By now, Covid protocols everywhere from concert venues to workplaces have become commonplace: Present proof of vaccination and/or a negative test result to enter. At the Weekly, I needed to get tested for Covid-19 after the New Year’s holiday before returning to work in-person – sensible enough. I waited in line at Monterey Regional Airport for a PCR test, as I had done before (only then, before the surge, the line was two people deep, not 200). When it was my turn, an attendant scanned a QR code on my phone screen, I self-swabbed and walked away to wait for test results. Easy, fast. But this time, unlike in the past, my result wasn’t a day or two away; in this case, it was six-and-a-half days away. By the time I received my negative test result, I’d already exceeded the CDC’s advised five-day isolation period – by then, it’s just a matter of anxiety mitigation, no longer controlling the spread of the virus.
Of course lines are longer and labs are backlogged – we’re in a surge. But this is precisely when it matters. Nearly two years into the pandemic, why is it still so hard to get tested?
Ultimately, the blame lies with the federal government, specifically the FDA, for its cumbersome requirements for testing companies and failure to scale up.
PCR tests – or polymerase chain reaction – like the one administered by the South San Francisco-based company Virus Geeks at MRY – are more accurate, but slower to deliver results. Rapid tests, which are less sensitive but far more efficient, delivering results in 15-20 minutes instead of days at an off-site lab, are what we need more of these days. But the FDA has been slow to embrace rapid tests, and now local testing companies are literally running out.
Sameer Bakhda is an ER doctor at Community Hospital of the Monterey Peninsula, and a dad of students at the International School of Monterey. Last year, inspired by dual goals – getting his kids back to school and keeping people out of the ER – he set out with his wife, Kristin Bakhda, a nurse/midwife at Kaiser in San Jose, and CHOMP colleague Michelle Kalinski, to offer more rapid tests locally. They formed a company called Lightspeed Testing, got loans from family, hired about 60 people and have set up to offer rapid tests at local sites including the downtown Monterey farmers market and Monterey Bay Aquarium. From May-October last year, they did about 5,000 tests; in the last two weeks of December alone, they did 5,000 tests.
Lightspeed orders BinaxNOW tests from Abbott Laboratories, which has a corner on the U.S. market for rapid tests, and gets them delivered to the Bakhdas’ garage. “We put in an order with Abbott in December for more tests,” Sameer says. “It’s now mid-January, and they say we might get it to you by the end of February.”
Besides the supply chain issues, Lightspeed is facing other challenges with scaling up. Licensing requires that a medical professional, like a physician’s assistant or paramedic, is present at each site. And after spending about $350,000, the partners hope to get reimbursed by insurance companies, but they’ve started to get ridiculously low payments from insurance companies, like a $4.04 check from Blue Cross. “That doesn’t even cover the cost of the test, let alone the training, the staff, the electronic records – I mean, come on,” Bakhda says.
(I admitted to Bakhda that I’m guilty of typing in a phony insurance number, 12345, while waiting in line in a cold parking lot for a test – realizing now that this means they face paperwork problems in getting reimbursed anything by my insurer, I’m going to stop, promise.)
Meanwhile, there are other pressures, like staffing. The state still has a testing contract with OptumServe for PCR tests at limited sites, but their Seaside Salvation Army site closed this week because a nurse there got sick. The Monterey County Covid Collaborative, working with VIDA to administer rapid tests at various sites, is also awaiting new tests. Kim Stemler, who has been the Collaborative’s testing/vaccine coordinator, called the California Department of Public Health to order 20,000 more BinaxNOW tests. “We don’t know if we are going to get the 20,000 and we don’t know when,” Stemler says.
And meanwhile, the virus keeps on spreading.