Rise in cases threatens California's health care system; state urges workers to get tested weekly

California has asked hospitals to ramp up their coronavirus testing amid a surge of new cases, urging them to test health care workers at least once per week while testing all new patients before admitting them.

California reported 7,787 confirmed coronavirus hospitalizations on Monday, with 1,812 of those patients in intensive care units. Statewide, 75% of intensive care beds are filled and state officials expect to reach capacity by mid-December.

The California Department of Public Health sent hospitals a letter last week that “strongly recommends” they test their employees at least once a week, defining workers as all paid and unpaid people who have the “potential for direct or indirect exposure to patients.” The broad definition includes doctors, nurses, students, volunteers, security, laundry and administrative workers, among others.

“There are simply too many asymptomatic people with COVID, and without robust testing, our hospitals will remain centers for spreading the disease instead of centers of healing as they should be,” said Zenei Triunfo-Cortez, president of the California Nurses Association.

Carmela Coyle, president and CEO of the California Hospital Association, said hospitals are concerned about the safety of workers but “we simply don’t have the testing capability to make this happen.”

She said hospitals oppose the requirements not because of how much it would cost, but because of the amount of supplies that will be required. California has a half-million hospital workers, about 250,000 of whom would have to be tested weekly, she said.

“We will burn through the supplies that are available ... at a time when we are about to see more COVID19 patients than we have ever seen before,” she said.

Coyle said the letter from the state about testing is a recommendation, but labor unions for nurses and other health care workers say it is a requirement.

Lucia Hwang, spokesperson for National Nurses United, said such all facilities letters” are often worded as “guidance,” but state officials expect hospitals to comply. The union noted that the state issued similar guidance earlier this year for skilled nursing facilities to regularly test their workers.

“Facilities do not pick and choose which (guidance) to follow,” Hwang said. “We expect general acute-care hospitals to comply with this new weekly testing standard.”

The California Public Health Department, responding to an email from The Associated Press, said hospitals are required to submit a testing plan and that the state recommends that plan include weekly testing of health care workers.

The new state guidance says hospitals should put health care workers on a weekly testing schedule. The exception is workers who have tested positive within the past three months and have since returned to work. The state says those workers should only be tested if they show new symptoms or it has been more than three months since their infection.

However, hospitals “must understand that routine ... testing of (health care workers) does not replace or preclude other infection prevention and control interventions,” Heidi W. Steinecker, deputy director of the California Department of Public Health, wrote in the letter to hospitals.

Coyle says she knows of no hospitals currently doing such widespread testing, but many are testing any employees who fear they may have been exposed, and health care workers are free to get the same community testing as anyone else.

Moreover, the development comes as some front-line health care workers are likely weeks away from being among the first to receive vaccinations that will make regular testing unnecessary. Gov. Gavin Newsom said Monday the state would receive 327,000 doses of the new Pfizer COVID vaccine in “mid December.”