Why Is It So Hard To Get A Coronavirus Test In America?

There have been almost 11,000 documented cases of COVID-19 in the United States — and the key word here is documented. Because of a clusterfuck of bad decisions on the government's part, coronavirus tests, and the accompanying equipment, are in extremely short supply, leading to a proliferation of stories about sick people who have been denied tests for the deadly, highly contagious virus. Yet, even as ordinary Americans can’t find a way to get tested, celebrities, politicians, and professional basketball players have been able to do just that, and are posting their results on social media.

“As predicted, #COVID19 is exposing all of the societal inequities,” Uché Blackstock, MD, a Brooklyn urgent-care doctor, wrote on Twitter. “It’s upsetting for me to 1) have to ration out #COVID19 testing to my patients, then 2) have to wait 5-7 days for the results, when celebrities are getting tested with ease and quick turnaround times.” 

This isn’t to say the rich and famous shouldn’t be tested — there is no such thing as unnecessary testing in this case. But, because of the shortage of tests, it can feel egregious that celebrities appear to have unlimited access to tests when many doctors are being forced to aggressively screen patients, allocating tests to those who are highly symptomatic, those who have had recent exposure to someone who tested positive, and high-risk groups such as the elderly and immunocompromised. (Quick question, though: How are you supposed to know you've been exposed if no one's getting tested?) Let’s not forget, young people are vulnerable to coronavirus, too: New Centers for Disease Control and Prevention (CDC) data shows that 40% of patients in the U.S. who were sick enough to be hospitalized are between the ages of 20 and 54. And those who have no symptoms can carry the disease and spread it to others.

That’s why, according to medical professionals, mass testing has been the key to reining in an outbreak like this, because it allows doctors to find and isolate carriers — including asymptomatic ones — and prevent them from spreading the disease. South Korea has tested about 270,000 people to date and is testing about 10,000 people a day; new cases there have dropped from a peak of 909 on February 29 to 74 on March 17. Mass testing also seems to have stopped a recent outbreak in an Italian town. The U.S. has only tested about 96,000 people so far, according to the COVID Tracking Project, and it's been about two months since the first case appeared. 

It's pretty evident that "regular folk" are getting the short end of the stick, particularly in hard-hit states like New York, Washington, California, and Massachusetts. While eight NBA teams and scores of politicians and celebrities have been able to get tests, the stories of people — many of whom have severe symptoms and think they have been exposed to someone with coronavirus — running into hurdles are piling up. They are so numerous they have their own hashtag: #CDCWontTestMe. On top of this, there are other matters of privilege baked in: A New York Times reporter has the time and economic means for five days and a dozen calls to get his test (his results showed that he had COVID-19), whereas a single mother who works in retail and can't make calls on the job does not.

Jenna Rosen, a 34-year-old policy associate for a Manhattan DA campaign, said she woke up last Friday with chills, body aches, a sore throat, and a 99.6 fever. A friend she had dinner with about three days prior — before restaurants had closed and New York City had been told to stay inside — was sick and had been in direct contact with someone positive, as Rosen found out later. Rosen's fever went up to 100.4 on Saturday and she started to cough. She called her urgent care, Mount Sinai Brooklyn, and they told her not to come in. They said it was because she should stay home in order not to potentially expose others, and because she had been exposed by proxy — it was her friend who had been in contact with someone positive.

During a virtual visit through Mount Sinai's app, the doctor told Rosen she most likely has COVID-19, but that it appeared to be a mild case. Because Rosen is not in a high-risk age group, doesn't have underlying health issues, and didn’t require hospitalization, she was told to monitor her fever and check back if it lasts for more than seven days. She was also asked to self-quarantine for 14 days. In the days since, Rosen's fever decreased, but she started becoming short of breath, "like I can't really talk for too long without needing to take a breath, almost like if you walked up 10 flights of stairs or something," she told Refinery29.

Rosen says she knows there are others who need the test more. But she's worried she may have exposed other people to the virus. "It's basically just horrible I can't get a test because who knows how many people I came into contact with when I wasn't showing any symptoms," she said. "There are so many conflicting messages. Trump says everyone can get one, New York City says don't get one if you're not horribly sick, and I know I'm a mild case compared to others. I'm also the kind of person who never wants to take something away from someone who needs it more than me. I would never want to take one and then find out a doctor or a person with cancer couldn't get one." 

Nicole*, who is in her early 40s and lives in the NYC area, said both she and her one-and-a-half-year-old daughter started exhibiting symptoms like coughing, congestion, and fever. "We had been doing everything right," she told Refinery29, including washing their hands and sanitizing surfaces. "I essentially had coronavirus without a positive test confirmation. Three doctors agreed. Two calls to the Department of Health, a 311 survey, and a healthcare questionnaire all pointed to the obvious. But no one will help me prove it. One doctor tells me to call the Health Department hotline, then the Health Department tells me to ask my doctor for testing. My doctor’s office doesn’t have tests, so I begin calling every hospital in town to find one that does. It’s extremely frustrating, to say the least, and a test of one’s patience at best." 

But like Rosen, Nicole was too young to meet testing criteria and had no underlying health conditions. Finally, she had a virtual urgent-care visit that led to a doctor recommending her for testing. She is still waiting for the call to schedule her test, "but I finally feel seen," she said.

The U.S. has chosen to design its own coronavirus tests without relying on the World Health Organization (WHO), which has shipped thousands of tests to countries around the world. (On top of this, Trump administration officials reportedly misled the public about the efficacy of the WHO tests.) This, in itself, is not unusual, given that the U.S. and other wealthy countries don't typically rely on the WHO for resources like tests. 

But in early February, just as the first cases were found in Washington state, some labs reported that the CDC tests weren't working. According to CNN, officials have launched an investigation into why, but have yet to give a detailed account of what went wrong. 

In the past few weeks, capacity for testing has increased beyond the CDC, with states and private labs being allowed to conduct their own testing. Drive-through testing sites, like those that have been successful in South Korea, are starting to open around the country. But this hasn't happened quickly enough. And while the tests are now free thanks to new federal legislation, that hasn't opened up more access to them — or reduced potential ensuing medical bills.

"The testing capacity remains extraordinarily limited compared to where we should be. And in many ways we are absolutely flying blind at the moment," Michael Mina, an epidemiologist at the Harvard T.H. Chan School of Public Health, told NPR. 

Some are blaming the federal government's lack of mobilization on Trump's "obsession with numbers"; he wants the official number of cases to be smaller so the number of people who vote for him is bigger. Either way, we are behind other countries when it comes to testing and our "curve" is likely to look drastically different because of it.