Take-home rapid tests and PCR testing appointments are hard to come by for everyone amid the surge in coronavirus cases. But for marginalized groups statewide, the scavenger hunt for COVID testing is tougher to navigate.
A lack of reliable transportation, jobs with little flexibility, and language barriers make the search for tests more grueling in low-income, immigrant, and BIPOC communities, advocates and public health specialists say. Even weather variables, such as the extreme cold last week that closed some outdoor tent sites, add another challenge to the mix.
“The inequities have continued to plague communities of color and low-income communities across the state,” said Carlene Pavlos, executive director of the Massachusetts Public Health Association. “They continue to be the hardest hit.”
Takiyah Cummings spent hours outside in the winter weather recently securing a test for her school-aged daughter, a PCR test at Bowdoin Street Health Center in Dorchester. The day before, she’d arrived to find a line that spanned blocks and gave up without trying.
Cummings, who is Black, said she appreciates the health workers for doing all they can, but she said she wished the government would do more to help make the waits shorter and more comfortable.
“I’d rather it be a long line of testing if you’re in a vehicle, but everybody in the city isn’t so lucky to have a vehicle,” she said. “The fact that I and other people had to stand outside for one to two hours to get a PCR test is a little ridiculous.”
City public health officials have made several efforts to bolster testing since the Omicron variant emerged, including in Black and brown communities. In a statement, the Boston Public Health Commission said it has distributed over 230,000 of its 260,000 rapid home test kits, including 160,000 kits through the city’s schools, libraries, and community centers. They’ve allocated the remaining kits to 200 community partners to disseminate to vulnerable populations.
On Tuesday, the city will open the first of three new high-capacity testing sites in the city, an effort that could go a long way toward improving access in Boston. The Bruce C. Bolling Building in Roxbury will offer free, walk-in testing from 12 p.m. to 8 p.m. Tuesday through Saturday, the public health commission said in a release Monday evening; self-administered PCR tests will be available, with results normally within 24 hours.
Two additional sites, the city said, will open soon in Dorchester and Mattapan. Free walk-in testing is also available at the Anna M. Cole Community Center in Jamaica Plain and the West End House in Allston.
“We understand that barriers like location, long wait times, and limited hours disproportionately impact vulnerable groups,” the commission said in a statement earlier this month. “We’re centering equity as we ramp up capacity so that anyone who needs a test can get one.”
The disproportionate devastation COVID has caused in marginalized groups has been clear since the early days of the pandemic. Those in neighborhoods of color and low-income areas got sick at higher rates because of their exposure at work, in public transportation, and in accessing food than people in wealthier, whiter neighborhoods. State data show that, to date, the positivity rate is far higher for Black and Hispanic residents than it is for whites.
In spring 2020, public officials were slow to mobilize health resources to these communities, but they gradually arrived. The state created free “Stop the Spread” surveillance testing sites for residents, regardless of symptoms and later amped up efforts to provide vaccine access to hard-hit communities.
After the Omicron variant emerged late last year, the Baker administration sent 2.1 million at-home test kits to 102 towns with the highest percentage of people living below the poverty level, including Boston, Springfield, and Worcester. These cities distributed their supply through local organizations.
A spokesperson for the state’s Executive Office of Health and Human Services said its 40 “Stop the Spread” testing site providers have also increased staffing and expanded their hours “to meet this demand where needed.”
Yet the testing infrastructure is still inadequate to meet the need, and low-income people and people of color have disproportionately borne the burden of test scarcity, advocates said.
Meanwhile, some evidence suggests these same communities may be hardest-hit once again: Many of Boston’s neighborhoods with large numbers of people of color have reported higher positivity rates than other neighborhoods. Four Dorchester zip codes had a positivity rate of more than 38 percent between Jan. 4 and Jan. 10, according to city data, markedly higher than the rate for the city (31.6 percent) or the state (20.3 percent).
Chelsea, Lawrence, Revere, Everett, and Springfield, all cities with substantial populations of people of color and immigrants, reported the highest average daily incidence rate per 100,000 residents between Dec. 26 and Jan. 8, according to the state’s COVID-19 dashboard.
Getting a clear picture of testing numbers is now complicated because rapid test results aren’t reported to public health authorities, Pavlos said. She said health officials need to funnel resources to local leaders and organizations most familiar with their communities.
“[The Vaccine Equity Now! Coalition and Massachusetts Public Health Association] have been asking the [Baker] administration to speak directly with the communities impacted and their leaders, so there’s a real seat at the table,” Pavlos said. “We’ve been calling on this for some time.”
State and local efforts to ramp up testing availability are ongoing. Governor Charlie Baker announced last week that the state will distribute 26 million rapid tests over the next three months. The state will prioritize K-12 and early childcare providers in its distribution, he said.
Toni Wiley, CEO of Sportsmen’s Tennis & Enrichment Center in Dorchester, said the center has worked to widen access to vaccines in the neighborhood through late-night clinic hours and information sessions. The Boston Public Health Commission has also contacted Sportsmen’s to see if it can add testing to its Friday night vaccination clinics, she said. Still, staff shortages and limited space make the possibility uncertain.
“We want to make sure we do everything we can to make information, resources, and tools available for people to stay safe,” Wiley said.
But scarcity has been a troubling issue. At East Boston Neighborhood Health Center earlier this month, dozens of parents and children queued in the chilly weather for PCR tests. The neighborhood health center welcomes many of the area’s residents, which includes over half of Boston’s Latino population.
A white sandwich board with the announcement, “We do not have any more COVID-19 test kits today!” scribbled in English and Spanish with a black marker greeted the shivering guests. Among the people waiting was Stephanie, who declined to share her last name for privacy concerns, along with her husband and two children.
Stephanie said her family came from their Paris Street home after myriad problems finding tests.
“According to all the online services, they have no appointments, but then we called and were able to make four appointments,” Stephanie said. “Most people might not call and just think they can’t be tested.”
East Boston Neighborhood Health Center stalled walk-in testing last week, but by Monday, a few appointments had opened up online. Other health centers also discontinued walk-in tests, and getting an appointment slot has been difficult.
Many hard-hit communities also have large immigrant populations. Yet some immigration advocates, such as Helena DaSilva-Hughes, feel they’ve been left to navigate the testing maze alone.
DaSilva-Hughes, president of the Immigrants’ Assistance Center in New Bedford, said the center had received a surge in calls from clients panicked about symptoms and who can’t understand appointment sites in English, don’t have the Internet to find appointments, or fear questions about their immigration status.
The center’s staffers are doing what they can, but the resources aren’t available for them to meet their needs, DaSilva-Hughes said.
“Even though we’re trying to help our clients, we’re not able to get appointment blocks online,” DaSilva-Hughes said. “We’re looking for every way we possibly can to help, and we just have not been able to get enough testing for our clients.
“It’s important we do not forget them,” she added.
Globe correspondents Grace Gilson and Rose Pecci contributed reporting.
Tiana Woodard is a Report for America corps member covering Black neighborhoods. She can be reached at firstname.lastname@example.org. Follow her on Twitter at @tianarochon.