By Dominic Fracassa & Trisha Thadani

Testing for coronavirus in California has expanded significantly since midweek, with 23,200 tests completed as the number of cases of COVID-19 grew to more than 1,200, state health officials said Friday.

Coronavirus testing increased by more than 84% since Wednesday, when Gov. Gavin Newsom said the state had tested about 12,600 people.

The increase is due in large part to more labs being able to handle the tests throughout the state, data show. Public, commercial and private labs performed the tests, state health officials said. By Friday, nearly 11,500 tests were returned, with 11,700 results pending.

Across California, 22 state and county labs are conducting tests, on top of a growing number of commercial and private labs, the officials said. The result is that testing capacity — the number of samples that labs can analyze — has risen considerably in just a few days.

Still, many people have complained of difficulty obtaining tests — even nervous health care workers, who say delays in getting tested could put them, their colleagues and other patients at risk.

Adding capacity to perform more tests will prove crucial in the coming days, health experts said, as the state and the nation struggle to understand how many people could be infected and try to strike a balance between resources and need.

As of Friday evening, California had 1,206 confirmed coronavirus cases, including 515 in the Bay Area.

Even though the state is processing more coronavirus tests, by week’s end California health officials could not say how many test kits were available at a time when demand for them is swelling. There is no centralized maker or distributor of the tests, which are now coming from a growing list of private companies, private labs and public and private universities.

Vulnerable populations — including people over 65 and those with existing respiratory ailments — are given priority, and the San Francisco Department of Public Health said it is working on expanding its testing capabilities even further.

Still, even frontline workers with fevers, coughs and aches — and even one with known contact with a COVID-19 patient — have said they are having a hard time getting access to a test.

An emergency room nurse at San Francisco General Hospital said her manager told her she could still come to work this week, even though she felt sick after having had contact with a patient who tested positive for the virus last weekend.

“It was annoying and frustrating because I feel like all of these protocols are just for show,” said the nurse, who asked to remain anonymous for fear of retaliation. “I don’t feel like they have mine or my co-workers’ back.”

The nurse, who complained of a sore throat, piercing headache and a cough, was told by Occupational Health Services that she was medium-to-high risk for the virus. So she pushed back — repeatedly — and was finally tested this week at a public health clinic.

She is still waiting to receive the results.

Brent Andrew, a spokesman for San Francisco General Hospital, said he could not comment on an individual case. He said nurses are being tested in line with Centers for Disease Control and Prevention guidelines, and those with known contact with a COVID-19 patient are supposed to self-quarantine and contact their physician or the employee health clinic for a test.

Nearly all coronavirus tests are performed at the behest of a doctor. The CDC has issued guidelines for who should seek a doctor’s recommendation for testing, including people showing symptoms of COVID-19 — fever, cough and shortness of breath. Those who have had contact with a COVID-19 patient should also be given priority, as well as those who have symptoms of pneumonia but test negative for that ailment, the guidelines say.

“Whenever we get a positive test, we are really careful about identifying every one of our staff who had contact with that person,” he said. “And, typically, they are put on administrative leave during that incubation period. We are very attentive to staff safety.”

Andrew said it wouldn’t be smart to test people without symptoms, as then there may be a situation where there are “false negatives,” where people believe they don’t have the disease — when, really, it just hasn’t incubated yet.

But other ER nurses said that the hospital should be eager to test them, because they are at high risk for spreading the virus to vulnerable patients.

An ER nurse, who also asked to remain anonymous for fear of retaliation, said she developed a cold last weekend after working a shift late last week. She said she didn’t bother asking for a COVID-19 test because she knew she didn’t meet the standard.

She felt uneasy, she said, because so few of the patients she interacts with are getting tested, either.

“We’re not testing so many other people that walk in the door. ... I can’t say they were incorrect in not giving me a test,” she said. “But there is a huge delay in the return, which means you have all these patients who were potentially exposed but you just don’t know it yet.”

Dr. Robert Wachter, chairman of UCSF’s Department of Medicine, tweeted Friday that shortages of swabs, gowns and masks are presenting “big problems” for the team of clinicians there. Even as testing expands, he said, it is “amazing” that a lack of swabs could be a hurdle.

Christa Duran, an emergency room nurse at San Francisco General, said she started to feel a sore throat and fatigue two days after working a shift on Sunday. By Wednesday, she had a fever of 101.4 degrees.

But when Duran called her manager and the hospital’s employee health clinic and asked for a COVID-19 test, she was told to wait and see whether her fever broke on its own. Then if she didn’t have symptoms for seven days, she said, she was told she could go back to work.

“We’re running out of personal protective equipment, and we’re not flattening the curve if we’re being told to come in and not know if we’re carrying it,” she said.