UPDATE:  At the May 26th Irvine City Council meeting, the Council voted to cancel the testing program that had been unanimously approved at the May 12th Council meeting.

When I was out walking this morning, I noticed that our City’s golf courses have reopened.  Seeing more residents outdoors was a welcome sight.  It was also nice to hear the golfers chatting and laughing with one another.  However, I was alarmed to see that they weren’t wearing face masks or practicing any sort of social distancing.

This morning’s experience has led me to question the basis for the City’s decision to begin reopening.  Did Irvine meet the benchmarks set by the State of California?  Where’s the City COVID-19 Damage Mitigation Plan?

As a longtime Irvine resident, a mother, a grandmother, a physician, and a professor at the UCI School of Medicine, I have been struck by the lack of planning on the part of Mayor Christina Shea and the City Council.

Irvine is home to one of the most prestigious medical and scientific research universities in the nation.  UCI has been on the frontlines of the COVID-19 pandemic since January, with teams of researchers working on a vaccine, developing a contact-tracing app, and setting the groundwork for a large-scale test study which will help determine who is most at risk for the virus.  Irvine is also a hub for cutting-edge medical and scientific organizations.

As a UCI School of Medicine Professor, I find it disconcerting that the City Council would not consult our institution to develop and implement a program to mitigate the damage of COVID-19.

Every Irvine resident should be asking the same questions I am:  Why didn’t the Mayor and City Council take advantage of the amazing resources we have in Irvine?  Why didn’t the City partner with UCI and/or other medical research companies?  Why did Irvine do no testing in February, March, April…and now May?

We’re coming to the end of May and the Council has just voted to implement a testing program, which is scheduled to begin on May 26th.  That means we have lost four months with no testing in place.  And there are still no plans that have been announced for contact-tracing, which is critical to getting our City open again.

Four months into this pandemic, the Council’s desire to demonstrate that they are taking action by beginning a testing program has resulted in failing us…again.

Why?  Because the testing program that was outlined at the May 12th Council meeting doesn’t appear to follow generally accepted guidelines.

In order to reopen our cities safely, we should test:

1. Those who have COVID-19 symptoms
2. Those who are in quarantine
3. Health Care Workers
4. First Responders
5. Nursing Home Workers
6. Essential Workers (mail carriers, grocery store employees, etc.)
7. Those who would return to work

Testing is viewed by the medical community as only one part of a more comprehensive plan.  We need to test, trace, isolate and treat.  Public health and public policy leaders are adamant that all four parts of this comprehensive plan are essential in creating a safe work environment so that businesses can reopen.

I listened intently to the May 12th Council presentation by the US Health Fair — the company hired by the Council to perform testing.  As a pediatrician, I was appalled by the lack of discussion regarding critical public health elements of testing, tracing, isolating and treating.

Last week, I sent a letter to the City requesting answers to these critical questions:

1. Can you provide more information about US Health Fairs?  There is very little information on their website that informs on their protocols and experience on COVID-19 testing and the associated interventions.

2. Which COVID-19 antigen test is being used?  Is this an FDA and EUA (Emergency Utilization Authorization) approved testing kit?  Did the test developer submit external validity and specificity data to the FDA or is the validity and specificity simply internal and unreported?  What is the validity and specificity?

3. Which antibody test is being used?  What entity developed the test?  Was this FDA and EUA approved?  Did the test developer submit external validity and specificity results to the FDA?  What is the validity and specificity?  Which antibodies are tested?  How long does the immunity allegedly last based on their studies?

4. As we are all well aware, the appropriate intervention is test, trace, isolate and treat.  Other than testing, how is the City implementing these next strategies?

5. How does the City promote and ensure that each individual tested is connected to a medical doctor to interpret the results and guide treatment?  How is the City of Irvine dealing with families that do not have a primary care medical provider?

6. What are the expected outcomes from this program?  How does this help essential service workers, school re-opening, and preventing the spread of COVID-19?

7. Is this program coordinated with and approved by the Orange County Health Care Agency to ensure that it is consistent with their guidelines for our community?

I’ll let you know when I receive responses to these questions.

Right now, it appears that the Council’s plan is to begin reopening the City and then provide testing afterwards, with no contact-tracing or isolation and treatment efforts in place.  In other words, Ready – Fire – Aim!

Phyllis Agran, M.D.