Doctors from hospitals, community clinics and the Santa Barbara County Public Health Department urge people with symptoms who test positive with an at-home test to take that as confirmation they have COVID-19,
They should then isolate and not to seek out a confirmation PCR test.
Testing demand has increased along with the surge in new cases, and about 27,000 tests were reported in the week ending Wednesday compared to about 20,000 tests the previous week.
The number of people looking for tests is exceeding local capacity even with the addition of at-home rapid tests, which were not available during previous novel coronavirus surges.
The rapid tests, also known as antigen tests, can be purchased online and at pharmacies and other stores, but widespread shortages and the cost make their use theoretical for many people.
“If you are symptomatic during this surge and have a positive antigen test, you do not need a confirmatory PCR — in fact a confirmatory PCR could potentially impact access for others who need it,” said Dr. Lynn Fitzgibbons, an infectious diseases specialist at Santa Barbara Cottage Hospital.
“From the infectious diseases perspective, we strongly recommend we are thoughtful and careful about pursuing additional tests when we’ve done a test that tells us the likely answer.”
Getting a PCR test is strongly recommended for people who have COVID-19-like symptoms (fever, cough, etc.) and cannot take an at-home test, or have a negative result from an at-home test, Fitzgibbons said.
Emergency rooms are often the medical provider of last resort for people, and it appears to be the same way with COVID-19 testing.
Some people who cannot find appointments are turning up at the hospitals for tests, according to Fitzgibbons.
“Unfortunately our community is clearly struggling with testing capacity, and I think it’s really important to remind everybody that our emergency rooms simply cannot serve as testing centers for asymptomatic people who do not need emergency care,” she said.
“As much as we hate to do it, anybody who is not there for emergency medical care, we are turning away.”
Santa Barbara County has seen an explosion of new cases in the past two weeks, and South County communities are reporting the most of them, which is a change from past surges, during which community transmission was higher in North County areas.
Public Health Dr. Henning Ansorg attributed part of the trend to higher testing on the South Coast right now, and it’s worth noting that Santa Barbara-area schools returned to classes this week and many districts recommended testing for students before heading back to campus.
While the increase in testing could be contributing to the increase in reported cases, the test positivity rate is also skyrocketing, meaning that a higher percentage of people getting tested are reporting a positive result.
The countywide test positivity rate was 20.3% as of Jan. 1, which is the most recent data available on the Public Health dashboard at sbcdashboard.org.
The Public Health Department does not collect or report results from people taking at-home tests, so the reported numbers are undercounted compared to active cases in the community, Fitzgibbons said.
“Some well-meaning people want to make sure their case is counted in the (Public Health) count, and PCR is where most case counts are coming from. I would say at this point, we know that we are not going to capture every single case in those case counts, and that is OK.
“We know undoubtedly that this surge is more significant than the others,” she said.
The Public Health Department has isolation and quarantine guidance for people who test positive, which includes staying home for at least five days, monitoring symptoms, and informing close contacts.
“It’s not a requirement for people to report positive at-home antigen tests so we anticipate there are more positives out in the community, and trust that those who are positive will safely isolate and inform their contacts to quarantine,” Public Health Director Van Do-Reynoso told KEYT Thursday.
There are separate guidelines for healthcare workers and K-12 schools, Do-Reynoso noted.
Public Health has been criticized for closing two free PCR testing sites in December – in Buellton and Goleta – and Do-Reynoso said this week that the county will expand hours at its other South Coast sites at the Direct Relief bus testing site and testing trailer to cover the gap in capacity.
She also said the state’s contract to run the now-closed sites expired in early November, so closures as the holiday surge in cases started was “just the timing of it.”
Sansum Clinic testing demand is the highest it’s ever been, according to Chief Medical Officer Dr. Kurt Ransohoff.
On Wednesday, clinics tested 511 people and had a positivity rate of 52%, he said in a community message – that means more than half the people tested had COVID-19.
“That is many times the typical volume of tests and a positivity rate that is more than 10-fold what we were seeing weeks ago,” Ransohoff wrote. “That amount of testing while we continue to also see patients is not sustainable for us, so we will likely have to set some limits on the amount of testing we can do.
“That positivity rate points to a widespread amount of virus in the community.”
He also advised Sansum Clinic patients that there is no need to confirm a positive at-home test with a PCR test.
“Antigen tests are quite specific (meaning few false positives), and with so much COVID around, a positive result is very likely to be a true positive.”
UC Santa Barbara conducts free testing for students, faculty and staff, even during this two-week period of conducting remote classes, and on Wednesday reported 304 positive cases, which is a 20.7% positivity rate for the 1,466 tests performed.
For the week, UCSB has reported 459 new cases and a positivity rate of 12.5%.
Where to Find Testing
There are a few things to consider when looking for novel coronavirus testing: the type of test and the cost of the test.
There are diagnostic tests that look for an active novel coronavirus infection (including PCR/molecular tests and antigen/rapid tests that use nasal swab samples) and antibody tests which look for antibodies produced in response to the novel coronavirus. Antibody tests are not used to detect a current infection.
Antigen tests typically have faster results (some as fast as 15 minutes) than PCR tests.
Scroll down or click here for an FDA information guide explaining the difference between the types of tests.
Health insurance plans are supposed to cover diagnostic COVID-19 testing regardless of whether the provider is in or out of network, and regardless of whether you have symptoms or not, but the key word there is diagnostic.
Insurance companies may not cover all costs for testing for work, or school, or travel, or attending events, or just peace of mind.
Tests can have a large out-of-pocket cost that patients sign up for or are surprised with later in a bill.
“Copays and fees may be charged at privately owned clinics and healthcare centers, including urgent cares and primary care providers. Your insurance may only cover COVID-19 tests if they are determined to be medically necessary,” according to Public Health.
The California Department of Managed Health Care suggests filing a grievance with your health insurance provider if they deny coverage for a COVID-19 test.
The county-and-state-run sites in Santa Maria, Lompoc, Goleta and Santa Barbara offer free testing, regardless of insurance coverage or immigration status.
Click here for the list of publicly-run testing sites, operating hours and appointment information.
Public Health suggests checking for testing appointments at doctor’s offices and pharmacies as well.
Some testing providers charge a cost up front, and suggest people submit the bill to their health insurance for reimbursement.
For example, Covid Clinic which operates a testing site in La Cumbre Plaza in Santa Barbara, says on its website there is no cost to patients, but some people will have to pay up front and try to get it reimbursed by insurance later.
Its prices are not listed on the website, but the main information phone line reveals costs ranging from $129 for a rapid antigen test to $299 for the “travel recommended” rapid PCR test.
California developed a directory of testing locations, but not all sites offer diagnostic testing to the public. Click here to view the map.
When they are restocked, at-home COVID-19 testing kits can be found locally at CVS, Walgreens, Rite-Aid, Walmart, and Target stores, as well as online.
Prices for at-home testing kits vary depending on the brand, type and store, with PCR tests ranging in pricing from about $99 to about $125, and rapid antigen tests costing between about $10 and about $40, Noozhawk staff writer Serena Guentz reported in late December.
Where to Get Vaccinated and Boosted
All COVID-19 vaccines are free and available throughout Santa Barbara County.
Everyone age 5 and up is eligible to receive a vaccine. The Pfizer-BioNTech COVID-19 vaccine is approved for use in people 5 and up, and the Moderna and Johnson & Johnson COVID-19 vaccines are approved for use in all adults 18 and older.
Pharmacies have regular appointments available, and the Public Health Department has community clinics scheduled at various locations.
Visit the county site at https://publichealthsbc.org/vaccine/ for more information on locations.
— Noozhawk managing editor Giana Magnoli can be reached at gmagnoli@noozhawk.com. Follow Noozhawk on Twitter: @noozhawk, @NoozhawkNews and @NoozhawkBiz. Connect with Noozhawk on Facebook.
