San Francisco City Launches Coronavirus Testing Necessary for Residents and Staff of Skilled Nursing Facilities

Press release from San Francisco Mayor’s Office:

May 1, 2020

The expanded test focuses on vulnerable populations and settings experiencing the highest mortality rates nationwide. Laguna Honda Outbreak Lessons Tell Plans for All Skilled Nursing Facilities in San Francisco

San Francisco, California — London Mayor N. Breed and Director of Health Dr. Grant Colfax today announced the next step in expanding coronavirus testing to focus on and protect San Francisco’s most vulnerable population during the ongoing pandemic. . The new directive requires all residents and staff working at 21 Skilled Nursing Facilities (SNF) in San Francisco to be tested for the COVID-19 virus. The city aims to start testing all residents and SNF staff next week and create a two-week test cycle after the first test is completed.

The Universal Test is one of a set of resources provided by the Public Health Service (DPH) to the city’s SNF. SNF’s DPH resources include guidance on prevention and control of COVID-19 in long-term care facilities, and a new set of protocols for outbreak preparedness and response. The pilot program and these resources are based on lessons learned from the rapid response to an outbreak in Laguna Honda and expert support and guidance from the Centers for Disease Control and Prevention and the California Public Health Service.

Details of the SNF test program will be described in a future Health Order. This is consistent with new testing guidelines issued by the California Public Health Service, which includes screening of asymptomatic residents and workers in collective living facilities such as skilled nursing homes.

“Protecting the vulnerable population living in skilled nursing homes has been one of our top priorities since this public health emergency began,” Mayor Breed said. “We responded quickly to the outbreak in Laguna Honda. During our ongoing response, we have learned a lot that can help other skilled nursing homes in the city. Complete testing of staff and residents of all skilled nursing homes in San Francisco is the next step in addressing vulnerable populations and universal access to testing. ”

“Our vision is to give everyone in San Francisco universal access to tests,” Dr. Colfax said. “We have continually expanded our testing to reach it, based on where our needs are and the availability of our resources. We first mitigate outbreaks and protect vulnerable populations. Followed by case-contact surveys and first-line worker testing, we have made progress in these areas and we have grown and tested to test all symptomatic people. Again, testing asymptomatic residents and staff of skilled nursing homes is a decisive move to protect these most vulnerable people and at-risk caregivers of Outbreak. “

A skilled nursing facility is one of the city’s top priorities in its efforts to mitigate and respond to COVID-19 outbreaks. San Francisco has 21 SNFs, including Laguna Honda Hospital, Suckerberg San Francisco General Hospital SNF Unit, and VA Hospital. All SNFs address some of the most vulnerable in San Francisco, including the elderly and residents with underlying illnesses. In addition, the collective nature of these facilities means that the inhabitants live close to each other and are in close contact with fellow inhabitants and the staff of the institution in a broad and casual manner. Once introduced to the facility, COVID-19 can spread rapidly, increasing the risk of death if the population becomes seriously ill or ill. Early on, the city Health order Limit all non-essential visitors from skilled nursing facilities to protect residents and staff from exposure.

As the city works towards its Universal Test Access goals, the next step is to test the asymptomatic people, starting with all SNF residents and staff. The city will continue to add other rally settings such as shelters. The city also tests asymptomatic health workers, front-line workers, and essential workers. Finally, the city will continue to test in geographical and cultural communities affected by the disparities in the spread of coronaviruses.

As long as COVID-19 is widespread in the community, residents and skilled nursing home staff remain at risk. The test identifies those who are COVID-19 positive on a particular day and allows the SNF to immediately implement protocols including quarantine and quarantine, screening, testing, and infection control procedures. Surveillance and surveillance are at the heart of coronavirus containment and are not a replacement for this new testing program.

Testing is an important tool for finding and confirming asymptomatic COVID-19-positive cases, but it is only one aspect of being ready and able to respond. DPH has created a new set of outbreak protocols in the SNF “toolkit”. It provides a set of strategies to mitigate outbreaks and infections. Testing is one of the larger strategies, including prevention such as social distance, frequent hand washing, proper use of personal protective equipment, and other recommended precautions.

The first round of a full SNF test takes about a month and is managed primarily by DPH staff. The test will begin at Laguna Honda Hospital on Monday, May 4th. In the first round of city-wide testing, DPH will train staff at other facilities as needed, allowing them to begin managing the tests themselves. Once all the facilities have been tested, the goal is to establish a regular testing cycle about every two weeks, based on what is currently known about the incubation period of the virus. Scientific and technical testing is evolving rapidly and will continue to inform response and testing strategies. Testing details may be adjusted as more information about the virus becomes available.

San Francisco began local COVID-19 testing at the Institute of Public Health on March 2, 2020, and is continuously expanding test capacity. As of today, 20,433 people in San Francisco have been tested, with an average of 9% testing positive.

Below is an example of the city’s test extension so far.

• City opened two CityTestSF Healthcare workers, frontline workers, mandatory workers, and other symptomatic San Francisco sites.
• DPH has opened test sites in the Zuckerberg San Francisco General Hospital, Castromission Health Center, Southeast Health Center, and Maxine Hall Health Center communities. In addition, the DPH Prison Health Service will test all the people entering the prison that will be held in the prison.
• These DPH test sites are part of a growing feature set including 26 test sites in the city, including UCSF, NEMS, One Medical, Kaiser, Sutter, Chinese Hospital and Dignity Health.
• The city is working with partners such as UCV and the Chan Zuckerberg Initiative to perform the COVID-19 test. Research is underway to use the test to find out more about the spread of the virus in the community.

This press release San Francisco Mayor’s Office. The views expressed here are those of the author himself.