Citing a continual lag in COVID-19 testing by hospitals, Santa Clara County issued a new order on Wednesday requiring hospitals and clinics to test at least three categories of people.

Health Officer Dr. Sara Cody's June 10 health order requires all large health care systems in Santa Clara County to offer COVID-19 testing to patients within their systems who have COVID-19 symptoms, have been exposed to COVID-19, or who need to be tested frequently because they are at higher risk of exposure such as being a health care worker or grocery store worker.

"Just as we expect all health care providers to test their patients for other communicable diseases and conditions that put their health at risk, healthcare providers need to test their patients for COVID-19," Cody said in a statement. "Many healthcare providers have already stepped up to meet this expectation, and we are grateful for their partnership as we all work to reduce severe illness and death from COVID-19."

Well over 1 million people in the county are covered by the large health care systems, but the percentage of those people who have been tested by hospitals and clinics remains small, said Dr. Marty Fenstersheib, the county's COVID-19 testing program officer.

Santa Clara County Valley Medical Center and its clinics have borne the majority of the testing, Fenstersheib said at a press conference. Many large health care systems have already made testing available to these patients, but all large health care systems in the county need to provide this level of care.

The order focuses on patients who are of highest risk, although Fenstersheib said during a conference call with reporters that all patients should ideally be tested.

The order includes all acute care hospitals, and all clinics and urgent care facilities operated by organizations that run an acute care hospital in the county or elsewhere. Clinics and hospitals included are those operated by the county's Health and Hospital System, El Camino Hospital, Good Samaritan Hospital, Kaiser Permanente, Palo Alto Medical Foundation, Regional Medical Center and Stanford Health Care. Several are already offering testing to everyone in these groups, but among those lagging are Kaiser Permanente, Stanford Health Care, Palo Alto Medical Foundation and Regional Medical Center, Fenstersheib said.

Kaiser has been doing about 285 tests per day over the past three weeks, he said.

Supply shortages have hampered testing for some hospitals, but most of those issues are now being addressed, according to county leaders. Health care providers who are experiencing shortages of testing supplies can now obtain help from the California Coronavirus Testing Task Force. The local order follows action by the state and federal governments to require health insurance companies to cover COVID-19 testing for their members.

"If Valley Medical Center can do it and find reagents, any of these other hospitals should be able to find it or with the help of the state," County Executive Jeff Smith said during Wednesday's press briefing.

Smith said that while a large percentage of the population is insured, the downside is that their access to testing is determined by somebody else rather than the county, which currently offers more than 46 sites where residents can receive free COVID-19 tests. In the past seven days, between 850 and 3,500 tests have been administered per day in the county, with an average of 2,354 tests per day. This is 120 tests per 100,000 residents. The county on its own can't get to the higher numbers it needs — eventually 15,000 tests per day — without the help of the other hospitals and clinics outside of the public system, Fenstersheib said.

"We can't get to those numbers when all of those health care systems are not stepping up and doing their share," he said.

Officials are particularly concerned as the economy opens up and recent large protest gatherings potentially exposed people to the virus.

"Without the participation of all health care providers in ensuring access to testing for those who need it most, we will not be able to protect the public from communicable diseases like COVID-19," Fenstersheib, said. "As we continue to reopen activity in the community, ensuring everyone has access to testing will be critical to keep the community safe."

In a written statement, Stanford Health Care disputed a claim that it isn't doing its share of testing. The hospital's testing data, which can be found here, shows that more than 60,000 people have been tested at all of its sites, including outside of Santa Clara County, and at least 11,000 of its workers are part of that number.

"The fact is that Stanford has been proactive on COVID-19 since the beginning, March 4," according to the statement. "Our CEO David Entwistle has spoken with both state and county medical directors and received compliments on our COVID-19 testing."

Find comprehensive coverage on the Midpeninsula's response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.