The federal funds for Covid-19 testing, vaccinations and treatment have run dry two years into a pandemic that is presently slowed but in no way over. On March 22 the federal government shut off the faucet from which reimbursements flowed to providers who were conducting testing and treatment claims for uninsured patients. The deadline to submit for vaccinations was April 5.
Since the start of the pandemic, providers in the county have received a total of more than $100 million in federal reimbursements, according to data from the Centers for Disease Control.
Although there will always be Monterey County health clinics available to uninsured patients, there is concern that as access to Covid testing, vaccinations and treatment narrows it could have serious consequences for the uninsured and the community at large. “Our health is interconnected and this will set back our work to keep Monterey County residents healthy,” Supervisor Wendy Root Askew says in an email.
On the state level, the California Department of Public Health is committed to keeping state-supported testing sites open through June 30. County public health officials, including Monterey’s, are asking for that date to be extended, according to county epidemiologist Kristy Michie. A county lobbying team is also working with other counties at the federal level to secure more money for more testing, Root Askew says.
In the meantime, VIDA will continue to test anyone regardless of insurance status as long as it’s in operation. It was set to end March 31 but the board voted March 8 to extend the program to Dec. 31 at a cost of $1.5 million. The board also approved $1 million on Jan. 25 to purchase home test kits which are being pushed out to groups that focus on underserved communities. Another source of free testing is the Salinas Valley Memorial Healthcare System mobile clinic using funds provided by the Salinas Valley Memorial Hospital Foundation, says SVMHS spokesperson Karina Rusk.
While home tests can be an important tool in helping people know if and when they need to isolate, it does impact the tracking of Covid data, “That is a challenge,” says Michie. “That’s why we’ve shifted some of the ways we monitor Covid-19.” Those shifts include placing less emphasis on watching case rates and test positivity, and looking more closely at hospitalizations and wastewater monitoring data. Michie is using wastewater data from the Carmel Area Wastewater District and the Watsonville Wastewater Treatment Facility in South Santa Cruz County.
The Health Department is also relying more on a system it put in place after the swine flu epidemic in 2009, called electronic syndromic surveillance, which is part of a national program. The system monitors respiratory symptoms reported by patients in local emergency rooms that could be Covid-related, like coughing and difficulty breathing. Michie says there are plans to expand monitoring to clinics and other providers.