Back to school: Young kids need COVID testing and lots of it. Why is it so hard to get?
It took nearly four hours to find a COVID test for my daughter. We must make this easier for families with young unvaccinated kids as schools reopen.
Some of the most humbling moments for physicians like me are when we become health care users rather than providers. Earlier this month, more than a year into the COVID-19 pandemic, I was shocked to find that it took me nearly four hours to locate testing for my 10-month-old daughter.
After she was sent home from day care with a fever, my first call was to our pediatrician to get her COVID-19 testing and cleared for day care, but there were no available appointments that day. I next sought out one of Boston’s free COVID-19 testing sites. After waiting nearly two hours with an infant in a sun-exposed parking lot on an 85-degree day, we learned that results might not return for 72 hours.
This would have meant three more days out of work for me, so we traveled across town to another testing site where we could get faster results. After an hour-long wait outdoors in the sun, my daughter was tested and fortunately, as we learned the next day, she was negative for COVID-19.
Too many obstacles to testing
We need accessible, free-of-charge and timely testing for families in every part of the country. My family’s experience was not unique. Americans are increasingly seeking testing and encountering long waits. Infections are rising from the delta variant, and schools are about to reopen.
Our national attention has rightfully been focused on vaccinating as many people as possible. However, vaccines are still not approved for children under 12. This fall and winter, a rise in infections from COVID-19 and other viruses is inevitable. Children are going to need testing, and lots of it.
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From the earliest days of the pandemic, we have known that testing was central to identifying infections, tracing contacts, guiding quarantines and determining when an individual can return to school or work. Like masking and physical distancing, testing is a critical tool that helps us minimize the spread of COVID-19. It is therefore enormously concerning how complex and time consuming it was for my family to find testing – particularly since I am not only a father but also a pediatrician, and seeking testing in Boston, which boasts some of the nation’s highest quality health care.
Barriers to testing are too high. My state of Massachusetts maintains a comprehensive list of COVID-19 testing sites, and fortunately there are plenty. But all have restrictions. Very few sites offer testing to young children. Appointments are often necessary and difficult to obtain on short notice. At many sites, someone seeking testing must be a patient of a particular health care system or live in a specific ZIP code.
Most testing sites have cut back their hours, often only offering testing for two or three hours a day, and only on certain days of the week. Testing is usually only available during work hours. No information is provided on the turn-around time, leaving enormous uncertainty on when results will be available.
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At-home rapid COVID-19 testing is an attractive alternative to in-person testing. However, some home tests are not suggested for very young children. And they may be overly expensive for many families, typically costing at least $20 per test. These expenses mount even higher when testing multiple family members.
Parents can't do this on their own
Governments at every level – federal, state and local – need to prioritize COVID-19 testing now, just as they did earlier in the pandemic. An increasing number of delta-variant infections are breaking through among vaccinated individuals, and people of all ages are increasingly going to need testing in the months ahead.
Children should be a priority; they are unlikely to be eligible for vaccination until the winter and are especially vulnerable to illness from the delta variant. Governments should increase funding for testing sites to expand services to children of all ages, including infants, and on evenings and weekends (outside parents’ work hours) and regardless of ability to pay.
Resources must also be specifically earmarked for communities of color. Throughout the pandemic, Black, Hispanic and Indigenous people have been more likely to become infected, be hospitalized and die from COVID-19, and vaccination rates remain lower among people of color than white Americans. Without ready access to free testing, communities of color will be disproportionately affected by economic hardship when children fall ill and cannot attend school or daycare, leaving their parents unable to work.
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The rise in infections many of us expected this fall has arrived early, and our COVID-19 testing capacity is inadequate. Our country’s health and economic recovery is at risk. When my daughter fell ill, I was fortunate to have the job flexibility and know-how to take time off to navigate our complex health systems. Many other Americans are not so privileged. To help keep kids in school and their parents at work, we cannot forget that alongside our push for mass vaccination, we must ensure that testing is readily accessible for everyone, particularly children and their families.
Dr. Scott Hadland (@DrScottHadland) is a pediatrician and the chief of adolescent medicine at MassGeneral Hospital for Children and Harvard Medical School.
