CALIFORNIA ASSESSES COVID-19 IMPACT

California has stopped removing or adding to a list of counties facing more restrictions on businesses and schools as it tries to determine the impact from an unresolved technical problem with the state's coronavirus testing database, health officials said Wednesday.

KCRA News reported that the state has recorded a highest-in-the-nation 525,000 positive tests. But California health officials say the true number is even higher. They don't know how much so until they can add backlogged testing data and fix the problem with the California Reportable Disease Information Exchange (CalREDIE).

The incomplete data in the nation's most populous state has hampered public health officials' ability to follow up with those who test positive and contact people who have been around them to limit the spread.

“Back in February and March when we didn’t have enough testing, I would say we felt blind,” said Dr. Sara Cody, Santa Clara County’s public health director. “I would say now we’re back to feeling blind. We don’t know how the epidemic is trending.”

In Los Angeles County, which has a quarter of the state's 40 million residents, public health officials have reached out to labs to get testing data directly so they don’t depend on the state. Barbara Ferrer, the county's health director, said she hopes to have an updated case count by the end of the week.

The CalREDIE system collects data from testing labs around California. The state uses data such as infection rates to determine which counties land on a watch list. Counties must come off the list for 14 days to be able to reopen certain businesses and offer in-classroom instruction for elementary students. There are 38 counties on the list, including Los Angeles and every other major county.

In a statement, the state Department of Public Health said as it works to “assess the impact of the data issues on disease transmission metrics," no counties would be moved on or off the list “until further notice."

The problem comes as California appears to be making progress against a surge of infections that led Gov. Gavin Newsom last month to close bars and indoor restaurant dining statewide and shutter school campuses in much of the state. On Wednesday, the state reported only about 5,300 new virus cases, a far cry from the peak of nearly 13,000 reported about two weeks ago.

The state's infection rate, a harbinger of how much hospitalizations are likely to increase, has dropped rapidly in the last week, when the data problem became apparent. It stood at 5.5% on Wednesday, but it's unclear if when the additional data is added the decline will be as pronounced.

Meantime, the data on hospitalizations has shown improvement. It's collected differently, and in the last two weeks has fallen by more than 12% to 6,184 patients.

County health officials say without knowing how many cases are missing it's hard to know where the virus is heading.

In Riverside County, public health officer Dr. Cameron Kaiser said the county's virus case rate now is frozen at a level that's too high for elementary schools to seek a waiver to reopen classrooms. Kaiser told school officials in a letter that the state won't accept waivers until the county has a reliable case rate and it's below the level mandated by the state - 200 cases for every 100,00 residents. Riverside's rate now is 202.

In San Francisco, public health officials receive test reports directly from labs so they don't depend on the state to track or trace cases, said Dr. George Rutherford, epidemiologist at University of California, San Francisco. But long delays can make contact tracing - seen as a critical tool to stop the spread of disease - futile, he said.

“From a disease control standpoint, the more time people have walking around who are infected and infectious without getting isolated, the more people that are going to get exposed,” he said.

In Los Angeles County, Ferrer urged anyone who tests positive to call county health officials so they can conduct a contact tracing interview and identify those who may have been exposed so they can avoid infecting others.

"We are really worried about the fact that we're losing some cases, and that that may in fact result in some small increases in transmission in the weeks ahead,” she said.