoms will be prioritized for tests with quick results so they can get a diagnosis and be treated.

According to the new rules, people who have been hospitalized fall in the <strong>Tier 1 priority group</strong>, along with people who must be tested as part of investigations into specific outbreaks.

<strong>Tier 2</strong> includes everyone else with Covid-19 symptoms, as well as people who live or work in the kinds of facilities where outbreaks have been most severe, such as nursing homes, prisons and homeless shelters. It also includes health care workers who have “frequent interactions with the public or with people who may have Covid-19.”

<strong>Tier 3 </strong>includes workers in remaining essential sectors, like grocery stores, logistics, manufacturing and education, if they don’t have symptoms.

And then, there’s <strong>Tier 4</strong>, which will be implemented only when the test turnaround time is less than 48 hours, as monitored by the state. That’s when anyone else who doesn’t have symptoms but is worried they may have been infected, can get tested.

How will these new rules help stop the spread of the virus?

While individual actions, like following distancing and mask-wearing rules, are critical for curbing the spread of the virus, increasingly, experts have recognized that many transmissions are taking place because Californians who work in low-wage, high-risk jobs haven’t been able to stop working.

In a first-of-its-kind analysis, researchers at the University of California, Merced, Community and Labor Center found a connection between high concentrations of low-wage work in certain counties — like at farms and in warehouses — and the prevalence of Covid-19.

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“Our findings emphasized the importance of not just regulating business openings, but mitigating Covid-19 spread by innovating health and safety reforms for workers,” Ana Padilla, the centre’s executive director, told me.

One way to do that is to ensure that workers in those communities have access to testing — and that workplace outbreaks are transparent. That would mean requiring counties to report test results by industry, the report said.

“Although we have guidance and support, we know that testing in those environments is key,” Ghaly said Tuesday, adding that that’s why the new testing strategy involves homing in on workplace outbreaks.

Still, he said the state hadn’t specifically asked counties to report test results by industry or employer.