As Americans prepare to travel for holiday gatherings, the celebrations appear increasingly likely to overlap with surging Covid-19 cases and the rapid spread of the omicron variant. Those threats, in turn, are spurring a clamor for PCR testing, rapid tests and at-home kits.
"For that extra reassurance, as we have more disease in this country right now, do a test and make sure that you're negative before you mix and gather in different households," Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said in a White House briefing on Friday.
The problem? Covid-19 tests are getting harder to come by. Some public health officials anticipate a renewed strain on testing resources, while sites in cities like New York City and Miami are already seeing long lines.
"The reality is testing resources aren't infinite in this country," said Dr. Meena Brewster, the health officer in St. Mary's County, Maryland, which is south of Washington. "Depending on how omicron goes, we may very well get to long delays in test turnaround times and very restricted access to testing, like where we were early on in the pandemic."
Brewster said libraries in her Maryland county that are giving out free at-home tests can't keep up.
"We pretty much run out of those tests really quickly," she said.
In New York City, long lines stretched outside of testing sites this week, and the daily average of new Covid cases reached 3,700 on Thursday — a figure not seen since early April. CityMD, an urgent care provider with clinics throughout the city, said its testing volume climbed more than 25 percent over the last two weeks, and lab results are taking as many as three to five days to come back.
In Indiana, some local health agencies warned this month that they have limited rapid tests or are no longer offering them. The health department in Clark County, Indiana, which borders Louisville, Kentucky, ran out of the tests for a couple of days, then was able to procure a small shipment.
“Our cases are trending back up, so our testing demand is high,” the county’s health officer, Dr. Eric Yazel, said. “I’m not comfortable to say our supply will last us a significant amount of time.”
In Hartford, Connecticut, some residents were hunting down at-home tests at pharmacies like CVS, only to find them out of stock of brands like BinaxNOW and QuickVue At-Home.
In Florida, Miami-Dade Mayor Daniella Levine Cava held a news conference Thursday at a drive-thru testing site, showing cars lined up. She suggested residents consider moving celebrations outdoors but stopped short of urging people to pare down their holiday festivities.
"Despite all of our efforts, the pandemic is not over," she said.
Ron Goncalves, the Florida general manager of Nomi Health, which oversees the county's vaccination and testing sites, said there's been a spike in testing demand in recent days, which required his company to add staff.
"What was normally a 15-minute wait here has gone up to an hour in some instances," he told reporters.
Jason Feldman, the CEO of Vault Health, which sells at-home tests, said sales started increasing as Thanksgiving approached. He warned that consumers may find store shelves empty by Christmas.
“The demand on testing has never been greater,” he told NBC affiliate KING 5 in Seattle this week.
As winter weather pushes people indoors, Brewster said, she's anticipating a "triple spike" of factors that will lead to more testing: outbreaks driven by the delta variant, rising omicron cases, and flu symptoms that may be mistaken for the coronavirus.
Health officials continue to recommend testing for anyone who exhibits Covid symptoms, regardless of vaccination status, as well as for those who come into contact with someone who tests positive for Covid. Many people also rely on testing as a precaution ahead of large gatherings.
Rapid tests in particular are a key tool, said Elizabeth Stuart, a professor at the Johns Hopkins Bloomberg School of Public Health. Although PCR tests, which are processed in labs, are more reliable, the turnaround time for results can be more than two days.
"We're seeing mild breakthrough cases, and people before gathering indoors should be doing a rapid test," Stuart said. "But knowing you weren't infected three days ago isn't the information you need in the moment."
However, Quest Diagnostics said its average turnaround time remains one day, and Labcorp said that although it has seen an increase in demand, it also still delivers results in one to two days.
Another factor that could further increase demand for tests is a new strategy the Biden administration unveiled on Friday, which relies on increased testing to keep unvaccinated children in school after being exposed to Covid.
Stuart said the federal government should ensure rapid kits are accessible to everyone at an affordable cost or for free, if possible. Test kits can run from about $15 to $40. The Biden administration has said that Americans with private insurance would be able to request reimbursement for at-home tests, though that hasn't started yet.
Dr. Matilde Castiel, the health and human services commissioner of Worcester, Massachusetts, said her city received 135,000 rapid test kits on Thursday as part of a state effort to increase access to testing in low-income communities. She said she expects to have handed out all the kits by Friday.
"We need to keep focusing on equity because not every family can afford to pay for these test kits every time they should be testing," Castiel said. "It's especially important now because our numbers are trending upward."
Brooklyn resident Tyler Hazard said he waited two and a half hours for Covid testing at CityMD in New York this week. He said he was having upper respiratory symptoms after attending an indoor gathering after which someone tested positive for the virus.
Hazard is fully vaccinated and got a booster shot, but said he wanted to get tested before going to a family gathering in Massachusetts with his grandparents.
He received his rapid test result the same day — negative — but was told the PCR result would take up to five days.
"We may be over the pandemic, but the pandemic isn't over us," Hazard said. "It's ridiculous that given everything we've gone through the last two years that we still aren't adequately prepared for mass testing during surges."
