WATERTOWN — New Yorkers may experience delays or increased difficulty to get a coronavirus test at their closest location as several walk-in sites ration COVID-19 tests, prioritizing symptomatic high-risk individuals, those in contact with a positive person and healthcare workers, nursing home employees and first responders on the pandemic’s front line.
Several walk-in north country testing sites, including urgent care centers, recently limited walk-in tests to symptomatic patients as facilities become overwhelmed by long lines and wait times. Demands for COVID-19 diagnostic tests, completed by swirling a swab deep inside a patient’s nasal cavity for at least 15 seconds, have increased following last week’s Thanksgiving holiday, which health experts estimate will contribute to a surging outbreak.
QuikMed Urgent Care on Washington Street changed to offering tests by appointment two weeks ago because of the increased volume, said Milagros “Milly” Smith, a QuikMed physician’s assistant.
On Friday, the clinic was booking its Tuesday appointments. The multi-day delay to get an appointment has frustrated patients, Smith said, as the facility has been known as a walk-in testing site for months.
“That’s the whole premise of an urgent care, and the fact that we’ve had to switch to appointments is very disturbing to me, personally, as a practice manager,” she said. “I don’t like the fact that we’re doing appointments, but we really, in order to meet the demand and to be safe, we have to do it this way.”
The decision was not mandated by the state Department of Health, a DOH spokesman said Friday, but health providers may set varying parameters based on the facility’s testing availability.
“I’m not aware that there’s been any shortage,” Smith said. “If someone were to call today and had like a unique situation, of course we would try to accommodate them, but you have to be fair, because people are waiting to get tested. There is some consideration given, but for the most part it is first come first serve. People cancel, and within five minutes, it’s filled.
“It’s very difficult for us in the healthcare field to meet the demand and try to make everyone happy,” she added.
The state has more than 1,200 designated coronavirus testing locations, with 15 DOH drive-thru locations statewide.
The department has not rationed COVID tests at state testing sites, or required a ration at other facilities to date. Several medical facilities across the state are diverting or prioritizing COVID-19 rapid test and other testing inventory to balance the increasing demand on state and national labs.
About 200,000 COVID-19 tests — some days more, others fewer — are conducted in New York state each day, and is more than any other state in the nation. The state could perform 500 tests in 24 hours at the pandemic’s start in March.
Appointment availability and wait times have exponentially increased at all sites, but more at certain locations than others.
DOH officials recommend New Yorkers call and ask providers about their available types of COVID-19 tests and requirements. Testing result timeframe, proximity and availability varies depending on multiple factors at the state’s 1,200-plus sites.
“There are many ways a patient can get tested ... we’re not the only game in town; there’s a lot of different options,” the spokesman said. “The state’s testing sites do not put any parameter on an individual being symptomatic or asymptomatic. Since the summer, we have worked with anyone who wants a test, and anyone who wants a test can get a test.”
Certain locations have left patients waiting in line for hours.
“So call,” the DOH spokesman said. “The department down the street might be jammed ... but pick another one if the line is longer at one. You have options.”
The spokesman could not provide the state’s estimated COVID-19 testing supply, he said, as equipment at 1,200 state and private medical facilities vary by the hour.
“You’re seeing increasing rates here all around the state, and that’s partially a product of people paying attention and increased awareness,” he said Friday.
“The state is answering the bell; the state has proven that we can meet that demand and will continue to.”
QuikMed staff ask patients their reason for requesting a rapid test. The clinic also cannot meet a general walk-in demand because of safety of congregated patients. Patients are asked to wait in their car and a staff member will call you when they’re ready for you to come into the building.
“It was just getting too chaotic, and with all of the COVID restrictions, it’s not a safe environment to have a bunch of people waiting in your waiting room or in your building,” Smith said.
The facility performs 80 to 100 tests per day, and orders one case of rapid tests each week, or about 300 in 12 boxes.
The state has sent tens of thousands of testing kits to each of New York’s 62 counties, hospitals and nursing homes statewide.
The state’s Coronavirus Task Force has targeted virus microclusters, or geographic hot spots, with thousands of increased tests, which have put a greater strain on state labs.
The facility offers antibody tests, which determine if a person has had the novel coronavirus within the last few months, but the demand is low, Smith said.
A few times, the facility was forced to reschedule scores of patients because of inadequate testing inventory.
“We do replenish our inventory as quickly as possible — we’ve never gone longer than a whole day that we haven’t been able to offer rapid COVID testing, but the inventory has been rationed now,” Smith said.
Snow last week caused a delivery delay, forcing the clinic to reschedule about 60 patients.
The state’s average infection rate has hovered at about 4% over the last week — reflecting a gradual climb from about 1.5% positive this time last month.
New Yorkers are required to get a negative COVID-19 test before admission in a hospital for elective surgeries and procedures. Several states mandate travelers test negative before arrival.
Watertown Urgent Care, which has offices in Watertown and Adams, give residents COVID-19 tests by appointment for potential exposure, or pre-travel and medical procedures. The facility offers tests to walk-in patients exhibiting symptoms, including cough, fever and shortness of breath.
“If they’re sick or showing symptoms, they’ll be seen by a provider and then administered a rapid test,” said Mike Lettiere, physician’s assistant at Watertown Urgent Care.
At times, testing supplies have tightened, delaying appointments by a day or two.
“But that’s the extent at this point,” he said. “Of course, we’re depending on the manufacturers to ship us at periodic times so the demand may outstrip our ability to continue the schedule, but right now, we’re keeping pace with demand.”
The Gaffney Drive facility has about a week’s worth of tests, or about 200 on hand.
“We do have a continual supply,” Lettiere said.
The center conducts between 80 and 100 rapid tests a day.
“Demand is so great ... which is definitely putting a strain on the system, the wait times, the staff, PPE, but everybody’s trying to hold things together as best we can,” Lettiere added.
The state requires all hospitals, nursing homes and medical facilities to have a 90-day supply of personal protective equipment, such as masks, gowns, gloves and face shields, after a significant shortage last spring.
Testing locations are not mandated to have a specific number of testing kits on hand, the DOH spokesman said.
Watertown Urgent Care patients waited an average of two hours to get a COVID-19 test Friday, with wait times climbing to three hours last week because of increased demand.
Urgent care staff advise patients who do not need a same-day COVID test result to go through the drive-thru at Samaritan Medical Center. Appointments are made within a one-week span.
“There may be a point sometime soon that we may not offer that appointment just because of the demand ... so that’s on a week-by-week basis,” Lettiere said.
Some patients have influenza or both the flu and COVID-19, Lettiere said. The flu season started in October and ends in March or April each year.
The increase in time to make a testing appointment is a product of demand, but generally has not affected the turnaround time for results, the DOH spokesman said.
COVID-19 infections are expected to increase through the upcoming holiday season and winter months. Numbers likely do not yet reflect the anticipated surge from Thanksgiving.
Health officials are prepared to build temporary pop-up testing locations in communities as needed, or increase the number of lanes to accommodate more vehicles at drive-up sites.
DOH opened a temporary COVID testing site in Watertown in July after an increase in new cases following the Fourth of July holiday. Hours increased at testing sites in Rochester and the Finger Lakes region, which have seen spiking infection hot spots over the last month, after patients experienced heightened testing wait times.
“We’re not surprised by our increase here — we’re prepared for this. We’re increasing testing capacity, we’re prepared at every turn,” the DOH spokesman said. “This public health response is constantly evolving and we’re evolving with it.
“Part of the effective public health response is to remain nimble” he added. “We’re better suited to be able to respond to increasing cases at this stage than we were in the spring because there was so much unknown at that time.”
Medical facilities are capped at the COVID-19 testing they can order based on order history.
“So because we have a high volume, we’re able to obtain more testing kits,” Smith explained. “But it’s not a perfect system. There have been a couple of times when we have either run out, or we have not been able to receive on a timely basis.”
QuikMed uses the deep nasal swab, or PCR COVID testing, when rapid tests run out.
“Most people don’t want the alternatives — most people want immediate gratification,” Smith said.
Lewis County Health System offers free COVID-19 drive-thru testing this month from 11 a.m. to 1 p.m. Mondays, Wednesdays, and Fridays at the Maple Ridge Center in Lowville. Results take an average of five days. Rapid testing is not available.
Watertown’s Samaritan Medical Center is a state drive-thru testing site and tests up to 300 community members per week, as well as any patient requiring testing after calling the Samaritan Resource Line at 315-755-3100. All pre-surgical patients for Samaritan and other surgical providers require tests as well.
The DOH spokesman encouraged all New Yorkers to call and ask providers questions about availability, COVID testing options, potential cost and result turnaround to determine their ideal testing site.
“We built a testing network that would rival anyone in the country and we did it quickly,” the DOH spokesman said. “We’ve done it to ensure all New Yorkers who want to get a test can get a test.”
Testing is one piece of the puzzle in the state’s battle against the disease, the DOH spokesman said.
“(A) negative test result is as good as that moment in time,” he said. “It doesn’t mean throw caution to the wind. ... That test maybe gives you confidence, but wear a mask, stay home, wash your hands — all the things we’ve been saying for months.
“These infection rates can and will go back down if we maintain vigilance,” he added. “It worked once. We do it again, it will work again.”
The state has ramped up testing and contact tracing capacity since its first official coronavirus case March 1.
DOH official encouraged New Yorkers to pick up the phone when a contact tracer calls, and answer their questions truthfully.
“There are instances we’ve seen or heard where a contact tracer is given a hard time,” he said. “They’re doing important public health work; the more forthcoming an individual is with information, the better chance we have in identifying potential spread.”
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