One Medical, based on SF, offers coronavirus tests to everyone without symptoms

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One Medical, a San Francisco-based primary care provider, has started offering coronavirus testing for people without symptoms, becoming what experts say is one of the first medical providers to extend diagnostic testing beyond of those who are sick.

The vast majority of test sites require patients to have symptoms such as cough, fever and shortness of breath – and a prescription from a doctor, nurse, medical assistant, or nurse practitioner – to be done test for COVID-19. The only exceptions are first responders and healthcare workers, who may be tested without symptoms if they believe they have been exposed to the virus while on the job.

Although One Medical is a membership-based service, its tests are open to the general public. The company has a significant presence in the Bay Area, with 32 medical offices in the region. It has locations in eight states and 422,000 members nationwide. The COVID-19 test is done in some places, but not all, and tests are by appointment only, although patients must first undergo a virtual assessment by One Medical.

The company said demand for testing among people with symptoms has decreased in the Bay Area and other parts of the west coast, while demand is increasing among people without symptoms who fear they may have get in touch with someone with COVID-19 or who wish to be tested before interacting with people at high risk.

“This is mainly due to the normal seasonal decline of the flu and other cold-causing viruses, but may also indicate lower rates of new COVID-19 infections in these regions,” the company said in a statement. “However, the number of patients concerned that they have been exposed to COVID-19, or worried about returning to work, or visiting an elderly relative or friend at risk, is increasing. As a result, as the number of symptomatic patients wishing to take tests gradually decreases, the total number of patients wishing (or in some cases requiring) tests continues to increase. “

One Medical said it has the capacity to do 10,000 tests a day across the country, including 2,000 in the Bay Area. Given its large membership and geographic reach, the company’s decision to relax previously stringent test criteria is important and may indicate that shortages of test supplies such as swabs may be running out. mitigate at some suppliers. One Medical said it only orders the amount of supplies it needs each week from LabCorp, Quest and other labs.

Some infectious disease experts have applauded the decision to generalize testing for asymptomatic people, while others have warned of its limitations. As a general rule, screening asymptomatic people who have recently come into contact with a positive patient, as is the case with contact tracing, is a smart disease control strategy.

“I think it’s a good thing if you have enough tests and reagents,” said Dr. George Rutherford, head of the infectious diseases and epidemiology division at UCSF. “I think we will all get there eventually.” These guys are just the first to do it. “

But experts say testing all asymptomatic people may not be the wisest route.

“It is not because a person is tested negative at the time of the visit that he is not infected, because the incubation period is two weeks,” said Dr. Lee Riley, disease expert infectious at UC Berkeley. “So if the test was done while the infection was still incubating, the test may turn out to be negative. And the next day or three days later, that person could become positive. So just one test at a time for asymptomatic people makes no sense, since these are only tests at that time. … To really determine if an asymptomatic person (has the virus), you need to be tested every day for 14 days. It’s just not practical. “



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