Coronavirus (COVID-19) tests: Should I get one? How to know? Where to go?

By TINA KELLEY and PHOEBE PINDER

(Note: Coronavirus news is changing quickly. We’re trying to update as warranted.) As the coronavirus spreads, many Americans with symptoms wonder if they should get tested, and where. (We discuss how much it can cost to do so here.)

Do you have something we need to know about this? Email us at info@clearhealthcosts.com or put your test info into our handy form. 

According to the website of the federal Centers for Disease Control and Prevention, “If you are a close contact of someone with COVID-19 or you are a resident in a community where there is ongoing spread of COVID-19 and develop symptoms of COVID-19,” call your healthcare provider, who will decide if you need testing. For a quick checklist, see the bottom of this story. 

On Friday, March 20, the New York City Health Department issued a statement saying that — despite a new availability of tests — people should not get tested. “Outpatient testing must not be encouraged, promoted or advertised,” the Health Department said in an advisory.

The New York Times reported: ‘Facilities were asked to ‘immediately stop testing non-hospitalized patients’ for the virus unless medically necessary. City officials said they were worried the testing centers were drawing sick people out from isolation in their homes. To perform each test, health care workers must use fresh protective gear, including masks, which are already in short supply. The Health Department also discouraged hospitals from testing asymptomatic health care workers, alarming some doctors who believe it could lead to increased transmission within hospitals.”

California also strictly restricted coronavirus testing. In other parts of the country, the situation is less clear.

Across the country, regardless of regulations, tests remain hard to find, according to a New York Times article on March 30. ”Although testing has picked up since a series of setbacks left the United States behind, governors have continued to warn in recent days that their response is still hampered by shortages, including of basic supplies like swabs. Gov. Jay Inslee of Washington, a Democrat, told CNN on Sunday that “we have a desperate need for the testing kits.” And Gov. Ralph Northam of Virginia, also a Democrat, warned last week that there was a shortage of testing materials in his state,” The Times wrote.

         On another CDC page, healthcare providers are instructed to give priority to:

  1. Hospitalized patients who have signs and symptoms compatible with COVID-19 in order to inform decisions related to infection control.
  2. Other symptomatic individuals such as, older adults and individuals with chronic medical conditions and/or an immunocompromised state that may put them at higher risk for poor outcomes (e.g., diabetes, heart disease, receiving immunosuppressive medications, chronic lung disease, chronic kidney disease).
  3. Any persons including healthcare personnel, who within 14 days of symptom onset had close contact with a suspect or laboratory-confirmed COVID-19 patient, or who have a history of travel from affected geographic areas within 14 days of their symptom onset.

The University of Utah Health website advises that if you don’t have symptoms, you don’t need to be tested.

It’s best to check your state health department’s site directly for guidance on criteria for getting tested in your state. Here’s a directory

Here’s our data from our reported and crowdsourced “where to find a test site” collection. To add your data, go to this link. Story continues below spreadsheet. (Pro tip: If data is not visible, you may need to scroll to the top of the spreadsheet; we are adding data daily, and welcome your contributions.)

Private labs are now joining state and federal ones in processing the tests for COVID-19, but are not necessarily offering them directly to patients.  Doctors must order the tests, and patients are not to visit private labs directly, according to the websites of two large private lab companies, Quest and Labcorp. The scene is changing quickly, so check local sources regularly.

Drive-Through Tests

At least 11 states, California, Colorado, Connecticut, Indiana, Minnesota, New Jersey, New York, Ohio, Texas, Utah, and Washington, have started drive-through testing, where ill patients can be tested from cars, rather than risk spreading the virus, should they have it.

San Antonio opened Texas’s first drive-through testing facility Friday for qualifying first responders and health care workers. It is not open to the general public, and its exact location has not been disclosed. In order to qualify to receive a test, “a person’s employer must confirm he or she is ill and meets the criteria to be tested — having symptoms of COVID-19 and testing negative for the flu.”

Previously, the state’s public labs were only able to perform 270 tests per day, and many patients and medical personnel were turned down. The new drive through-testing should be able to provide “hundreds of tests per day,” according to Charles Lerner, a San Antonio-based epidemiologist. However, the tests results take three to four days to process, compared to the one-day turnaround rate NPR reported in South Korean drive-through facilities.

Kaiser Permanente has set up three drive-through testing facilities in Northern California, in San Francisco, Redwood City, and San Leandro, according to the Los Angeles Times. However, the facilities are not permanent and their undisclosed locations change daily. The facilities are not open to the general public – “only patients who are Kaiser members and have been provided an appointment with the facility by their doctor are permitted access.” Marc Brown, director of national communications at Kaiser, reported that similar drive-through sites will be opening soon in Colorado and Washington, D.C. Kaiser patients “who have double medical clearance from a primary care doctor and an infectious disease specialist are getting tested for coronavirus at the French campus in San Francisco,” according to ABC7.com, which noted that Kaiser has plans to expand to Southern California.

Express Care, Stanford Health Care’s same-day primary care program, offers drive-through testing for people with appointments and identification, according to PaloAltoOnline. Appointments for Express Care can be made online through Stanford Health Care’s portal or app, or by calling 650-736-5211. Officials urged sick people not to take services like Lyft or Uber to drive-through clinics.

In Los Angeles, testing was hard to find. “Los Angeles has taken longer to implement widespread testing, and it has partially shied away from testing, fearing that it would waste resources. Andrea Garcia, a spokeswoman for Mayor Eric Garcetti, said that there were four testing sites in the city, but the locations were only disclosed to those who qualified for the test,” The New York Times reported on March 24.

In New Jersey, Riverside Medical Group, which serves 25 North Jersey locations, announced it had started doing screening for its patients via telemedicine, and if appropriate, referring them to a drive-through location just for Riverside patients in Secaucus, which began operating on Monday

Hudson Regional Hospital — located on Meadowlands Parkway in Secaucus — will conduct testing by appointment beginning immediately, it announced Tuesday, according to NJ.com. People who have a fever, cough and shortness of breath must first begin the hospital’s screening process by calling 201-388-1097.

Kurt Keydel, 58, from Seattle, was able to get a test, as his workplace requested it when he reported having a fever. He scheduled an appointment for Tuesday at the Polyclinic’s acute respiratory clinic at 1145 Broadway in Seattle, called from his car when he got there, and came up to the office 15 minutes later when a physician assistant could see him. They checked him for Influenza A and B, and a doctor evaluated him. Because he had a heart attack several years ago, and because his employer wanted to know his condition, the doctor, after consulting with other doctors, tested him for COVID-19. “If I do have this thing, I would say I’m probably one of the lucky ones – fever is really my only symptom,” he said, adding that he did not have to pay anything for the test, although the front desk did ask about what insurance he had. His test results came back negative on Thursday.

Anecdotally, as of March 18, we hear that some CityMD locations in New York are doing testing, and that a child of an acquaintance got tested at Mount Sinai Urgent Care. We are adding other locations as we can, and we are building a database that we will post on this page.

Here’s a pop-up testing location in Snoqualmie, Wash. A commenter on Reddit said she “walked right in and got tested. I will get results in 48-72 hours. They are open 10am-6pm for anyone else that needs it. It’s free and avoids the beurocracy and incompetence described above.”

“The Medical Board of California is looking into physicians selling COVID-19 tests while sick people around the country can’t get tested because of a nationwide shortage, a board spokesman said Monday morning,” according to The Los Angeles Times. “The inquiry comes after The Times reported that ‘concierge’ doctors who cater to rich people and celebrities have been selling testing to patients and their families, in some cases even if they have no symptoms or any other reason to be tested. Dr. Jay Gordon, a Santa Monica pediatrician, told clients who purchased the tests for $250 each — to be taken at home with a cheek-swab and then sent to a lab to process results — to save the tests until they’re feeling sick.”

In Buncombe County, N.C., testing opened up and closed down three days later. “After three days of providing drive-through testing for COVID-19, Buncombe County has closed its two test sites at Biltmore Church in Arden and UNC Asheville,” The Mountain Xpress reported. “Dr. Jennifer Mullendore, the county’s interim health director, said during a March 20 press conference that the decision was made primarily to conserve resources for ‘the long haul’ in Buncombe’s management of the disease caused by the novel coronavirus. Every test … Mullendore explained, exposes health care workers to potential infection and uses personal protective equipment such as masks and gowns, which are also critical during treatment of the disease. She noted that most COVID-19 cases are mild and can be managed at home with rest and over-the-counter treatments such as acetaminophen for fever reduction.”

There are two locations in New Orleans, according to news reports, but they closed unexpectedly on March 23 because they ran out of test kits. This is common — the sites go up and down,  move locations, change requirements for testing. It’s complicated.

The New York Times published this piece about “what it’s like to get tested.” Generally, people started with a call to their primary care doctor. Other bits of advice are also included.

Driving through in New Rochelle

In the New York City suburb of New Rochelle, a drive-through testing facility was set up at Glen Island Park, part of the Westchester County Parks System, over the weekend. People who want to get tested need to drive up to the bridge over a snippet of Long Island Sound that leads to the park, and show that they have registered with the state health department to get permission to get a test. New Rochelle is a locus of infection, with several hundred cases, and that’s why the testing center was set up there by Gov. Andrew Cuomo.

Local people talking about the experience on a local Facebook group said they had sought to register with the health department and waited for permission to go, but did not receive permission and went anyway. They said they were told they could indeed get the test, if they qualified under certain criteria — active symptoms and/or exposure to a known case of coronavirus — even if they didn’t have the permission.

They said they were told results would come in 2-3 days. They said the testing was limited to New Rochelle residents, though several of the local people are from Pelham, a neighboring community.

It appeared to be true that the rules were changing on the ground — it seemed to be that traffic at the site was light over the weekend as it was being set up. Reports on the ground on Tuesday indicated that there were six lanes of testing, with tents and National Guard personnel on the parking lot at Glen Island County Park. According to the Westchester County Health Department website, “the mobile testing center is prioritizing tests for individuals that are part of the highest risk population.” It noted that New Rochelle residents who would like to be tested can make an appointment by calling 888-364-3065.  

She did say that the results seemed delayed, so she tracked down the name of the lab processing the tests and called them for results. In her case, the lab was BioReference Labs, telephone 800-229-5227.

ONLINE SCREENING

(Updated) In mid-March,  President Donald Trump announced that the White House is collaborating with Google to build a website to help Americans find coronavirus testing nationwide. However, Trump seems to have been confusing several different projects currently at work. Verily, a subset of Google’s parent company, Alphabet Inc., is building a site intended to triage and refer people for testing, but the site is still in its early stages and experiencing many issues, and currently limited to the Bay Area  (although they say they do hope to expand). Healthcare insurance company Oscar launched a similar service on Friday, featuring an online testing-center locator available to individuals who qualify, via an online survey, for testing.

People who see an easy online testing site should be sure they know exactly what they are signing up for, and be careful what information they dispense, as always. If it seems too good and easy to be true, it probably is.  

Google has announced that it is indeed partnering with the government in an effort to fight coronavirus, but that they are aiming to build “a nationwide website that includes information about COVID-19 symptoms, risk and testing information,” a far cry from the national triage and testing referral site Trump seemed to be describing.

Verily

Verily, a subset of Google’s parent company, Alphabet Inc., launched a pilot version of their new website intended to facilitate COVID-19 testing and screening. The site was launched in Northern California and is meant to point people to testing centers in two San Francisco Bay Area counties. Users fill out an online screening form to determine if they qualify for testing. According to CNBC, in order to qualify for screening and testing, users must have a Google account, “must be at least 18 years of age, a U.S. resident, able to speak and read English, located in one of the available counties, and willing to sign the COVID-19 Public Health ‘authorization form.’” 

Verily informs users that their personal information, such as name, address, email, and health information, will be shared with Google and various government and health authorities for “public health purposes.”

Confusingly, the first question in the initial screening survey asks whether the user is “currently experiencing severe cough, shortness of breath, fever or other concerning symptoms” – the known hallmark symptoms of coronavirus. If users select “yes,” they are immediately denied referral to one of the testing facilities. When asked to clarify, Carolyn Wang, a Verily spokesperson said, “The initial question is meant to ensure that anyone who is seriously ill does not come to our sites because they are not prepared to provide medical attention.”

Within a few hours of launching, Verily announced that it had reached capacity and could no longer schedule any appointments. Verily assured users in a blog post that the program is still in its early stages, and will take time to fully develop. 

Oscar

On March 13, Oscar, a health insurance company co-founded by Joshua Kushner, launched an online testing center locator, featuring more than 100 centers around the U.S. Users take an online risk assessment survey and, if selected for testing, are sent directly to an online testing center locator. The survey is accessible to the general public – you do not need to be an Oscar member in order to access it and use a version of their locator tool. Oscar said it will waive cost-sharing for testing for all members. This is their language; they did not say they are waiving deductibles and coinsurance and co-pays, but “cost-sharing.”  

Non-members and members alike need to put in information; members are directed to one link, and non-members are directed to a different link. While you are not required to put in identifying information in the questionnaire, people who are thinking about using these tools should remember that nothing is ever secret on the internet.

On March 30, Atlantic magazine reported that Oscar had built the Google site.

“Oscar Health—a health-insurance company closely connected to Trump’s son-in-law, Jared Kushner—developed a government website with the features the president had described,” Robinson Meyer wrote in The Atlantic. “A team of Oscar engineers, project managers, and executives spent about five days building a stand-alone website at the government’s request, an Oscar spokesperson told The Atlantic. The company even dispatched two employees from New York to meet in person with federal officials in Washington, D.C., the spokesperson said. Then the website was suddenly and mysteriously scrapped. … The full extent of Oscar’s work on the project has not been previously reported. The partnership between the administration and the firm suggests that Kushner may have mingled his family’s business interests with his political interests and his role in the administration’s coronavirus response. Kushner’s younger brother Joshua is a co-founder and major investor in Oscar, and Jared Kushner partially owned or controlled Oscar before he joined the White House. The company’s work on the coronavirus website could violate federal ethics laws, several experts said.”

Fake testing efforts

People should also be aware that there are fake testing efforts. More are likely to pop up in this atmosphere of scarcity and confusion. 

A yellow box truck spotted in Nashville advertising coronavirus testing for everyone is linked to a disgraced weight-loss doctor who lost his license due to unscrupulous medical claims and sexual misbehavior,” Brett Kelman and Adam Tamburin wrote in the Nashville Tennessean.

“Nashville police and the Tennessee attorney general’s office are investigating the truck and testing effort, which is being led by Richard Feldman, 72, a Nashville doctor who lost his license 12 years ago and has never gotten it back.”

In Pelham, N.Y., next door to New Rochelle, police issued a warning about a nationwide home testing scam, in which people go door to door claiming to be from the C.D.C. and offering home testing. They said anyone with such a case should call the police. Here’s the story.

Home testing

Several companies have offered or promised home testing kits. At this point, according to The New York Times, the FDA has not approved any home testing kits, and at least two of the companies promising them — Nurx and Carbon Health — have withdrawn their offerings.

The Times’s full story is here.

Celebrities

It seems at this point that athletes and celebrities are not having trouble getting tested. Among those testing positive are actors Tom Hanks and Idris Elba, and four members of the Brooklyn Nets.

Non-celebrities like Tim Herrera, a 33-year-old New York Times editor and writer, have a harder slog. Herrera wrote of his journey: “Almost a dozen calls with five health care providers over five hours. Two hours of hold music. Two hours in a hospital. Four days of anxiously checking an online portal for results. And lots of confusion. That’s the winding path through bureaucracy that took me from placing my first phone call last Wednesday to getting my positive coronavirus test results on Monday night. Five days in limbo.”

What you can do

  • Try to stay healthy by washing hands regularly for 20 seconds each time.
  • Practice social distancing to slow the spread of the disease. If you’ve been exposed, this will keep you from passing it on to anyone else even if you have symptoms, and whether or not you have tested positive.
  • If you have symptoms similar to those of the coronavirus, fever, and a cough and/or difficulty breathing, call your doctor and follow instructions as to getting tested. Directions seem at this point to vary state by state and jurisdiction by jurisdiction.
  • Do NOT show up unannounced to a doctor’s office or hospital if you have symptoms.
  • If you don’t have a doctor, call ahead to a walk-in clinic or a federally funded health center.
  • There are efforts to extend testing, but right now the availability seems to be limited. Asking friends and neighbors if they got tested and how seems to be a good strategy. If you are genuinely in need, be persistent. Some people said they had been turned away from several testing sites, while others eventually prevailed.
  • Remember, though, that keeping the limited testing capabilities open for people who are in great need is a social good. If you aren’t experiencing symptoms and you don’t meet local official testing requirements, don’t try to insist on getting tested.

Resources

GENERAL

The national hotline for coronavirus is here: 1-800-525-0127.

Medicare and coronavirus (Kaiser Family Foundation)

Medicare and coronavirus (Centers for Medicare and Medicaid Services)

Center for Disease Control and Prevention Site

Medicaid Official Site

NYTimes Coronavirus live updates

Johns Hopkins Bloomberg School for Public Health Center for Health Security COVID-19 site

Johns Hopkins COVID-19 live tracker

Quest Diagnostics

LabCorp

Kaiser Permanente

C.D.C. list of state and territorial health department websites

Directory of hundreds of mutual aid resources nationwide

List of Coronavirus/COVID-19 hoaxes from Buzzfeed News

How states are responding to coronavirus, in 7 maps.

Small business resources, particularly for women who are founders, from The Helm

CALIFORNIA
City of Los Angeles COVID-19 test referral site

CONNECTICUT
Two medical institutions in Connecticut have set up telephone hotlines for people of Fairfield County who are experiencing symptoms that they are concerned could be linked to the coronavirus, according to the New Haven Register:
Norwalk Hospital: 888-667-9262 / 8 a.m. to 6 p.m. Monday to Friday.
Stamford Hospital: 203-276-4111 / 7 a.m. to 7 p.m. Monday to Friday.

FLORIDA
News 6 “Click Orlando” map of COVID-19 testing sites in Florida

MASSACHUSETTS
Massachusetts essential services

NEW YORK
NYC United Against Coronavirus resources-donations, deliveries, relief funds etc.

New York County county breakdown of cases from health.ny.gov

Tricks for navigating New York’s archaic unemployment web site

Westchester County Health Department site

New York City MTA transit updates

Washington
Online screening and test referral for Snohomish County residents

Health insurance and COVID-19 FAQ from the Office of the Insurance Commissioner of Washington State