As demand for COVID tests spikes, Tarrant County’s test sites ‘completely booked out’
Over the weekend, Jeff’s elderly father developed a fever, chills and broke out into sweat. Among other tests, his doctor recommended he get tested for the novel coronavirus.
At 81 years old, Jeff’s father is at higher risk of developing complications if he contracts the virus. And while his dad lives alone in Arlington, Jeff, who asked his last name not be used to protect his father’s privacy, wanted to be cautious and help reduce the spread if his dad did have it — especially for the handful of caregivers that assist his dad.
So on Sunday, Jeff, who lives over 1,500 miles away in California, started to look for an appointment in Tarrant County for his dad to get tested. Jeff filled out the screening questions through Tarrant County Public Health’s portal and was told his dad qualified for a drive-through COVID-19 test.
“These are the earliest available appointments based on the zip code you provided,” the webpage read.
There were none.
Jeff called the county’s COVID hotline to try and find out exactly when more would be available. They didn’t have a concrete answer, and recommended to just keep checking back.
“That’s the part where the system seems to be broken. It’s very disappointing. It’s discouraging, disheartening. It creates a little bit of anxiety,” Jeff said, noting that cases are only increasing. “Are we gonna be able to make things better if we can’t get enough testing to find out who’s got it?”
Jeff isn’t the only one who’s been unable to schedule a test. Demand for testing has skyrocketed, in both Tarrant County and across Texas as the state sees all-time highs in new cases.
Tarrant County Public Health Director Vinny Taneja said that recently the county’s screening portal has seen as many as 1,500 people try to schedule an appointment per day. Meanwhile, available appointments through the county’s portal are between 150 to 550 depending on the number of sites operating, Taneja said.
Appointments for this week were already filled by Saturday night, Taneja said. And through next Friday, appointments were already completely booked through the county’s screening portal as of Thursday afternoon.
“Demand spiked so much that everything was completely booked out,” Taneja said.
A lack of available tests could mean that cases of the virus are going undetected — leading to an undercount. And without a test confirming if someone is infected, they could be unknowingly spreading the virus to others in the community, said Catherine Troisi, an infectious disease epidemiologist at UTHealth School of Public Health in Houston.
“Testing is the eyes of the epidemiologist, and you don’t know what’s happening in a community if you aren’t testing — and testing the right people,” Troisi said.
Increased demand
In March, testing was extremely limited. Test kits were in low supply, and labs worked to ramp up their capacity. Dallas-Fort Worth residents had reported being unable to be approved for a test despite experiencing COVID-19 symptoms.
By late May, the county had increased its testing capacity and had seen so few appointments made through its portal that it expanded its testing criteria to allow for retail workers, regardless of symptoms, to get tested. People over 65 years old and adults with pre-existing conditions can also qualify for a test without exhibiting COVID-19 symptoms.
But that quickly changed. In the second week of June, the county’s testing sites started to hit full capacity. And around June 15 it kicked off. That week, a testing site in Arlington maxed out at 300 tests in one day, Taneja said.
“And after that, it just took off,” Taneja said. “And as we had more testing sites available, they kept getting consumed, and we’re like, ‘Alright, the trend has turned.’”
The county had originally partnered with the University of North Texas Health Science Center at Fort Worth and UT Southwestern through the Moncrief Cancer Center to help staff testing sites with students and faculty. But demand increased and student volunteers also needed to return their focus to their classes, Taneja said. UNTHSC stopped providing staffing on June 12, Alexander Branch, a spokesman for the center, wrote in an email Thursday.
The county now collaborates with the Texas Division of Emergency Management (TDEM) to offer roving mobile test sites that move throughout the county. The number and location of sites changes from week to week in an effort to offer greater flexibility and travel to hotspots, Taneja said. Three of the state’s mobile testing teams are currently active in Tarrant County, Seth Christensen, a spokesman for the agency, wrote in an email Thursday.
On a weekly basis, between 3,000 to 4,000 tests are completed through publicly supported efforts in Tarrant County, Taneja said, noting that TDEM can also schedule appointments through the state’s portal. And in hopes of expanding the county’s publicly supported testing capacity even more, Taneja said both the county and TDEM are discussing transitioning staffing for the county’s sites to private vendors.
To process tests, Christensen said the state already partners with 12 labs, including private ones, and that this week the state’s mobile testing teams began utilizing Curative oral swab tests which increased the state’s capacity by about 25,000 tests per day.
Public health departments and testing sites across Texas are facing surges, with some beginning to restrict who qualifies for a test and encouraging people with health insurance to seek tests from private providers.
Taneja said the county currently doesn’t plan to restrict or loosen its testing criteria. As of 11:45 a.m. Thursday, 11,493 people had qualified and were able to secure an appointment through the county’s portal. Meanwhile, 14,885 people had qualified but hadn’t scheduled an appointment — either because they chose not to or because none were available.
By 6 p.m. that same day, only 48 more people had been able to qualify and schedule an appointment. Meanwhile, the number of people who qualified but didn’t or couldn’t secure one had risen by 508 to 15,393.
A work in progress
Between 20 to 30% of people don’t show for their scheduled appointment, Taneja said, which allows the sites to accept more walk-up patients. But the county’s portal also has no way to allow someone to cancel online ahead of time, and therefore free up their appointment for someone else to sign up.
The portal is a work in progress, Taneja said, noting that it is developed pro bono from the county’s technology partners, which include companies like Adobe, Oracle and Splunk. A team from the public health department had previously called people the day before their appointment to remind them and see if they still planned to show up at the scheduled time, Taneja said.
But Taneja is shifting that team to help the department call people who test positive in order to meet the growing number of cases. Next week, the Tarrant County Public Health Department also plans to begin mailing letters to people informing them of of their test results if they can’t be reached by phone.
It’s slower, but Troisi said informing people of their positive COVID-19 result is the most important place to devote resources to slow the virus’ spread. If someone has symptoms or thinks they have been exposed but can’t find a test, they should contact their healthcare provider and begin the process of self-quarantining, Troisi said.
“The volume just has been too much to keep up with,” Taneja said, noting that this week Tarrant County reported consecutive days of all-time highs in new cases.
Taneja stressed that the county is working on fixes and to increase capacity. Thursday afternoon, Taneja was going to assess a location in the 76014 zip code in Arlington for a potential new site.
And Taneja stressed that the county’s publicly-supported sites are not residents’ only option, noting people can find additional sites through the state’s virtual map and can register for a test at the state’s mobile sites at txcovidtest.org.
But for Jeff, it wasn’t that easy. For three days he and two others searched and called to find an appointment for his dad. CVS, which offers self-swab tests, was booked days out, and the one time Jeff got close to securing an appointment through them it was taken by the time he had finished inputting his dad’s info.
Eventually, after calling at least a dozen places, Jeff was able to find a test through a private provider. Jeff is hopeful the antibiotics his dad was put on for a different issue will help clear up his symptoms. As of Thursday, his dad still has yet to hear back on his COVID-19 test.
“It’s a lot harder than I expected it to be,” Jeff said of scheduling a test. “As hard as I found it for me, I know that there are a lot people that it may be just overwhelming and may be preventing people from being able to find one at all.”
This story was originally published July 3, 2020 at 5:30 AM.
