The California community-based program to test high risk individuals for COVID-19, in collaboration with the Baseline COVID-19 Program, enters its second week of operations with two new testing sites, in Lake Elsinore City in Riverside County and in Sacramento County. With this expansion to the program — in partnership with federal, state, and local public health officials — we expect to be able to serve thousands more across four counties in California.

In the first week of operations, we scaled testing to 20X the capacity at launch, testing over 1,200 individuals at initial sites in San Mateo and Santa Clara counties. Now, we are adding a self-service scheduling capability for eligible individuals to the Baseline COVID-19 screening tool, further increasing efficiency across all testing sites.

We launched the program pilot with a limited number of appointments to allow us to quickly understand and adjust protocols and processes for safety and scalability. The program has involved medical centers and federal, state, and local public health officials to identify and to inform best practices for establishing local testing programs for broader population screening. We plan to share a consolidated report on our approach to support public health authorities in their efforts to quickly stand up testing initiatives.

The screening and testing criteria that inform the screener are directed by the California Department of Public Health (CDPH) and are updated in accordance with public health guidance as the situation develops. The California community-based testing program began by testing higher risk individuals as determined by CDPH. Eligibility requirements will continue to be updated based on public health needs and testing capacity.

We have identified a number of lessons learned from our first site launches that will help us ramp up quickly at Sacramento and Riverside:

Testing site design and flow 

• An incident command system oversees testing site operations. Each testing site consists of a command center for quick decision-making, and “hot zones,” accessible to testing personnel in personal protective equipment (PPE) for sample collection. 
• Hot zones are accessible only to a streamlined set of healthcare workers to minimize risk and to help conserve personal protective equipment. 
• Testing site layouts are designed to align with social distancing measures, limiting areas where multiple individuals can congregate.
• The focus is on establishing drive-through testing sites, as that framework should reduce the risk of COVID-19 transmission. Sample collection has been adapted to work for multiple scenarios, including individual drivers seeking testing, drivers bringing loved ones for testing, and instances where both drivers and passengers are getting tested.
  
  

Foundational processes

• Managing capacity at the testing sites is critical to balancing the need for efficiently testing the appropriate people and optimizing precious PPE resources while avoiding overcrowding — which can increase risk of contagion. We have a dedicated analytics team monitoring the time required to gather samples and other important testing site metrics to optimize scheduling, and these insights will be included in our report.

• Our goal is to automate as much of the workflow possible. Often, placing orders for lab testing is a manual process. Direct integration between the Baseline platform’s software and test ordering systems helps get people tested more quickly.
  
  

Incorporating global best practices

• Countries like South Korea are establishing sound procedures that we are working to integrate into our operations, such as temperature checks for on-site personnel as another safety measure in addition to social distancing and PPE.

As part of the California Community-Based Testing Program, we are privileged to work alongside numerous organizations who are contributing to increasing testing capacity in the state. Thermo Fisher Scientific and Becton Dickinson are rapidly producing critically needed testing kits. PWNHealth is the physician network that approves testing for individuals and provides post-test telehealth consults, and the nurses and healthcare providers from Hawthorne Effect and Elligo are onsite at the frontlines performing tests. Tests are then processed by Quest Diagnostics. Together, with federal, state, and local public health agencies, we are pushing forward to bring testing to the people who need it.

For more information, please visit the Baseline COVID-19 Program website, and follow Twitter @VerilyLifeSci for the latest updates.