Looking for a COVID-19 test in Orange County? Many others are too

The coronavirus’s highly infectious omicron variant plus holiday travel and gatherings have sent COVID-19 cases and potential exposures skyrocketing in Orange County and around the U.S. – and that has sent people scrambling to get tested.

Local health care officials say tests are available – both in person and via free at-home kits Orange County will mail to anyone who asks – but residents have been reporting long lines, fully booked calendars and empty shelves at local stores.

Over the past few days, community Facebook groups saw posts including, “Need a covid test and everything is booked!! Any suggestions without insurance?” and “Does anyone have an at home covid test I can buy or know where I can buy one?”

The sudden surge in demand seems to have backed up the system, since there’s a limit to how much labs can speed up their processing of tests, and to how fast rapid tests can be produced and shipped out.

“We’re seeing a shortage – it’s a national one, and it’s translating to the hospitals as well,” Dr. Shruti Gohil, associate medical director of epidemiology and infection prevention at UC Irvine Medical Center, said of the more accurate, lab-based PCR tests.

And for those who want to self-test at home, she said, “The big problem with (rapid) antigen tests right now is that you can’t get any.”

Finding a test

In the three days ahead of Christmas Eve, tests reported in Orange County topped 20,000 a day, a peak not seen since a year ago, when vaccines were just starting to become available.

During the pandemic’s earlier waves of infections, tests were sometimes hard to find because there weren’t as many federally approved options and manufacturers were struggling to ramp up production. But more mitigation strategies were also in place then, including stay-at-home orders, said Sanghyuk Shin, an epidemiologist who directs UC Irvine’s Infectious Disease Science Initiative.

Now, with many people (whether vaccinated or not) getting together for holiday celebrations, there are “more opportunities for exposure,” he said. “I think that’s one of the things that’s driving demand.”

Add to that how infectious the omicron variant appears to be – Shin called it “by far the most transmissible infection that I’ve seen” in 20 years of research – and requirements by schools, employers and some event producers that people show a negative test to come through their doors, and it has pushed demand up to and sometimes beyond the limits of supply.

Test providers say they’re doing their best to keep up.

John Koval, director of public affairs for rapid diagnostics at Abbott Laboratories, said in an email the company is “seeing unprecedented demand for BinaxNOW (rapid tests) and we’re sending them out as fast as we can make them.”

At COVID Clinics, which operate 180 public testing sites nationwide including about 25 OC locations, “we’ve seen a 400% increase in demand for tests” in the past two weeks, CEO Matt Collins said.

While the company has testing materials and adequate staffing now, Collins is concerned supplies could tighten by the end of January if the current surge continues.

“I think it’s fair to say that no one expected the speed at which this wave has come about,” he said.

When to get tested

Before the holidays, people were encouraged to get tested before seeing relatives or going to parties. But some health experts say when tests are hard to come by, people may want to think harder about whether they need one.

If you have symptoms or you know you were exposed to someone who tested positive, getting tested is appropriate, said Dr. Charles Bailey, medical director for infection prevention at Providence Mission and Providence St. Joseph hospitals.

But not all exposures are equal, Gohil said. Just being in a room for a few minutes with someone who later tests positive is less of a concern than, say, having lunch across the table from them.

“With the limited supply of tests, I would encourage people not to test just for peace of mind,” Bailey said.

For people who do need a test, it’s worth noting that the omicron variant is believed to have a shorter incubation period than other versions of the virus.

Gohil said the current recommendation is to take a test between three and five days of exposure. Testing earlier than three days could yield a false negative, and most people will have developed symptoms by day five if they’re going to. And the advice to stay home if you’re sick – whether or not you’ve been tested – still stands.

“Shortages like this are the reason why we ask people to exercise judgment, wear the mask and be distant,” Gohil said. “Our responsible actions will help the entire system.”

What the test means

For those who can lay hands on a rapid home test, experts caution not to put too much stock in a negative result. The U.S. Food and Drug Administration this week announced that antigen (rapid) tests may be less sensitive to the omicron variant, and health professionals say lab-performed PCR tests remain the gold standard.

Experts are also concerned the soaring number of positive tests – 22.8 cases per 100,000 OC residents, more than double what it was last week, according to the OC Health Care Agency – doesn’t show the whole picture of how widespread the virus is in the community.

“The reality is I think that our official numbers are an undercount because of the volume of home testing that’s being done” and doesn’t get reported to local health authorities, said David Souleles, who directs UC Irvine’s COVID-19 response team.

OC District 2 Supervisor Katrina Foley, whose office handed out nearly 5,000 test kits in the past three weeks, said she’s encouraging people to request a kit to collect a saliva or nasal swab sample at home, then send it to a county-contracted lab with the pre-paid shipping label. Results can take 24 to 48 hours.

People who live or work in OC can have kits sent to them by mail, or pick one up at John Wayne Airport or one of the county’s health clinics. More information on requesting a home kit or where to get a test in person is on the OC Health Care Agency’s website, occovid19.ochealthinfo.com.

Although the number of people in OC hospitals with COVID-19 has jumped significantly in the past week – from 217 a week ago to 420 as of Thursday – some experts don’t expect the current surge to burden health care facilities as much as the winter 2020 wave, with vaccinations and the milder symptoms of omicron keeping many from needing acute care.

But what UCI’s Souleles called “the perfect storm of timing and holidays” has already taxed emergency departments and it’s straining the testing system.

He said he takes the current test crunch as a reminder that “it’s hard to know when the end of a pandemic is.”

“We have to be vigilant,” he said, “and we have to make sure that our preparedness plans are as responsive as they can be.”