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MythBusters – California County Edition

Too many myths
People just assuming things that aren’t true
There’s too many myths
Coming between me and you

- Van Morrison, “Too Many Myths”

Santa Clara County’s recently revised public health order, which takes effect Friday, enacts fines of up to $5,000 per violation for private health care providers that do not make COVID-19 testing accessible and fast enough. This order comes on the heels of the county’s June health order – one trumpeted by politicians without a single health care provider on hand – that mandates large health care providers increase testing. Both orders were created without broad hospital input, even though input was offered by Hospital Council and individual hospitals several times.

This is a troubling sign, and one that demands a public response. We’re working on a strategy for Santa Clara County now, but we know Santa Clara is not the only county that has or is considering testing orders for hospitals. Here are the myths we’ll be working to debunk:

Myth: Hospitals do not want to test.

Fact: Few would argue the importance of testing in containing COVID-19, nor the crucial role it plays in helping resume a bit of normalcy in our daily lives. Hospitals know without question that testing is critically important, have been working hard, and continue to work to increase testing capacity.

Myth: The supply chain issues for testing materials have been resolved.

Fact: There is currently a finite availability of testing materials. This issue is not unique to any California county or even the state. The Federal Emergency Management Agency (FEMA) continues to acquire testing materials and supplies through contracts that supersede hospital deals. Those resources are then allocated to states with higher positivity rates – many with much higher positivity rates than California.

Myth: Hospital labs should “build or buy” testing capacity.

Fact: This is little more than a political slogan, and the reality is much different. Public health agencies have access to large machines and supplies distributed by a state contract that private hospitals are not able to access, and FEMA contracts retain priority over hospital contracts for testing supplies. Even in this challenging environment, hospitals continue to try to increase capacity, and many have purchased machines that are backordered because of the national and international demand.

Myth: Hospitals are not doing their fair share of testing.

Fact: Hospitals are a critical part of public health, but they are not a replacement for public health. Hospital labs were designed to serve the needs of the hospital and/or system – not for large-scale testing. Despite this, hospitals and systems have greatly increased lab capacity and testing in a very short period through unprecedented investments of time, money, and expertise.

Myth: All hospitals are the same.

Fact: The proposed and actual testing order assume that all hospitals have the same capacity, same type of supply chains, same ability to provide testing. With just a cursory look, it’s clear that hospitals are very different depending on the communities they serve. A “one-size-fits-all” testing mandate ignores this reality.

Recent articles in the San Francisco Chronicle and San Jose Mercury News have highlighted the challenges of systems such as Kaiser Permanente and Sutter Health as they struggle to keep up with the demand for testing. While local government leaders may see mandated testing as a way to show progress and drive down positivity rates in their county, hospitals are already doing as much testing as they can, given the limited supply of testing materials and lack of access to those materials.

Here’s our core message for the public: Putting the onus on hospitals and health systems to increase testing may make for good politics, but a more effective and efficient use of scarce public health resources would be to partner, collaborate, and communicate with hospitals and other providers on strategies to increase testing. Time spent on enforcement and fines is time that could be used to make testing more efficient and share capabilities across providers. One potential path is to create a joint agreement allowing hospitals to access publicly funded machines and supply contracts for testing capacity.

When inaccuracies like these surface, the most effective way to combat them is to speak with one voice. As we develop a plan to respond, we will ask for your help in amplifying these efforts to make sure the people setting policies are doing so with the most accurate information and in a way that benefits the communities we all serve.