California renewed its guidelines for COVID-19 testing to target those in hospitals or considered at high risk for infection as the growing capacity for tense pandemic testing.

The state health department released a four-tier priority system for testing Tuesday. People hospitalized with COVID-19 symptoms top the list along with “close contacts” of people with confirmed infections.

Next in line are other people with symptoms and those living in high-risk facilities, such as nursing homes, jails and homeless shelters, and healthcare and emergency services workers.

After that, the non-binding guidelines recommend testing for a wide variety of employees who have “frequent interactions with the public.”

They include employees in retail stores, factories, restaurants, markets and convenience stores, teachers, agricultural jobs (including food processing plants and slaughterhouses), and on public transportation, including airports and rail services.

Examining Californians to determine if they have been exposed to COVID-19 and tracing people they came into contact with is considered crucial to reducing the spread of infection as hospitalization rates and positive tests increase.

California now averages more than 100,000 tests a day through a combination of public and private test sites, but some researchers have estimated that it needs to double that number to deal with the virus.

But as California joins other states in seeing a sharp increase in cases, it has become more difficult to obtain test supplies, and commercial laboratories are taking longer to provide test results, the US Department of Public Health said. been in a press release.

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The new evaluation guidelines are being made “as we work in parallel to increase evaluation capacity statewide,” said Dr. Mark Ghaly, secretary of the California Health and Human Services Agency.

The rules mark a departure from the Newsom administration’s plans for anyone, including those without symptoms, to be screened for the virus in California. Earlier in the pandemic, some counties offered tests to anyone who wanted one.

But Los Angeles County, home to a quarter of the state’s population, saw its highest number of confirmed COVID-19 cases and hospitalizations in a single day on Tuesday, with more than 4,200 additional cases reported. 9% of people tested in the county are positive for the virus, higher than the state rate of 7%.

Hospitalizations also set a record in the San Francisco Bay area.

Asymptomatic people who are not in essential jobs are now at the fourth level, the lowest priority, and will only be evaluated once the state can obtain the test results in less than 48 hours, according to the guide.

On Monday, Governor Gavin Newsom partially withdrew from the reopening of state businesses by ordering the closure of bars, indoor restaurant canteens and similar closed venues. More than two dozen counties that have been placed on a state watch list due to virus outbreaks have also been told to close gyms, shopping malls, nail and nail salons, and ban religious services in places of worship.

Dr. Hala Madanat, director of the San Diego State University School of Public Health, said the new testing guidelines make sense. She said she heard from people with symptoms waiting several days to get tested, making it difficult to control the spread.

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“It would be ideal if we had all of these tests approved and available and we could screen all asymptomatic people and do surveillance, but it’s not realistic where we are right now in the supply chain,” he said.

Ghaly said the state is also drafting emergency regulations to ensure that health insurance companies cover all coronavirus testing in the state, especially for “essential” workers at increased risk of contracting the disease. The regulations have not been published.

“It will strengthen and support our delivery system, clinics, hospital systems, so that we can do more testing and more confident testing to make it widely available,” said Ghaly.

California health plans already cover tests at no cost to the patient if the tests are ordered by a doctor, according to the California Association of Health Plans. Federal guidelines do not require health plans to screen for work or for public health surveillance.