Fewer getting tested for COVID-19, which is a problem, experts say

Preparing to travel, Yara Rocha and her son, Christian, got COVID-19 tests Wednesday at DotHouse in Dorchester.Jessica Rinaldi/Globe Staff

After a winter of long lines, frustrated test-takers, and extended wait times for results, some COVID-19 testing centers in the Boston area say they are now experiencing an eerie quiet.

“We have seen a recent dramatic decrease in patients looking for outpatient COVID-19 testing,” said Nick Duncan, director of emergency management at Tufts Medical Center, describing a phenomenon seen across the country. The large downtown testing site, which once saw lines that stretched to the end of the block, has recently reduced its hours.

The declining testing numbers threaten the progress the state and country have made in curbing the virus’s spread this winter, experts and officials said. Fewer people being tested means an increased chance that emerging outbreaks will go undetected, infected people will spread the virus to others, and the key metrics policy-makers rely on for reopening decisions will be skewed, experts and officials said.

“The better the job we do with testing, the more certainty we have in what’s going on, and the more certainty we can have in what actions we need to take — whether that’s relaxing [public health] measures or increasing measures,” said Samuel Scarpino, a Northeastern University epidemiologist.

Individuals should continue to test regularly if they experience symptoms, are exposed to someone with the virus, or interact with people outside their household without proper social distancing, experts and health officials said.

But they worried that vaccine distribution and falling cases and deaths have lulled the region and nation into a false sense of security.

In the testing rush before Thanksgiving, Tufts served nearly 700 people a day. It now sees between 125 and 170, a spokesman said. At the East Boston Neighborhood Community Health Center, the number of people seeking tests has declined from 3,600 tests the first week of December to 2,992 last week, according to a spokeswoman. The Lynn Community Health Center also reported a steady decline in testing.

Nationally, the average volume of tests nationwide over a seven-day period was down 20 percent last week from the week prior, the CDC reported last Friday. But testing remains crucial, CDC officials said, to curb spread but also to better address the threat of variants.

Michelle Nadow, president and CEO of DotHouse Health in Dorchester, said weekly numbers have dropped to less than half what they were in November and December when their clinic tested around 700 people a week.

Even as people get vaccinated, the need for testing remains strong, she said. Their community’s positivity rate is twice that of the city at large. Staff remind patients that scientists don’t know if vaccinated people can still transmit the virus.

“We really see [testing] as critical to the response,” Nadow said. “We are still trying to keep up the vigilance.”

Scarpino, the Northeastern epidemiologist, said metrics such as test positivity — a measure of what percentage of tests are positive — will continue to be important as individual organizations and the state as a whole continue to lift social-distancing restrictions. For those metrics to accurately reflect the level of infection in a community, they need to include a wide range of people, he said, not just routine test-seekers.

But the number of people seeking a test in Massachusetts has dropped dramatically, state data shows. The seven-day average number of new molecular tests hit its 2021 high on Jan. 8, with 25,022 individuals tested. As of Sunday, that figure had dropped to 9,573, a decline of more than 60 percent. This figure excludes repeat tests performed on the same person in one day.

As the number of overall test-seekers declines, Massachusetts data is increasingly dominated by routine testers, such as people screened regularly through institutions such as universities and hospitals, many of which have strict, routine testing requirements, as well as far lower rates of positive tests than the state overall.

Expanding the pool of people being tested is crucial, Scarpino said: “The more accurately we know what’s going on with COVID, the more quickly we can be confident in our return to something that’s more of a normal life.”

Widespread testing is especially important as new variants spread around the world, experts said.

“If we slow down testing and there’s suddenly a rapid spread of one of the new variants of concern . . . we’re going to miss what could be the beginning of an early flare in disease,” said Dr. David Hamer, an infectious disease expert at Boston University and physician at Boston Medical Center.

Encouraging people to seek testing more frequently can help preserve the progress Massachusetts has made, Hamer said.

“If we’re testing more people, identifying cases, isolating them, quarantining their close contacts, that’s going to further help decrease transmission and get things under better control,” he said.

Experts and health officials said a number of factors could be lowering the public’s interest in testing.

Demand for testing tends to peak when cases are surging, because a larger number of people are experiencing symptoms and because the general public is more concerned about the virus. Since cases and deaths have fallen steadily for the past several weeks across the state and country, some people may believe that COVID-19 is no longer a threat, despite the fact that tens of thousands in the United States still test positive each day.

Individuals who limited their travel and social circle after the winter holidays and subsequent surge might also feel safe, experts said. Still others may have let their guard down after receiving their first vaccine dose, or even after hearing news they are eligible.

Officials are working to combat that sense of complacency. The pandemic is ongoing, they said, and so is the need for testing.

“We want to make sure that people continue to get tested if they’ve been exposed, or they’re around others, or they have symptoms,” said Marty Martinez, Boston’s chief of health and human services.

That message applies even to people who have been partially vaccinated, Martinez said, and even fully vaccinated people should continue being cautious to help protect others.

Martinez said he understands many people are feeling COVID fatigue. But he urged the public to remain alert.

“Getting tested helps to slow the spread. It helps to protect people individually and to protect those they care about or might live with,” he said. “Even when we’re ready for it to be over with, we still need to make sure we use one of the most important weapons that we’ve got.”