The Circus That Is Covid Testing In America
Covid has been with us for one year today. I remember reading about it on New Year’s Day last year and filing it in the back of my mind as something I should keep an eye on in case it turned into a full-blown pandemic. Being a lifelong student of history even before I decided to become a professional historian, I’m well acquainted with epidemics and have long expected one to come along. We were overdue and I knew it. Yet, it still came as a shock, especially the speed at which it developed and spread around the globe.
What came as more of a shock was first the utter ineptitude and then the malign neglect of my own country’s response. I didn’t realize the rot started by the Trump administration spread so far and so deep. Yet it did, and here we are, a year into a pandemic, and people are complaining about flaws in vaccine distribution while we still have not even mastered testing and contact tracing. We are like a baby trying to learn to fly a plane when we have not yet learned to walk.
I’m going to use my own county as an example of the circus covid testing currently is in the United States. Before I begin, please keep in mind that my county has it together better than most, we have relatively low case counts for our state, and have generally been doing a good job. And let’s not even get into the idiocy of doing this on a state by state level, much less county by county. For any international readers, it’s as absurd as if every village in England decided to manage the pandemic all by itself.
Tomorrow I will get my latest test for covid-19. It will be my fifth or sixth test; I’ve lost count at this point. I don’t really think I have it, but I work with the public, I’m moderate risk, and my mother in law is high risk and is watching my daughter a couple of days a week so I can work. Getting tested is the responsible thing to do. Finding a test is a chore in and of itself, however.
First, do you have insurance? If not, the only place you can be tested without paying for is the county’s community testing sites, offered twice a week on Sundays and Thursdays. They’re drive-through testing sites, so if you don’t have a car, good luck. You also have to schedule an appointment, preferably online but they also have a phone number if you don’t have internet access.
Okay, if you don’t have insurance and are willing and able to pay, how much does it cost? $149 if you don’t have symptoms, and $249 if you do. This varies by location, but that is the price at the urgent care location I went to for my last test. I thought I had it that time, and the doctor thinks I did, but the test came back negative (possibly because they did it wrong -after so many tests, I can tell.)
Now let’s say you do have insurance. Great. The test is free. Assuming you have symptoms. If you don’t have symptoms, you have to pay at most locations. So much for being responsible, unless you want to lie, or shell out $149.
That’s the financial part. Scheduling the test is even harder. You go to your primary care doctor’s office, right? Not so fast; many doctors aren’t doing the testing in house. It’s too risky for the staff. Mine only does it once per week at an after-hours covid clinic. I’m night blind, so driving down there at 7 pm isn’t a great idea.
What about the health department? Surely that’s an option, right? Some counties do have testing at their health department. Not mine. Mine only operates the two drive-through testing locations. They offer a link to private testing sites on their website. So you go there, put in your zip code, call the first place that pops up, and go get the test, right?
If only it were that simple! Each testing center is different. They all have different criteria for whom they test, when, how they do the test, what kind of test they give and for whom, and a different costing structure. (Costing structure? I thought it was free. Well, it is if you have insurance and symptoms, but many places require an office visit with its attendant copay.)
Are you still with me? Because I’m not sure I’m with myself at this point. Here’s my latest foray into the world of scheduling a covid test. I haven’t even gotten the test yet. I ended up contacting four sites this time. Here’s a description of each.
Site 1, a local urgent care clinic. They have drive-through testing, appointments required. They only do the lab test that gets sent off with results in 2–4 days. Or 8–10, if they’re backed up. For asymptomatic testing, you just make an appointment, pay the fee ($149, remember?), and show up. First appointment three days out. If you’re symptomatic, you have to have a virtual visit with one of their providers first to see if you meet their qualifications.
Site 2, another local urgent care clinic. Rapid testing only, results for everyone in 15 minutes or less. But you have to make an appointment several days in advance and have an office visit before the test. They are backed up several hours on appointments most days due to high demand. You have to wait in their waiting room and be seen in person.
Site 3, yet another urgent care facility. You have to have a virtual appointment before being approved for the test whether or not you’re symptomatic. They come to your car to take the specimen; no need to get out. If you’re a frontline worker, as defined by their criteria, you can get the rapid test. Otherwise, it’s off to the lab. The first appointment was four days out.
Site 4, a national pharmacy chain with testing locations throughout the area. All tests are sent off, so no rapid testing. They have both self-administered and drive through testing locations. All appointments are booked online. This was the easiest experience I’ve had so far. Say you have symptoms on the online form or pay the fee, make the appointment, and show up. The first appointment was three days out.
Does this make ANY sense to anyone? If it does, you’re better at sorting out the logic than I am. It took me several tries over a couple of days to find and get an appointment for a test and it only happened because I’m being responsible enough to make sure it happens. I should be getting a test every week, and healthcare workers definitely should, but you can see the impossibility of that under this current system. (No, healthcare workers aren’t routinely tested by their employers. Surely you jest?)
We can talk about the promise of a vaccine all we want. But vaccines alone can’t save us. It is going to take a lot more than that to get this epidemic under control. We have to get the basics down -testing, contact tracing (don’t even get me started on that one), masking, washing hands, or we’re doomed to live with this for another year. Or five.
Stay home when you can. Stay safe. We can beat this scourge, but it’s going to take all of us.