With a week to go until in-person learning begins in New York City public schools and limited indoor restaurant dining coming by the end of the month, mass testing for COVID-19 has new urgency.
On Monday, Mayor Bill de Blasio tried to assure the public that the city had testing under control. After his administration gave teachers and Department of Education staff priority at city hospital testing sites, he revealed that nearly 17,000 staffers had been tested in less than two weeks.
Of those people, 0.32% tested positive for COVID-19, de Blasio said.
The mayor also announced a “COVID Response Situation Room” for the Department of Education that would serve as a “central command headquarters” for handling all positive COVID-19 cases within the school system.
That’s on top of his recent announcement that every school will have monthly randomized testing, beginning Oct. 1.
Six months into the pandemic, New York’s testing system remains a major engine driving economic recovery but is still opaque to many New Yorkers.
To help bring some clarity, THE CITY tackled a few basic questions about testing in New York right now.
Where is the fastest place to get a test result in New York?
With no good way to measure the turnaround times citywide, many New Yorkers have taken to social media and word of mouth to share the spots with the fastest results.
THE CITY is investigating testing speed and invites all New Yorkers to share how quickly they got their results at testing sites in the five boroughs.
So far, early responses show that of 219 reports THE CITY has received from people who say they got tested since Aug. 1, 12% of people got a result the same day, 34% got it the next day and 79% had a result in five days or less. The average wait time was about three days, although 20 respondents (9%) had to wait longer than a week.
If people need a really quick result, City Councilmember Mark Levine (D-Manhattan), chair of the City Council Health Committee, directs them to nine rapid testing sites where free tests are offered at public health clinics. Each is equipped with a Cepheid machine that can turn a result “within a few hours,” he said.
But good luck getting an appointment. When THE CITY checked the city’s rapid testing website on Monday afternoon, only a handful of openings at three of the nine locations were available. On some days, no open slots appeared on the appointment portal.
Laboratory-based testing takes longer to yield results but tends to produce more accurate findings. At those sites, both public and private, whether you’ll get a result back quickly has less to do with where you give a sample than where that sample is processed.
“The bottlenecks are really at the labs, not at the collection point,” said Levine.
The more pressure on labs, the slower test processing will be.
For example, Quest Diagnostics, one of the largest lab companies in the country, handles all laboratory testing for CityMD, which has struggled to get results back to New Yorkers quickly. (CityMD’s average turnaround time was three to four days as of Sept. 11, the company said.) New York’s Health and Hospitals Corp. recently ended its contract with Quest, the New York Post reported.
On the other side of the spectrum, high-end, boutique testing sites use smaller labs like Lenco in Brooklyn, which limits the number of tests it processes, Levine said.
“They’re just not taking on a ton of business so that they can use their resources and just process everything fast,” he said.
Levine said he generally tells people to go to one of the city’s public hospital testing sites because “they all have faster capacity” through in-house testing or good relationships with labs.
Does New York have enough tests available, and the materials needed to do them?
Testing capacity in the city is currently 50,000 per day, according to a City Hall spokesperson.
The number of tests administered, however, can be much lower, depending on the day. On Sept. 13, the last date for which data is available, 27,533 tests were conducted in New York.
Levine thinks that number should be much higher, but noted that a big barrier remains from the earliest days of the pandemic: limited amounts of supplies needed to test — including reagents, swabs, viral transport media and even pipette caps.
“There’s no part of this system, nationally, that isn’t facing these shortages,” he said.
What types of tests are available now, and how do they differ?
Generally, tests to detect an active coronavirus infection fall into two categories: molecular and antigen.
Molecular tests are the most common type of test and include what you’ve probably already seen or had — a swab stuck deep in the nose, or nasopharyngeal area. Then the sample is tested in a lab using the reliable polymerase chain reaction method, or PCR.
The mayor has said that randomized testing in schools will be conducted this way, albeit with a more shallow nose swab, which is CDC-approved and has been found by medical experts to be as effective as the nasopharyngeal swab.
An antigen test is a less-common but much faster method for detecting certain proteins in the virus through a nose or throat swab. Antigen tests are less accurate than molecular tests and have not been widely used. However, a growing group of medical professionals are trying to change that, arguing that wider testing is better, even if it is less accurate.
Bear in mind: Antigen tests should not be confused with antibody tests, which detect only remnants of the virus, not active infections. Recently, a major medical panel determined that antibody tests are inaccurate to the point of being useless for diagnostic purposes.
Where will the tests for school personnel take place?
If you are a Department of Education staffer, you will be given priority testing at 20 city hospital testing sites, which are listed here.
As for the planned randomized testing, a City Hall spokesperson said it will take place inside schools, or immediately adjacent to them.
Who will pay for the testing happening at schools?
City Hall and Department of Education officials have said repeatedly that testing will be free.
“With or without an insurance card, there is no cost to employees or students to get tested,” the city’s testing website reads.
However, reports of bills associated with coronavirus testing have cropped up around the country, including a recent report from a public hospital site in Brooklyn. If you have an issue getting charged for a coronavirus test administered for or in schools, we’d like to hear about it. Contact THE CITY at firstname.lastname@example.org.
Which lab will handle all of those school tests, and who will administer them?
A spokesperson for City Hall said the school testing will be conducted by a combination of labs, including BioReference and Fulgent.
Who will actually administer the swabs is unknown. Levine said the City Council got no answer on that at a Sept. 3 hearing on school health issues.
“A question asked over and over was, ‘What personnel would do it?’ And there was just no answer there,” he said. The idea was floated that school nurses could give tests, but Levine stressed that may not be feasible.
“We’re scrambling to get one nurse per school every day and there’s other roles the nurses need to play, particularly if there’s a sick student,” he said.
What happens when someone in a school tests positive? What is the contact tracing process like?
In a deal struck with New York’s teachers’ union, the de Blasio administration has begun a school-specific contract tracing program. Ahead of the school year, Chalkbeat New York reported that the union has said the program appears to be working, while some teachers have their doubts.
The mayor has said if any staff member or student tests positive for COVID-19, they will be removed from the school and asked to quarantine for 14 days.
Then, the contact tracing teams will go to the school building to figure out who could have been infected. Regardless of their findings, a positive test result will mean the whole class will switch to remote-only learning for the 14-day quarantine period.
“Some people will test positive and those folks will immediately get support,” de Blasio said Monday. “They’ll be helped to get home, to safely separate. The contact tracing will go into effect right away.”
He insisted that for the “small percentage of people” who test positive, “it is a very temporary reality” — despite research and studies that show that for some COVID-19 symptoms can last for weeks or months, or turn fatal.
“People will go through that period of safe separation, quarantine, come back, and get right back into their job, get right back into their studies and continue forward,” the mayor said.