California urges priority coronavirus testing for asymptomatic people in high-risk settings

California has issued new guidelines this week urging priority coronavirus testing for asymptomatic people in high-risk settings, becoming the first state to expand testing beyond federal guidelines.

The state instructions released Sunday name asymptomatic people living or working in places like nursing homes, prisons and some households as a No. 1 priority to be tested. 

California is the first state to move beyond the Centers for Disease Control and Prevention’s (CDC) recommendations to prioritize hospitalized patients and symptomatic health care workers for testing. In the second tier of priority, the CDC lists those who are elderly or have underlying conditions and are experiencing symptoms.

The state guidelines also included a fourth-level priority, involving the testing of all low-risk symptomatic people and surveillance testing of asymptomatic people when possible.

California cited that testing is “becoming more readily available” across the state and increasing testing capacity in the guidance as reasoning for its decision.

Doctors previously could make autonomous decisions on who received tests but faced pressure from hospital and government officials to conserve the tests for the sickest patients, The Los Angeles Times reported. The state did not test a lot of people with mild symptoms or who were asymptomatic and had the ability to spread the disease.

Several experts applauded California’s decision as a step in the right direction to find every coronavirus case, so the infected can be isolated, according to the Times.

But other experts say it could be too early to expand testing as supplies are still lacking. State officials said last week they did not have sufficient swab and reagent supply chains across the state.

Bob Kocher, a member of Gov. Gavin Newsom’s (D) coronavirus task force, told the Times that facilities across the state can conduct more than 80,000 tests per day collectively but do not have enough samples to do so. California aims to complete 25,000 tests per day by the end of April.