County leaders agree to contract with Quest for testing

In a split vote, Humboldt County commissioners opted to turn local COVID-19 testing over to Quest Diagnostics in an effort to decrease test result wait times. The 4-1 vote came after over two hours of conversation and public comment during a special meeting Sept. 15. Commissioner Tom Hoss was the sole nay vote, while commissioners Ron Cerri, Jim French, Jesse Hill and Ken Tipton voted in favor. 

While the agenda item allotted $100,000 to pay for testing, commissioners voted instead to cap the expense at $50,000 and revisit the issue once those funds are exhausted. According to county leaders, Quest Diagnostics charges approximately $100 per test, so the amount earmarked by commissioners will pay for around 500 tests. According to officials, there has been a recent weekly average of roughly 400 tests performed. 

The move to enlist Quest Diagnostics to process COVID-19 tests came in response to long wait times at the state level.

Several commissioners and leaders noted that the state lab is backed up and it’s been taking an average of 5-8 days to receive results. Consequently, citizens who are awaiting results are — if abiding by health recommendations — isolated in their homes and taking time off of work, oftentimes unpaid. The latter, commissioners say, needs to be addressed. 

“What I see is people who are getting tested and they don’t get the results back for 6, 7, 8 days,” said commissioner Ken Tipton. “They can’t afford to be off their jobs for that long and a lot of people are employed by companies and businesses that require a negative test to go to work. That’s one of my biggest concerns, and if we can’t get it done within two to three (days) max, it doesn’t really do us a lot of good for the situation that’s in front of us right now.”

County Administrator Dave Mendiola echoed that concern, noting that at the county there has been several people over the last few months exposed to COVID-19 or tested positive, but as new hires, did not have annual or sick leave. 

“I think there’s great value in the quick turnaround of tests, because we have people who can’t afford to miss work,” Mendiola said. “Let’s get them tested and get them back to work. We’re running at 20% infection rate, which means 100 people get tested, 20 are positive and 80 are negative. We have people who are sitting at home who are losing money by not being at work which puts tremendous stress on families. Let’s get them tested — 80% of them are going to be negative — let’s get them back to work.”

Commissioner Hill said it’s crucial that citizens know as quickly as possible whether or not they have tested positive. 

“I would be in favor of getting those tests back as quick as we can. I feel we owe that to our citizens to have as fast a turnaround as we can on the testing,” he said.

As of early September, the turnaround time for Quest is between two and three days, said Dr. Charles Stringham MD, the county’s health officer. 

The challenge in Humboldt County is testing, the time to get test results, and contact tracing, he said, as well as procuring enough tests to keep up with demand. The R value of Delta — which is the rate at which a virus can be spread during its contagion phase — is between 5 and 8 people. 

“What that means is that the average person who gets infected with this virus is expected to transmit this virus to between 5 and 8 other people,” Stringham said. “The initial variant of the virus was somewhere between 2 and 3 (people).” 

With testing done at the state level and the delay in getting results, Stringham said the disease can be spread rapidly by those who choose to continue being out in the community. 

“During the 5-7 day interval while awaiting test results, the person (could be) walking around in the community because they don’t believe they have the virus,” he said. “It takes three days for the virus to go from infecting a person, to that person becoming infectious.” Stringham said with the R value between 5 and 8, that means during the interval of wait time between getting test results back and contact tracers to call people, 25 to 64 people could become infected with this virus. 

“I find that very compelling,” he said. “We need things to be faster locally with tracing, and at the state lab with results.”

Although the issue of resurrecting the local contact tracing program was also on the agenda, commissioners opted to take no action on that issue.

The non-action effectively keeps the current tracing program in place, which likely means tracers in Elko will continue to call on local cases.

Stringham explained that although initially the local program allowed officials to determine the most common cause of spread (small gatherings), it was disbanded and the responsibility was turned over to the state late last year. 

“Then the state — through the epidemiologist’s office — knew the Elko County team was very robust and well-developed and grant funded so the state of Nevada subletted that responsibility back to Elko County. If we gave it back to the state, they likely would give it to Elko, which they’ve done,” Stringham said.

Commissioners largely questioned the effectiveness of any tracing program, with several saying they felt it was a waste of local funds to resurrect the program since it was difficult to see a benefit at this point and since the state is funding the current program with its own dollars. 

“I don’t know how effective it is because I know a lot of people who are not getting tested,” said Cerri, who was attending the meeting via video conference. “I’m one of them. I took the shot, I got vaccinated, I have a cough. I don’t see a need to go in and (have them) tell me that I’ve got COVID. They’re not going to be able to trace back all the people that were around me. So I don’t know that it’s effective.” Cerri assumes he contracted the virus during the Labor Day Weekend festivities and has been self-isolating since symptoms appeared. “I’m not opposed to contact tracing, but the state can do it. I don’t know that it’s the county’s responsibility or the county’s will to do its own tracing. Let the state continue to do what it’s been doing.”

Commissioner Hoss agreed. 

“The contact tracing in my opinion didn’t work well the first time. We had personal family get COVID (and) there was never a contact on anybody,” he said. “There’s got to be something else out there that we’re not touching on. Something that the federal government isn’t letting us to do to actually cure this disease. Contact tracing, they tell you you’re positive, go home, stay there for a period of time. What are they supposed to do in the meantime? They’re not doing any research into what we could be taking that would make the COVID a little easier to take through this. We’re going to do the same thing we did last time and not have enough people to do the contact tracing. I think it’s money not well spent; I think we can look at other things.”

Commissioner French was in favor of resurrecting the local program if it meant helping stave off the infection rate. 

“I’m in favor of doing whatever it takes to improve our efficiencies and minimize the risk of other people being infected,” he said. “And if that is to change contact tracing contracts to bring it in closer to home so we can regulate it better, I’m in favor of that.”

Citizen concerns raised at public comment ranged from violations of privacy related to medical information, misuse of funds, and allocating resources to explore other treatment and prophylactic options. 

Concerns related to the Heath Insurance Portability and Accountability Act (HIPAA) were among the most voiced, with citizens wondering how it’s not a violation for contact tracers to call citizens with detailed medical information. 

“You’re handing out someone’s personal medical information, where is HIPAA in all this,?” asked one citizen. “Who’s in charge of making sure our information is confidential?” 

Lisa Verner suggested that handing out bags with vitamins could be another way to utilize the funds, other than allocating it to testing or contact tracing. 

“I think there’s a better way to use $100,000,” she said. Local business owner Lyndsee Jimenez agreed. 

“We should research all of the options that are available,” she said. “Not everyone is comfortable with the vaccine, and not everyone is able to take it.” She suggested designating those funds to giving additional resources — such as vitamins and general immune-boosting health tips — to people who have tested positive. “There are multiple options. There are prophylactics that have been used safely for decades. We should consider those options.” 

Stringham said there are provisions within HIPAA for dealing with emergent situations concerning communicable illnesses. 

“We can’t ignore a communicable illness in order to comply with laws that really are designed to protect people in other situations,” he said. “We absolutely obey HIPAA laws under these circumstances; we do not disregard them in any way. Information is only shared with people who absolutely need to know.”