Coronavirus (Covid-19) and testing: Omicron and holidays have made the market crazy

Filed Under: Costs, Health plans, Patients

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The combination of the surge in the new Omicron Covid variant, people’s decisions to travel for the holidays and the shutdown of some public testing sites has driven a sudden overnight change in the Covid testing landscape.

Many people who had settled on a testing place in their neighborhood have now found that place has closed. Lines are long and getting longer. New options have sprung up, for example a flood of privately run mobile testing vans parked around New York City. Waits for results are getting longer. And over-the-counter means for in-home testing have become available, but are now suddenly in short supply many places because of soaring demand.

We wrote about this ia href=”https://clearhealthcosts.com/blog/2021/08/coronavirus-covid-19-and-the-tests-suddenly-in-many-places-its-hard-or-costly-to-get-tested-and-the-results-are-slow-in-coming/” target=”_blank” rel=”noopener”>in August, and now the landscape has changed even more.

At-home tests

At-home tests were widely available even a few days ago. But the market has changed. I bought 5 BinaxNow tests from CVS in late August for $23.99 a box, two tests per box. But now the BinaxNow tests are not available on CVS online, or on Amazon.

I just bought four Quidel home tests on Amazon at $23.99 for two tests. A day later, they too were unavailable on Amazon. I don’t know much about them beyond the fact that they are approved by the FDA on an Emergency Use Authorization.

A friend reported Thursday that she got a maximum 4 Binax boxes from CVS in the store in Westchester. Other friends reported anecdotally that there were no CVS tests available on the West Side of Manhattan for purchasers in the upper 70s; one woman went 40 blocks south, to the West 30’s, to buy.

On Wednesday, Pete Newman of Maplewood, NJ was able to get six FlowFlex at-home antigen tests to prepare for a family holiday party this weekend, at the CVS in nearby Springfield, for $10 each.

(Update: By Saturday evening, CVS had no home Covid tests for sale online. Walmart had tests ranging from $29.99 for two and up. )

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Amazon was offering multiple unfamiliar brands, including its own brand for $39.99. It’s wild out there.

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Am I hoarding tests? Good question.

I live in New York, where Covid has been a huge problem. I had Covid in March 2020 and don’t want to have it again. I live with a family member and I want us both to be safe. Is having a number of Covid tests at $10 or $12 a pop a bad idea? Maybe not, if commercial places are charging up to $400, which we learned in our San Diego research in the spring.

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But is it really reasonable to have a system that asks us to stock up on tests at $10 or $12 apiece? There’s a big question about availability and affordability.

Here’s Katelyn Jetelina, who is online as Your Local Epidemiologist, talking about what you might do for a testing protocol this holiday season, or as you plan to see other people in person for any reason.

Long and short lines for testing in the city

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“I keep hearing about the hours-long waits at every citymd and testing site in brooklyn, but meanwhile in midtown there is a mobile testing site on nearly every block with almost no lines. I got a test in 5 mins at 33rd/5th,” Nisha Chittal tweeted on Friday.

She asked why there weren’t more sites in Brooklyn. Lauren Kelley responded “Dammit (from a 2+ hour line in Brooklyn.)”

Taliah S. added, “I did a mobile testing site in Midtown and it took several days to get results (PCR). CityMD was the rapid test and I got results within an hour.”

TD Tso chimed in: “There are mobile sites in Brooklyn too, lines used to be manageable but are also inundated now.”

And welcome to the $395 PCR test  in New York City. Ron Lieber, the New York Times consumer affairs columnist, wrote on Twitter: “Good morning to everyone except storefronts selling $395 PCR tests and promising 30-minute results and then not delivering on that promise. Yes, this is a thing amid the overall testing meltdown that you may be experiencing.”

A Manhattan exposure

A woman I know in Manhattan was exposed to Covid on Monday of this week and learned of that exposure on Tuesday or Wednesday, when a person she had been with on Monday told her of a positive test result.

My acquaintance happened to have an in-home test that was sent to her family in connection with a planned event where they needed to test in advance. This is the kit; it calls itself a test for current infection, and comes, in her description, with a battery pack and resembles a PCR test. It is one of several rapid molecular tests for home use that are said to be more accurate than the more common in-home antigen tests.

The marketing material says this:

  • First and only FDA EUA authorized single-use molecular home test
  • 98% accurate compared to one of the best known high sensitivity lab PCR tests1
  • Results in as fast as 11 minutes for a positive result and 30 minutes for a negative result
  • Authorized for self-collection for individuals aged 14+ and adult collection for children aged 2-13
  • 100% of people 14 and older were able to run our test2
  • Detect alpha, beta, delta, gamma, lambda, mu and omicron COVID-19 variants

A new place in the suburbs

In Pelham, in southern Westchester just north of New York City, a state-run drive-through testing place at Glen Island Park was opened by Gov. Andrew Cuomo in the early days of the pandemic. It was fast and free, and served the neighborhood for many months. It closed in late June, and since then local residents have been trading information on Facebook about where to get tested.

Social media posts document long wait times at many testing sites in lower Westchester and New York City. Lines stretch around the block, and the wait for results is significant at many places.

At Pilgrim Pharmacy in the Bronx, walk-ins are welcome. The location at 2941 Westchester Ave., 15 minutes away from Pelham via the Hutchinson River Parkway, tested a Pelham woman in 15 minutes on Friday afternoon;  results came early Saturday. She had been exposed to a person with Covid, and her test was covered by insurance.

A new testing place in Pelham’s downtown popped up in a week. The door has a sign for www.htmpmedical.com, Healthy Therapeutics, phone 917-750-6412. There was a lot of conversation online about whether it would be covered by insurance; a local woman wrote on Facebook, “The test is 36 hours turnaround unless you pay for 1 hour ($300) or end of day ($175). For insurance covered testing, it’s 36 hours.”

Here’s a report from a local person about the new location.

“It was packed (2:30pm). So much that people were asked to stand outside. …

“We wait there for 90 minutes during which time I see not one single person swabbed. Not one.

“So I left and went to Pilgrim Pharmacy in the Bronx. They were accepting walk-ins. PCR are $50 and results promised within 12 hours.

“A friend who stayed at the new place (for the 36 hour insurance covered test) said it took her 90 min and a consult with a nurse practitioner was required before they would do the swab.”

Someone else wrote:

“The new COVID testing place on Fifth Avenue is incredibly misleading. It’s more like a clinic, and you are required to have a televisit with their doctor before they administer the test, or it will be declared invalid. We have been waiting an hour already and they’ve swabbed literally two people in that period of time. People here are not happy – it’s ridiculous.”

Someone else wrote:

“Sorry you had a bad experience. I went today with my daughter at 12:45, waited for nurse practitioner on the iPad for a while, completed 2 pcr tests by 1:45. The rapid costs $300, not covered by insurance.”

(Update Dec. 27: Local folks reported that there is a sign in the window noting that the site is closed because they are worried about staff getting Covid. Another commenter said the site is closed.)

Crowded clinics in New Jersey

On social media in Maplewood, N.J., it was noted that the Essex County test sites are walk-in and fast, while one person reported that MedRite in Springfield, which he had visited many times with no wait, had “a huge line out the door and around the building.” One visitor there reported a two-hour wait on Sunday, in a room without social distancing and questionable mask-wearing, which caused a great deal of anxiety.

One neighbor, Fan Winston, tried to take her 11-year-old son, Bo, for an antigen test, as he had had a fever and stomachache and could not return to school without a negative rapid Covid test. She headed to MedRite in Springfield, but it had changed locations, so she went to the nearby Care Station Medical Group. Some people in the waiting room looked sick, and weren’t wearing their masks correctly, so after half an hour they decided to wait in the car, and 45 minutes later they finally were seen.

She would have left, but had already paid a $20 copay, she thinks because it was treated as a sick visit. “It felt like they had just opened. It felt like the Wild West,” she said. She felt it might have been easier to get a test in New York City, as she’d passed three testing spots on a recent walk from Penn Station to Bryant Park, where the lines looked as long as coffee shop lines. Bo tested negative.

Free home testing for New Jersey

On Monday, New Jersey announced residents could take free at-home saliva tests, which the state will mail on request. To take the test, people have to get on a Zoom call with the testing service, spit into a tube in front of an observer (there’s a great job!) and send the completed test to the lab via UPS. Results are available in 24 to 48 hours.

New York closed testing sites

The City NYC reported on Thursday that the number of public testing sites in the city was slashed recently.

“The number of city-operated fixed-location testing centers listed dropped dramatically in the middle of November from 54 to 34, with 31 operating as of Wednesday, an analysis by THE CITY of city Health + Hospital system data shows,” The City wrote. “On Wednesday, 8,318 New Yorkers had a positive COVID lab or rapid test, according to state Department of Health figures tracked by THE CITY — up from 5,084 Tuesday and 3,124 Monday. That’s a seven-day average rate of 54 per 100,000 people, up from around 30 per day earlier this month.”

“Posted maximum wait times for tests at the remaining city-run sites have risen from a seven-day average low of 7 minutes in mid-November, before the removal of the 20 locations from the website, to 30 minutes in the past week.”

With city sites closing, the article noted, private companies are moving to fill the need.

Also on Thursday, Mayor Bill de Blasio announced that he would be distributing free at-home Covid tests to homes throughout the city. Details of the plan are unclear.

Facebook Testing resources

On a New York City Facebook page called “Helping NYC Get Vaccinated (Covid-19), one of the group members, Karyn Pavich, said she had seen a message that LabQ, one of the local private companies, sent to a patient saying that wait times for results would be 48 hours instead of the previous 14 hours.

She made this graphic for Astoria, Queens, testing locations.

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New York City Department of Health Express PCR testing sites are listed here.

This Manhattan test site list was posted on the same thread, from the New York City Health + Hospitals public hospital organization. The person who posted sent the link to the H+H site where the files reside; she said it’s updated weekly. Here’s the link;  there are similar files for all five boroughs.

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What you can do

The testing market seems to be changing nationwide. How can you protect yourself?

Ask up front “will this be covered? what will it cost me?” and take notes, take names, take numbers.

We have been reporting since last year, and with increasing frequency since the spring, that insurance coverage (or “free testing,” which is not always exactly the same thing) is not guaranteed. Some insurers ARE covering if 1) you were exposed 2) you are symptomatic. But NOT covering if 1) you are going to visit grandma or 2) you are flying to Hawaii on vacation. This seems to differ from provider to provider, city to city, insurer to insurer.

At some places, the test is free (or covered by insurance) but you may be charged for an office visit, or for lab fees. It’s unpredictable.

The bottom line: It pays to shop around and ask up front.

Local reporting can really make a difference: Our reporting for the online news organization INewSource in, this San Diego project was very immediate and fresh. We notice that some local groups (my local Moms Facebook group, for example) have up-to-date information about costs, locations and the times in getting a result.

From our San Diego reporting, and other sources, it seems often to be true that faster can be more expensive. Also tests for travel (“I’m going to Hawaii! Clear me please, according to Hawaii rules!”) are more expensive than tests for symptomatic or recently exposed people (“I was just exposed without PPE, along with my whole work group.”).

In general; faster tests can be less accurate. A negative result on a fast test can bring a medical professional to recommend a polymerase chain reaction (PCR) or molecular test, which takes longer but is more reliable. As we have been reporting from the beginning of the pandemic, all the tests are far from 100 percent reliable — either rapid test, or PCR test, or antigen test for current infection. Also far from 100 percent reliable: antibody tests (which gauge the presence of antibodies signifying a previous infection, not a current infection).