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Nearly two years into the pandemic, Minnesota still doesn’t have enough COVID-19 tests

In the Twin Cities area at least, appointments for tests are scarce.

The line for COVID-19 testing at Saint Paul RiverCentre on Wednesday.
The line for COVID-19 testing at Saint Paul RiverCentre on Wednesday.
MinnPost photo by Greta Kaul

If you’re looking to get a COVID-19 test appointment in the Twin Cities today, good luck.

As cases in Minnesota rise with the new, more transmissible omicron strain, appointments at the state’s community test sites are mostly booked. Ditto local pharmacies and health care providers. Walk-in wait times are unpredictable and at-home rapid tests are so scarce they almost feel like a luxury good.

The Minneapolis Vaccine Hunter Facebook page, a group that formed to help people find vaccines in the beginning of the COVID-19 vaccination drive and now has more than 57,000 members, has morphed into more of a test-hunting page. Group members report where they’ve been able to get tests and how long they had to wait.

Earlier this week, the state announced expansions in the state’s testing capacity. In an MPR interview, Gov. Tim Walz acknowledged the testing shortage, but defended the state’s test infrastructure.

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“We have a robust system. I think the good news now is that people are using it, they understand testing is important. The bad news is, the supply chains are still strained, nationally,” Walz said.

But some Minnnesotans aren’t necessarily as sanguine about the state’s testing options at the moment. In the Twin Cities metro area, many travelers returning home after the holidays, parents trying to evaluate whether their kids are infectious in school and Minnesotans who are sick are expressing frustration at the testing shortage.

Scarce tests

As official COVID-19 case counts near their fall 2020 peak in Minnesota, COVID-19 tests have become harder to find. For much of this week, it was difficult to secure same or next-day COVID-19 appointments at state testing sites or in pharmacies, particularly in the Twin Cities metro area. The lines for walk-in appointments at testing sites can be long. Earlier this week at the Brooklyn Park community test site, the line stretched outside in chilly temperatures, and some without appointments reportedly waited as long as two hours.

The Minneapolis-St. Paul airport site temporarily closed to walk-ins early in the week due to crowding. The volume of at-home test kits available through Vault Health was reduced over the high-demand New Year’s weekend due to high demand, according to the company. More recently, the tests have had DoorDash delivery issues. On its website, Vault warns that due to high demand, results — typically available within 24 to 48 hours after arriving at the lab— are delayed.

At-home rapid tests, which for now cost Minnesotans who can afford them between about $7 and $39 apiece out-of-pocket are usually out of stock online. Major pharmacy chains like CVS and Walgreens have stopped indicating whether they’re in stock in stores, sending some Minnesotans on the hunt to check stock in-person.

While the state test sites and at-home kits are free to everyone, options at drive-up sites and pharmacies are fewer for Minnesotans who are less internet-savvy and those who don’t have transportation or access to insurance.

Hard to compare

Testing shortages are not limited to Minnesota right now. As the omicron strain spreads around the country, many big cities are reporting high demand for tests.

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“SF COVID Testing in Meltdown, as Lines Stretch Several Blocks, Results Taking Multiple Days,” SFist reported.

“New year, same long lines for COVID-19 testing,” echoed KSAT San Antonio.

“Long Lines at Mass. COVID Testing Sites Keep People Waiting for Hours,” reported Boston’s Channel 10.

How is Minnesota doing compared to those places?

“It is really hard to be able to answer that question,” said Gigi Gronvall, a senior scholar at the Johns Hopkins Center for Health Security. “We don’t have visibility into how states are doing. Perhaps the CDC has some holistic view, perhaps the White House has some view. Certainly the companies know, but putting that all together is really challenging.”

Nearly two years into the pandemic, it’s not just testing capacity that remains a challenge, but also things as seemingly simple as counting tests. States report testing numbers, but they don’t all use the same definitions, an issue that has hampered many efforts to compare pandemic data state-t0-state. Furthermore, they don’t tend to capture the at-home antigen tests that people buy over-the-counter.

A Johns Hopkins tracker that compiles state data put Minnesota at 638 tests per 100,000 people this week, near the middle of states. Rhode Island had the most tests by this metric, with 1,918 tests per 100,000 people, and New York, Illinois, Vermont and Massachusetts were all above 1,000 tests per 100,000 people.

The data aren’t perfect, but they’re what we have, Gronvall said, and they indicate Minnesota seems to be doing about as well as similar states.

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Aside from data challenges, it’s difficult to assess state testing programs in relation to each other because they’re all different.

Studies show testing capacity going up, but “it’s still unclear what the distribution is,” Gronvall said.

Demand may not be uniformly distributed across communities in the U.S., which could explain why it’s often easier to get an appointment for a COVID-19 test in many of Minnesota’s more rural communities as compared to the metro area.

“States are taking different approaches to how they’re distributing tests, which could be contributing to whether or not they’re adequately meeting people where they are,” said Lindsey Dawson, the associate director of HIV policy and director of LGBTQ health policy at the Kaiser Family Foundation, who has been monitoring COVID-19 testing. While some states are distributing tests through counties, others are distributing them through community health centers or, like Minnesota, are making testing available through community testing sites and through the mail.

“Even in places that are doing a great job in creating a number of different avenues to access, we can still see delays,” she said, noting people tweeting about long lines in New York City, where testing is available on many street corners. “So clearly, the U.S. as a whole and localities individually, haven’t mastered making testing widely accessible and affordable at this point in the pandemic.”

Too much testing?

Demand has surged in recent weeks around the country. Part of that might have to do with a change in government and media messaging about the role of COVID-19 tests, Dawson said.

“The federal messaging, [particularly for home testing] was really focused on whether or not you’d had an exposure to COVID-19 or if you were showing symptoms,” she said. Recently, it shifted to using tests as more of a risk-mitigation measure, urging testing before gatherings.

This week, Dr. Benjamin Mazer argued in an Atlantic opinion piece that asymptomatic people are taking too many COVID-19 tests amid shortages, driving up demand. Using an adage about traffic (“You are not stuck in traffic. You are traffic.”) he urged Americans to temper their use of tests when it’s unnecessary.

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“Yes, the system failed us: Inadequate public investment in the nation’s testing infrastructure has worsened the congestion. But we can help ease it too — and clear the way for those who have the greatest need for their results — by staying off the road whenever possible,” he wrote.

All that demand, paired with supply chain issues and a reliance on the market to dictate test production has hurt test availability, Gronvall said.

Last year when COVID-19 was abating, for example, Abbott Labs shut down one of the sites manufacturing Binax rapid tests, citing low demand. Then delta hit, school started, and COVID-19 cases began to rise again. More recently, demand has surged with omicron.

Expanding capacity

Both the state and federal government are working to make tests more available.

Last month, the Biden administration announced it would make 5o0 million rapid tests available to Americans, starting this month, and is expected to announce a plan to have private insurance reimburse people for at-home rapid tests.

On Tuesday, Gov. Tim Walz announced the opening of three additional testing sites, in Anoka, North Branch and Cottage Grove, plus expanded testing capacity at the St. Paul site. He also announced the state would distribute free at-home tests to schools and communities “disproportionately impacted by COVID-19.”

“MDH collaborates daily with our testing partners throughout the state to monitor supply. Like elsewhere in the country Minnesota is seeing unprecedented demand and are working to ensure every Minnesotan who needs a test has access,” MDH spokesperson Erin McHenry said in an emailed statement.

Other countries, including Germany and the U.K., have done a better job at making COVID-19 tests available to residents, Gronvall said.

Gronvall said she thinks the U.S. may need more focus on a long-term fix for the pandemic: vaccines. While omicron seems to be better at evading vaccines, early evidence suggests those who are vaccinated and boosted are less likely to contract COVID-19 and less likely to get severely ill from it.

“We wouldn’t be dealing with the same issues with omicron if more people were vaccinated,” she said. “I love tests. Tests are fantastic. We need to know how bad the epidemic is … but I do think vaccination is the endgame.”