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A surge in coronavirus cases has Los Angeles County health officials telling doctors to give up on testing patients in the hope of containing the outbreak and instructing them to test patients only if a positive result could change how they would be treated, according to a new report.

The advisory from the Los Angeles County Department of Public Health Thursday was prompted by a crush of patients and shortage of tests and could make it difficult to ever know precisely how many people in L.A. County contracted the virus, The Los Angeles Times reported.

The department “is shifting from a strategy of case containment to slowing disease transmission and averting excess morbidity and mortality,” according to the letter, the Times reported. Doctors should test symptomatic patients only when “a diagnostic result will change clinical management or inform public health response.”

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The paper reports the guidance sets in writing what has been a reality all along--the shortage of tests nationwide has meant that many patients suspected of having COVID-19 have not had the diagnosis confirmed by a laboratory.

In addition to the lack of tests, public health agencies across the country lack the staff to trace the source of new cases, drastically reducing the chances of isolating people who have been exposed and thereby containing the outbreak, the paper reported.

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The Times quoted a front-line healthcare provider as saying that county doctors were interpreting Thursday’s advisory to mean they should only test patients who are going to be hospitalized or have something unique about the way they contracted the virus.

They are not planning to test patients who have the symptoms but are otherwise healthy enough to be sent home to self-quarantine — meaning they may never show up in official tallies of people who tested positive.

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The Los Angeles Department of Health Services, which runs the nation’s second-largest municipal health system, “is mobilizing all of its resources to fight the on-coming wave of COVID-19 cases expected in the coming weeks,” said Dr. Christina Ghaly, DHS Director, according to the paper. “We are ramping up hospital capacity and taking extraordinary measures to increase supplies.”

Gov. Gavin Newsom issued the nation’s strictest “stay at home” order Thursday night, taking effect at midnight Friday.

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“This is not a permanent state, this is a moment in time,” California Gov. Gavin Newsom said, trying to assure the nation’s most populous state that the order would eventually lift.