In one recent week, a New Yorker got a free COVID-19 test in a jiffy, with results the next day, while a Coloradan had to shell out $50 for a test two cities from her hometown after a frantic round of pharmacy-hopping. A Montanan drove an hour each way to get a test, wondering if, this time, it would again take five days to get results.
While COVID-19 testing is much easier to come by than it was early in the pandemic, the ability to get a test — and timely results — can vary widely nationwide. A fragmented testing system, complicated logistics, technician burnout and squirrelly spikes in demand are contributing to this bumpy ride.
“We’re still where we were 18 months ago,” said Rebecca Stanfel, the Montana woman who had to wait five days for test results in Helena last month after being exposed to someone with the virus.
Unpredictable waits can be a problem for those trying to plan travel, return to school from a quarantine — or even get lifesaving monoclonal antibody treatment within the optimal window if they do have COVID-19.
The White House said in early October it plans to buy $1 billion worth of rapid antigen tests to help improve access to the hard-to-find over-the-counter kits. But people are also facing problems getting molecular testing, including the gold-standard PCR tests.
Public health labs are no longer hamstrung by supply bottlenecks on individual test components such as swabs or reagents, said Kelly Wroblewski, director of infectious disease programs for the Association of Public Health Laboratories. But they are still bearing a large testing load, which she had expected to shift more to commercial or hospital-based labs by now.
Testing labs of all stripes are also facing worker shortages just like restaurants, said Mara Aspinall, co-founder of Arizona State University’s biomedical diagnostics program, who also writes a weekly newsletter monitoring national testing capacity and serves on the board of a rapid-testing company.
“The staffing shortage is very, very real and holding people back from increasing capacity,” she said.
Something as simple as proximity also still dictates how quickly test-takers get results.
“Northern Maine is a good example,” Aspinall said. “Anything you do with PCR is going to take an extra day because it’s got to be flown or driven a ways.”