Coronavirus testing was a breeze when J.D. Schroeder traveled to Abu Dhabi and Mexico this fall. Not so much at home in Pennsylvania when he felt sick Wednesday and found out he had been exposed.
The mechanical engineer started looking for an over-the-counter rapid test because the earliest antigen test appointment he could find in his Pittsburgh-area community was almost a week away. Rite Aid would only let him order online. The closest CVS pharmacies were all out of stock. He nabbed the last box at a Walgreen's, which came back positive.
When he traveled to the United Arab Emirates for work last month, he paid roughly $13 for lab tests and got results within two hours. A hotel in Mexico where he vacationed over Thanksgiving had ample rapid testing kits for guests.
"I'm 31 and I'm pretty tech savvy. I can't imagine someone who doesn't have access to a computer or isn't comfortable searching different places to figure this stuff out because it can be confusing," said Schroeder, who is now quarantining at home.
Easy access to coronavirus tests — both rapid at-home kits and PCR tests analyzed in labs — is uneven across the United States as the nation faces the prospect of explosive outbreaks linked to holiday travel and the highly transmissible omicron variant, connected to sharp surges in cases globally. Government officials and public health experts have urged Americans to get tested before they attend big events like holiday parties and gather for Christmas. It's a way to break chains of transmission by nipping outbreaks at the bud, especially in places declining to reinstate mask mandates or social distancing measures.
But some Americans trying to be good pandemic citizens are having a hard time finding tests. Some are turning to Facebook or group chats for leads on which stores still have rapid tests in stock. Some are waiting in their cars for hours for PCR tests. New York City, again emerging as an epicenter with infections skyrocketing, announced plans Thursday to distribute 500,000 at-home tests and expand testing sites as residents report waiting in line for hours to get tested.
Others may decide the hunt is not worth the hassle.
Because the testing system is decentralized and spread out across public and private labs, clinics and providers, there's no clear systemic data on the availability of testing. But health officials and experts say capacity is a problem as demand surges. Daily testing is averaging above 1.5 million a day for the first time since October, according to the Johns Hopkins University tracking.
The vast majority of states and counties report nearly all people tested in their community are still receiving results within three days, according to federal data. But that data doesn't capture those who attempted to find tests and gave up.
Challenges accessing testing are not insurmountable, and Americans can generally find a rapid or PCR test combing through various public and private institutions offering them.
Public health experts warn each hurdle, from the price tag of a rapid test to a several day wait for a PCR test, makes it harder to battle a winter surge. A person with the sniffles who forgoes a rapid test because it's too expensive could end up spreading to others at a holiday party. A college student who tried to find a kit at three pharmacies before giving up could end up infecting a grandmother with a weak immune system at Christmas.
"Testing shouldn't be just the gold ring at the end of an obstacle course," said Adriane Casalotti, chief of public and government affairs at the National Association of County and City Health Officials. "It should be easily accessible, it should be something that doesn't burden or take too much out of your day because that's the only way it becomes routine."
Casalotti said testing capacity is under major strain as exposures to positive cases grow, schools, workplaces and travel destinations require proof of negative test results and government agencies recommend testing before holiday gatherings. Local public health officials often have to decide whether to use their limited staff and resources on shoring up vaccine sites or testing sites, she said.
The Biden administration has taken steps to increase the availability of rapid testing, including streamlining the review process to authorize kits, and ensuring supply of about 200 million for December. But critics say the U.S. has still failed to make tests as readily accessible as they are in other countries such as the United Kingdom and Singapore. President Joe Biden also moved to require insurers reimburse rapid test kit purchases, which typically run about $25 for two tests. But it will not take effect until after the holidays and places the burden on the consumer.
White House press secretary Jen Psaki dismissed a question about sending free testing kits to households as costly earlier this month, although several states are already doing so.
Colorado has distributed nearly 1.3 million free rapid tests to about 180,000 residents this year, making them widely available in late September. Residents can place an order online for up to four tests, twice a week.
Justin McCammon, a 36-year-old software engineer in the Boulder, Colo., area, already made rapid tests a staple of pandemic life since he and his wife started buying them at Walmart in August and using them weekly after sending their toddler to day care. When Colorado started free shipments, he would request them weekly online to save money.
McCammon and his wife used rapid tests after attending concerts in October. His wife used one after returning from a trip to San Francisco over Thanksgiving.
When he started feeling cold-like symptoms this week, he quickly got negative test results using the rapid kits. They have even more on hand for when his relatives start flying in for Christmas over the weekend.
"It's just part of our routine, and it's just what we do and it gives us a little bit of peace of mind," McCammon said in a phone interview while in his car undergoing a PCR test to confirm the results. "Especially after a year plus of having so much anxiety around everything COVID related, and the ebbs and flows and the waves and any little sniffle you get making you wonder, 'Oh my God, is this it?' "
Free test giveaways have not been a panacea for testing problems.
New Hampshire Republican Gov. Chris Sununu touted his administration's efforts to make rapid tests available for online order in late November as his state battles one of the nation's worst coronavirus surges. But the supply ran out within 24 hours. State health officials did not immediately return requests for comment on whether they would offer more.
Customers are instead turning to retail stores where kits sell out quickly after arriving and access is spotty.
After unsuccessfully trying three pharmacies in West Lebanon, N.H., Kathy Brice found a Flowflex Antigen Home Test on display near the pharmacy section of a CVS about a 10-minute drive north in Hanover. Brice, 72, wanted the negative test result before visiting her 4-year-old granddaughter, who is too young to be vaccinated.
"I've taken all the boosters, all the shots, but I traveled to the Virgin Islands for the birth of my granddaughter and then Naples [Fla.] to see friends," said Brice, who lives just over the border in Vermont.
One of the CVS stores where Brice struck out in the morning received a new shipment later in the day. They were kept out of view by the cash register and limited to one per customer. Rachael Ringenberg of Bridgewater, Vt., left with a box in hand after asking the cashier if they had any in stock.
She described rapid tests as the ticket to a semi-normal life in Vermont, which has been reeling from a recent surge despite being the most vaccinated and boosted state in the United States.
"I have four kids and it's starting to feel like if you have the test, then you can do stuff," said Ringenberg, 37. "People are asking to do it before they meet up. I'm going to go to a play tonight and they want to see the negative tests before that for the kids because they're not vaccinated yet."
Her children all tested negative in time to marvel at the fake snow and beautiful costumes in an evening performance of "The Lion, the Witch and the Wardrobe."
Rapid tests are not always accepted as a proof of a negative test result for travel, school or events, leaving some people jostling to find PCR appointments.
Chris Patterson called a local pharmacy in his Hudson River valley community and was quoted $150 each for a PCR test after his two daughters developed cold symptoms and couldn't go to school as cases surged in New York. The closest site that accepted insurance was 25 miles away at an old drive-through bank in a strip mall. He waited more than an hour and said staff told him they were surprised by how many people showed up.
They tested negative and were able to return to school the next day. But Patterson was surprised at the obstacles along the way and is on guard for insurance denying his claims.
"We are trying to do everything right by getting tested to know we are not spreading the virus and so we can have a normal holiday," said Patterson, 39. "We were hoping to have a little more sense of normalcy this year, but it just seems fleeting with the uptick in cases and it's a financial burden to get tested, so you feel like you are penalized for doing the right thing."
Patterson noted he was fortunate to be in a position to step aside from his finance job for several hours on short notice. Experts said many people will not go out of their ways to get tested, especially if they lack flexibility with their jobs or have child-care obligations.
Michael Mina, chief science officer of eMed and a former public health professor at Harvard University, has criticized the Biden administration for not taking more steps to authorize rapid test kits that have been used extensively abroad and expand the nation's supply.
"We are still blind," Mina said. "Another unfortunate consequence is the people who are most blind are the people who are most at risk, who are already disenfranchised and poor and can't take time out of their work schedule to just go and take three hours of their day just because they woke up with a scratchy throat. Those people are going to wait until they are coughing. By that point, the virus has already tore through their lungs."