Academic paper sheds light on county’s decision-making over stay-at-home order

Daily Post Correspondent

Testing of patients for coronavirus infection at four urgent care centers in Santa Clara County fueled the county’s decision to order residents to shelter at home, according to a new paper published in a scientific journal.

The tests looked for community transmission of the coronavirus, meaning an infection in a patient who hadn’t recently traveled to an area with a COVID-19 outbreak and who hadn’t been in close contact with someone who had the disease.

The county had identified its first case of community transmission on Feb. 27, and wanted to get more information on the spread of the disease, according to the report published online April 3 in Morbidity and Mortality Weekly Report. The journal is produced by the Centers for Disease Control.

The so-called sentinel surveillance in Santa Clara County included 226 patients who showed up at the urgent care clinics from March 5 to 14 with symptoms such as fever, cough or shortness of breath. The first step was to see if the patients tested positive for flu. In 23% of the cases, they did.

Among patients who were negative for the flu, some were tested for the coronavirus. And 11% of those tests came back positive.

‘Community transmission’

The results “helped confirm community transmission” of the virus, the authors said. Those findings, along with a growing number of cases where the source of transmission wasn’t known, led the county to take action, starting with a March 9 recommendation to cancel events with more than 1,000 people.

That was followed by stay-home orders from Santa Clara County and five other Bay Area counties on March 16.

“Local public health departments can use sentinel surveillance to assess the level of community transmission of COVID-19 and to better guide the selection and implementation of community mitigation measures,” the report said.

Coronavirus tests weren’t performed on all of the patients who were negative for flu because of test shortages, according to the report. Instead, the first five to 10 patient samples that were negative for flu each day were sent for coronavirus testing. Out of 79 patient specimens tested for coronavirus, nine were positive.

County praised for its handling of outbreak

The report was mentioned Sunday (April 5) during a telephone town hall meeting on COVID-19 hosted by Santa Clara County Supervisor Joe Simitian. Dr. Mark Adams, chief medical officer at El Camino Hospital and one of the speakers during the meeting, said Santa Clara County has been a model for how to deal with an outbreak.

The report’s authors include staff from the Santa Clara County COVID-19 Response Field Team, state and county health departments, the CDC, Palo Alto Medical Foundation, and Santa Clara Valley Medical Center.