Santa Clara County Has Tested Just 647 Patients for COVID-19

In response to San Jose Inside’s prodding for more comprehensive testing data, Santa Clara County finally admitted how little it knows about the COVID-19 outbreak and how few people have been assessed for the highly contagious respiratory disease.

As of Sunday, the county Public Health Department lab has tested just 647 patients in a county of 1.9 million people, according to an FAQ posted online Monday evening.

In a phone call Sunday night, as we reported earlier today, county Executive Jeff Smith acknowledged that the actual number of infected people is probably somewhere closer to 4,000 or 5,000, although just 321 have tested positive to date.

How many tests private labs have conducted is something of a mystery since they have no obligation to report anything but positive results to local health officials. The county said the dearth of information and lack of widespread testing has hampered its ability to monitor the epidemic, mitigate its spread and inform people about their infection status.

“We appreciate you flagging the public’s questions regarding testing, and greatly appreciate your help and partnership with the county in sharing information with the public that will allow public health and the entire county organization to better protect and serve our community during this exceedingly challenging time,” county spokeswoman Betty Duong wrote in a letter to this news outlet before posting excerpts of it on the public health website. “Please reach out anytime if you are aware of issues you would suggest we prioritize as we do everything we can to share information around this quickly evolving and dynamic situation. We are doing our best but realize the demand for detailed information on everything that is happening is understandably insatiable.”

That said, she continued, while the county knows how many patients are tested in the public health lab, it has no clue how many are tested in other facilities. The problem is hardly unique to this county, which is grappling with a fractured system of public labs with fewer resource and stricter regulations and academic and commercial counterparts that report to federal authorities but not local governments.

“Large commercial laboratories have begun testing and have provided testing for patients of many different private and public healthcare delivery systems and test collection sites,” Duong wrote. “Some companies operate specimen collection sites but do not run their own tests; instead, they send those specimens to commercial labs for testing.”

Smith said on Sunday that an effort is underway to change that requirement. Duong reiterated as much in her letter tonight. “We are currently working on getting commercial labs to report all results to the Public Health Department,” she stated. “We are also working with the state and neighboring jurisdictions to obtain greater information about testing by private labs locally and regionally.”

According to the county, the public health lab performed its first COVID-19 test on Feb. 26, when the U.S. Centers for Disease Control (CDC) and Prevention finally authorized the diagnostic assays. Public health labs serve a limited role, county officials explained, by testing emerging infections such as COVID-19 while commercial and academic labs gear up to conduct high-volume analysis.

“For example,” the county FAQ explains, “at the beginning of the West Nile Virus epidemic, only public health laboratories were able to test for West Nile Virus, but West Nile Virus testing was very soon offered widely in the commercial sector. In the United States, unlike in some other countries, high volume testing is done exclusively by commercial private sector labs.”

The county public health lab can run a maximum of 100 tests a day, officials say, and only use kits from the CDC. The number of actual patients the lab can test is less than the volume of kits because some are used as controls and require multiple samples per person to ensure an accurate diagnosis.

“Our local public health laboratory, like all public health laboratories, functions as a specialty reference laboratory and as a bridge laboratory to enable testing to occur while other laboratory sectors come on-line,” the FAQ states. “The lab is not structured, physically and otherwise, to scale to commercial-volume testing. As a result, the current focus of the public health laboratory testing is to ensure that hospitalized patients get tested, as well as people who live or work in high risk settings such as long-term care facilities, healthcare professionals, and first responders, while we continue waiting for large-scale testing capacity to come on line through the commercial labs.”

There simply aren’t enough tests to go around.

“Unfortunately,” the county’s latest public health update reads, “local and national testing resources have not scaled to the extent that we expected, and not everyone who is ill can be tested at this time.”

Jennifer Wadsworth is the former news editor for San Jose Inside and Metro Silicon Valley. Follow her on Twitter at @jennwadsworth.


  1. So the county admits that it is still hiding information about where the virus is clustered because it doesn’t think the public can handle the truth. Shameful. This isn’t China!

  2. Why cant the County request non-County testing to report results to them?? We need an overall number as a matter of public health.

  3. nice pic from the San Mateo county fairgrounds where drive-in testing is being done. maybe use a pic that was taken in the county that your article is targeting?

    • Maybe because I’m under quarantine and working 18-hour days and don’t have the time or resources to take another photo? Yup. Sounds about right.

      • Jeez take it easy! Could have mentioned where the pic was taken cuz there is obviously not drive thru test station in Santa Clara county.

        • Wrong. There are at least two drive-through test sites in Santa Clara County. One’s at Stanford, another’s at the fairgrounds in San Jose.

  4. County is hiding that they mismanaged during the rich years. Cutting $60million from hospital in the middle of a outbreak won’t goes well.

  5. “How many tests private labs have conducted is something of a mystery since they have no obligation to report anything but positive results to local health officials.”

    Cindy Chavez, President of the Board of Supervisors, needs stand in front of cameras tomorrow and tell county residents how she is going to address this lack of information. Sounds like business as usual with our politicians who do not seem to realize we are in a crisis.

  6. Stay at home people. Many of us probably have it and it isn’t killing us. It is about protecting those that can be killed and not overwhelming local hospitals and staff with too many cases at the same time. Many of us will eventually get it, it is about getting it gradually and not all at the same time. Italy’s new cases are finally starting to decline after a two week lockdown. Until we see new cases are starting to decline, then we will know the lockdown end is close.

  7. I have been sick for 12 days with flu like symptoms. Pamf (Palo Alto medical foundation) told me they do not test unless you have come in contact with a known covid patient or have travelled or your condition is very bad. I called them on the 20th last week. They told me to come to the respiratory clinic if I have shortness of breath or very high fever. I had throat pain, cough, chills , fever, body aches and severe congestion. I will never know what it was.

  8. Sara, sorry to hear that. Many will never know if they have it. If you can fight this at home, that is the best thing to do, the flu or the virus. Other people I know are sick at home too and they were told the same thing. If you have had for 12 days and symptoms are not getting worse, then you will be OK.

  9. > Santa Clara County Has Tested Just 647 Patients for COVID-19

    Well, here’s a question that no one seems to have asked:

    What is the cost of COVID-19 test?

    Everyone seems to think they’re free because the gubbermint pays for them. So, the gubbermint is just being mean when they don’t drop test kits out of helicopters by the bushels.

    But, my understanding is that the COVID-19 testing procedure is very sophisticated, not-trivial, takes a lot of time, expert lab technicians, and expensive (and scarce) testing machines.

    My guess is that if you wanted to get a test from a private (for profit) lab that required cash payment, the test would likely be many thousands of dollars — maybe tens of thousands of dollars.

    A significant part of the cost of any medical procedure in this day and age is the “tribute” money that has to be paid to trial lawyers in the form of malpractice or liability insurance premiums, which are very high.

    So, anyone with a sniffle who thinks they want a test, or a second test, or a test every other day just to be sure that they don’t have the virus, probably doesn’t realize how much they are asking the healthcare system to pay for their peace of mind, and how much money and resources they are consuming that would be otherwise used for tests for really sick people.

    So, it would be helpful if people had some idea of the real economic cost for a COVID-19 test so they can make some informed judgements about “do I really need a test” or do I just want to do a sightseeing drive-through of the testing facility.

    • > Europe is more expensive but cost 100 euro

      Good answers, but it really didn’t answer the question I asked:

      “What is the real economic cost?”

      I think you’ve provided a valuable teachable moment, particularly for Republicans, which is that people really don’t understand what “economic cost” means.

      If people don’t know or understand what the real economic cost is anything is and think that scarce of expensive things are cheap or free, the result will be waste or shortages.

      Artificially making scarce and expensive housing “affordable” results in either housing shortages or people living in larger houses than the need or can justify.

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