Coronavirus testing throughout Massachusetts continued to be a roller coaster ride through the first days of the new year, marked by high demand, hard-to-come-by appointments, and an average turnaround time that at one point was more than three days.
And health care providers say there are even more challenges on the horizon. Some taxed testing centers will soon have to juggle a massive vaccine rollout along with an already overwhelmed testing program.
“We need to pivot to vaccinating people and that will come at the expense of testing people,” said Allison van der Velden, chief executive officer of the Community Health Center of Franklin County, in the western part of the state. The same staff, which cares for a variety of other patients, now plans to provide up to 180 vaccinations a week by month’s end.
State data show the overall number of tests across Massachusetts declined over the past month, partly due to the holiday recess of tens of thousands of college students, who were regularly tested once or twice a week. Still, the data show testing hit a peak four days before Christmas, with 138,275 molecular tests performed that day, the highest level since the pandemic began. But even that tally — health experts have made clear — isn’t enough.
Rising hunger for more easy-to-access, free or inexpensive COVID-19 tests has hardly abated, according to health administrators at a number of sites across the state.
“It’s still the same level as Christmas,” said Kelly Hennessy, director of COVID-19 testing at East Boston Neighborhood Health Center, the largest community health center in the state. There, heavy demand is pushing 500 tests a day and seems to have become, Hennessy said, “the new normal.”
While the center’s turnaround time for results has improved to about two to three days — down from as long as five days around Thanksgiving and early December — its website often shows the soonest available appointment is three days out.
Another factor that has remained frustratingly consistent is the percentage of tests that continue to come back positive.
“It’s been teetering between 15 and 19 percent since Thanksgiving,” Hennessy said.
The percentage of positive cases statewide has been steadily climbing since Thanksgiving, and stood at 9.1 percent Thursday, not including the limited testing currently occurring at colleges.
Massachusetts remains a national leader for its sheer number of tests per capita, but navigating the patchwork system can be overwhelming. With at least 350 public testing sites, there is a dizzying array of rules about price, hours, and whether an appointment is required. And while anticipation for vaccines is high, experts say the need for a robust testing system remains vital as infections surge, and many will not be able to get their shot for months.
Yet state data indicate average wait times for results from Dec. 23 through Jan. 5 stretched roughly three days, which means thousands of tests, each day, were taking even longer than that. The state’s COVID-19 Response Command Center did not respond to requests for comment and data on what percentage of tests were taking longer than three days. On Wednesday, the state’s publicly posted data showed the latest average turnaround time had dropped to just under two days.
Testing becomes less useful the longer residents have to wait for results. Prompt results in less than two days are a key part of the strategy for containing the virus with quarantines and isolation, because research indicates a person may be able to spread the virus for up to three days before showing symptoms and is most infectious in the first week of illness.
Philip J. Landrigan, director of the global public health program at Boston College, said balancing the need to test as many residents as possible against the imperative to produce results quickly has been a constant struggle in Massachusetts.
“You hope for the fastest turnaround time,” he said, “but you do the best you can in the real world against all the constraints.”
The state’s second largest community health center, Greater Lawrence Family Health Center, is witnessing the same twin factors as its counterpart in East Boston, of heavy demand and a high number of positive test results.
“There are people coming from all different cities and towns,” said Richard Napolitano, the center’s senior vice president and chief strategy officer. “We have people coming from the Boston area, people coming up from Worcester and Westford, too.”
At NEWHealth, a community health center with offices in Boston’s North End and Charlestown neighborhoods, administrators added an extra day for testing this week, because of continued high demand.
“We expect more [positive] cases to come up in the next week or so, and two or three weeks out, we will see more hospitalizations,” said Dr. John Foster, the center’s chief medical officer.
The state’s 52 community health centers have become popular choices for people seeking tests because they typically take all comers and offer free tests, unlike the hundreds of commercially run locations that may have more openings but can charge $120 or more.
The continued clamor for expanded testing extends to more rural parts of the state, too.
Van der Velden, of the Community Health Center of Franklin County, said the provider is booked as far as two weeks out. And still, they can’t meet demand.
“Whatever we can offer, people will take advantage of and use,” she said.
She noted that her agency, like many other testing sites, is also a full primary care office with patients needing treatments for a range of maladies from heart conditions to dental problems. “We can’t designate all of our staff to COVID services,” van der Velden said.
As anxiety grows over a more contagious form of the virus that’s been identified in several states, it’s an open question whether that will increase the demand and need for yet more testing.
While highly transmissible, the variant, first identified in the United Kingdom, is not believed to be more deadly than other versions of the virus, nor does it seem to cause more severe illness.
Infectious disease experts say, so far, that there is no evidence that the variant should affect the performance of COVID-19 tests. But it means more people could be getting sick, putting a further strain on hospitals.
“The vast majority of our tests should be in good shape,” said Dr. Angela M. Caliendo, a professor at the Alpert Medical School, Brown University.
Meanwhile, fast, reliable home tests may be available soon. Federal regulators last month authorized the first over-the-counter test that can be fully processed at home and doesn’t require a prescription. Ellume, the Australian company that created it, expects tests to cost about $30 and to start hitting the market later this month. But they aren’t expected to be widely available until later this year.