Los Angeles Mayor Eric Garcetti announced Wednesday that COVID-19 testing is now available for all residents across L.A. County, whether or not they show symptoms of the illness.

Those who do show symptoms of coronavirus infection will take priority, but all Angelenos are eligible to receive a test at no cost to them, Garcetti said. The mayor said L.A. is now the first major U.S. city to offer the tests to all asymptomatic residents.

After some contradictory statements, the mayor confirmed that the testing will be available to the whole county, not just Los Angeles city residents. L.A. County, with some 10 million residents, is the most populous county in the nation; the city of L.A. has about 4 million residents.

Garcetti announced the expansion during his nightly pandemic update, saying evidence of large numbers of people without symptoms spreading the virus “illustrates why making testing available to anyone who wants it is essential.” 

Appointments can be made via coronavirus.lacity.org/testing. But in the wake of Wednesday’s announcement, the site appeared to be overloaded with visitors.

Garcetti said that though appointments are available to all county residents, those who are asymptomatic can only get tested at one of the city-run sites. The appointment portal will guide those interested on what’s available to them.

The testing sign-up site on Wednesday evening indicated that — in partnership with the city of Los Angeles and Community Organized Relief Effort — the county was offering free testing to “ALL Los Angeles County residents, whether or not you are experiencing COVID-19 symptoms.” CORE, the group the county and city are working with, is a nonprofit disaster relief organization founded by actor Sean Penn.

Garcetti says the 35 testings sites countywide now have the capacity to test 18,000 people a day — up from 145 people on the first day of testing 40 days ago. So far, a total of 140,000 county residents have been tested.

Considering estimates that 200,000 tests are run each day nationwide, L.A. has the capacity to conduct 9% of all tests in U.S., Garcetti said.

County officials say testing capacity is still limited

Asked Wednesday afternoon about Garcetti’s comments earlier in the week that he hoped testing would be opened up to all residents countywide regardless of symptoms, L.A. County health officials said certain populations needed to be prioritized before that could happen.

Dr. Christina Ghaly, director of the county’s Department of Health Services, said people who are symptomatic, those in institutional settings and the homeless population must be tested first. The next priority is asymptomatic first responders and health care workers. Those priorities are in line with the state’s, Ghaly said.

“While test capacity continues to be limited, we’ll be focusing on that first priority population, with a continued eye to roll out to subsequent populations in the near future,” Ghaly said.

The state wants to see 60,000 to 80,000 tests per day, with L.A. County’s share making up 25 to 30% of that, Ghaly said. So the “general goal” is 15,000 to 20,000 tests per day in the county, she said — although Garcetti has said capacity is already within that range.

Garcetti announced the testing expansion countywide just a few hours after Ghaly’s comments.

In a tweet Wednesday night, the county said it had not issued new testing guidelines and would provide “clarification” during its Thursday afternoon news briefing.

Expansion started slowly, but quickly ramped up in recent weeks

Last week, Garcetti began expanding testing to asymptomatic essential workers, and he ramped up that effort further this week.

By Wednesday, health care professionals, first responders, grocery store and pharmacy workers, journalists, construction workers, and delivery and transportation drivers could all get tested. Officials are also working to test all staff and residents at the county’s more than 300 nursing homes.

Initially, testing was only offered to symptomatic people considered at higher risk of dying from the disease — senior citizens and those with underlying conditions — and people under mandatory two-week quarantine after travel or other exposure. On April 6, officials expanded access to any county resident experiencing symptoms of respiratory disease.

When efforts began last week to test people living in facilities with close quarters — at the nursing homes as well as shelters, jails and treatment centers — the county’s health director said the majority of residents who tested positive were asymptomatic.

On Wednesday, in announcing that more than half the inmates at the Terminal Island prison off San Pedro had tested positive for the virus, the Federal Bureau of Prisons said only 10% of those tested were showing symptoms such as cough and fever.

Testing access has been expanded for some more than others

Officials are still working to give communities of color and low-income areas more access to testing.

Dr. Barbara Ferrer, the county public health director, on Wednesday detailed findings from a department report showing more affluent Angelenos have better access to coronavirus testing and treatment, even as infection rates appear to be higher among low-income communities and many communities of color.

The virus is also spreading faster and more likely to be fatal in poorer areas, according to the report.

Ferrer called the findings “troubling and of great concern.”

To address the need, the county recently opened up more testing locations in South L.A., where 38% of the population is black, and in Inglewood, where more than 46% of residents are black.

Antibody testing remains very limited

As of Wednesday, the virus was confirmed to have spread to 22,485 Angelenos, including 10,380 in the city of L.A. Over the past week, the county has seen an average of 886 new cases and 46 deaths reported each day.

But officials suspect more people contracted the disease without ever showing symptoms or testing positive, and work to identify those individuals is in its early stages.

The county is working with USC to conduct antibody testing, which is meant to show if someone has already had an immune response to the virus.

Results from initial testing estimated 221,000 to 442,000 adults in the county were infected by early April — which would mean the virus was far more widespread than known, but around 96% of the population still hadn’t caught it.

The study participants are selected using random sampling methods, and the first run of testing included just 863 individuals. Researchers are now recruiting a few thousand more people for a second round in early May, according to Ferrer.

But debate is still open on whether people with antibodies are immune to the disease and, if so, to what degree. Experts have also expressed concerns about the tests returning false positives, and only a handful of them have been approved by the U.S. Food and Drug Administration.