New Yorkers stood for hours in long lines to be tested for the coronavirus on Friday, a disturbing indicator that shows the basic public health challenges that the United States still faces many months after the pandemic first hit.
People waited for tests they needed for work or school. Some feared they might have gotten sick after flouting social distancing while celebrating after the election. Others hoped to safely visit family on Thanksgiving, suggesting that the problem might worsen over the coming holidays. And some, dissuaded by the prospect of lingering on sidewalks for more than three hours in the rain, walked away untested.
“It’s so frustrating,” said Councilman Mark Levine of Manhattan, the Health Committee chairman. “We keep hitting new problems in tests. We solve one and another pops up.”
The lines and escalating demand for testing underscore how a second wave of the virus is threatening New York City, and they come as the entire country confronts record numbers of new cases — more than 177,000 nationally on Thursday. Several governors have warned that they are seriously considering further restrictions in a last-ditch effort to curb the outbreak.
The governors of California, Oregon and Washington urged residents to avoid all nonessential interstate travel in the days ahead. In Utah, which also just set a case record, Gov. Gary Herbert issued a statewide mask mandate this week and told residents to limit casual social gatherings to those in their immediate households.
In Illinois, which has recorded more than 80,000 new cases in the past week, Gov. J.B. Pritzker warned that the state could soon impose a stay-at-home order.
Mayor Bill de Blasio of New York announced that it was extremely likely that the city would have to shut down its school system, the nation’s largest, with 1.1 million children, because the seven-day test positivity rate across the five boroughs would soon hit 3 percent.
In Washington, President Trump made his first appearance to discuss the outbreak since the election and said it was possible that vaccines for the virus could be widely available by the spring.
Mr. Trump also deepened his feud with Gov. Andrew M. Cuomo of New York, threatening to withhold a vaccine from the state because of Mr. Cuomo’s criticism of the administration’s distribution plan.
The potential impact of the president’s threat was not immediately clear, given that Mr. Trump is leaving office on Jan. 20. President-elect Joseph R. Biden Jr. is a close ally of Mr. Cuomo and is likely to put in place a different distribution plan.
By all accounts, even if things go well, vaccines are still months away. For now, much of the attention is focused on testing problems, which were threatening to delay results and hinder efforts to control the spread of the virus.
New York City had a record number of tests on Thursday, more than 74,000, officials said. Across the country, nearly 1.5 million people a day are being tested, according to the Covid Tracking Project. That is nearly double the number in August and far more than during the pandemic’s first wave in the spring, when there was far less testing capacity.
Public health systems around the country are once again straining under the need for testing. Some areas face looming shortages of lab capacity. In other places, like New York City, clinics and other testing sites have been swamped by huge numbers of people seeking to be tested.
“The spring pales in comparison to what we are experiencing now,” said Karissa Culbreath, the medical director and infectious disease division chief at TriCore laboratories in New Mexico, where cases have rocketed upward lately.
In recent months, millions more tests have become available to Americans, but demand has grown faster.
“We cannot continue to just throw more testing at this pandemic without more strategy,” Dr. Culbreath said.
From March to October, Dr. Culbreath said, her team ran a half-million more diagnostic tests than is typical for their facility, a harried attempt to keep pace with the pandemic while still testing for other infectious viruses and bacteria that continue to afflict patients.
This week, the American Clinical Laboratory Association, which represents Quest Diagnostics and the other large commercial labs that have shouldered much of the virus-testing burden, warned that turnaround times for results would start taking longer, too.
The group said that its member labs had performed nearly a half-million virus tests on Wednesday and were experiencing shortages of pipette tips and other testing essentials.
“Labs have managed to make it work,” said Dr. Patrick Godbey, the president of the College of American Pathologists and the director of two labs in Georgia. “Pathologists and lab scientists have made heroic efforts to answer the call. But demand has not gone down, and now the numbers are going up again. You’re seeing it now in Illinois, in Wisconsin.”
In Washington State, Providence Health and Services, which operates a drive-through testing site near Olympia with Thurston County, had to turn cars away when more than 200 lined up on Monday, the health care provider said in a statement. In Denver, testing sites were reporting hourslong waits.
Facing escalating complaints, city and state officials in New York tried to play down the delays, saying that people could obtain tests if they searched around.
Gareth Rhodes, a member of Mr. Cuomo’s coronavirus task force, defended the state’s performance and pointed to the number of testing sites statewide, roughly 1,200.
More than 400 of those sites are in New York City. Some sites, Mr. Rhodes said, were running below capacity.
For people dreading long lines, Mr. Rhodes recommended calling ahead or scheduling an appointment. That way, he said, “people don’t have to wait at all.”
Dr. Andrew Wallach, a senior official with the city’s Test & Trace program, said that people could often get tested quickly at tents set up outside public hospitals, or at other city-run sites.
Confused by the terms about coronavirus testing? Let us help:
- Antibody: A protein produced by the immune system that can recognize and attach precisely to specific kinds of viruses, bacteria, or other invaders.
- Antibody test/serology test: A test that detects antibodies specific to the coronavirus. Antibodies begin to appear in the blood about a week after the coronavirus has infected the body. Because antibodies take so long to develop, an antibody test can’t reliably diagnose an ongoing infection. But it can identify people who have been exposed to the coronavirus in the past.
- Antigen test: This test detects bits of coronavirus proteins called antigens. Antigen tests are fast, taking as little as five minutes, but are less accurate than tests that detect genetic material from the virus.
- Coronavirus: Any virus that belongs to the Orthocoronavirinae family of viruses. The coronavirus that causes Covid-19 is known as SARS-CoV-2.
- Covid-19: The disease caused by the new coronavirus. The name is short for coronavirus disease 2019.
- Isolation and quarantine: Isolation is the separation of people who know they are sick with a contagious disease from those who are not sick. Quarantine refers to restricting the movement of people who have been exposed to a virus.
- Nasopharyngeal swab: A long, flexible stick, tipped with a soft swab, that is inserted deep into the nose to get samples from the space where the nasal cavity meets the throat. Samples for coronavirus tests can also be collected with swabs that do not go as deep into the nose — sometimes called nasal swabs — or oral or throat swabs.
- Polymerase Chain Reaction (PCR): Scientists use PCR to make millions of copies of genetic material in a sample. Tests that use PCR enable researchers to detect the coronavirus even when it is scarce.
- Viral load: The amount of virus in a person’s body. In people infected by the coronavirus, the viral load may peak before they start to show symptoms, if symptoms appear at all.
“Most people get in and out within the hour or so,” Dr. Wallach said.
Many New Yorkers were finding that it was not so easy.
New York City had for months promoted its progress in improving testing, but the lines this week showed that the public health structure still faced difficulties in addressing the outbreak.
Collecting samples should be the easiest part of the process, given the demand for testing.
The government has relied in large part on existing urgent care clinics, like the CityMD network, to do much of the sample collection. But there are simply not enough collection sites to keep up.
Joy Lee-Calio, a spokeswoman for CityMD, which has more than 130 clinics in the New York City area, said the number of visits, most of which were related to the virus, had jumped 25 percent in the past several weeks.
The long lines prompted CityMD to announce that its clinics would start closing 90 minutes earlier than usual in an effort to keep staff members from working late into the night.
“Our site staff and doctors have been seeing patients well beyond normal closing time for months now, and we’ve reached the point where they are sacrificing their own safety and health,” the company wrote in an email to patients on Friday about the closing-time change.
CityMD collects samples for about 15,000 coronavirus tests a day across its locations, more than half of which are in the five boroughs, Ms. Lee-Calio said.
Government-run testing sites in New York also had waits, but they were often somewhat shorter.
At a testing site under a large white tent in front of a public housing complex in Harlem, the line at midday did not extend far.
“I specifically avoided going to a CityMD because the lines don’t move there,” said Josh Fiene, 31, who after 20 minutes was at the front of an eight-person line.
He did not have symptoms, but he decided to get tested because his roommates had been hanging out with someone who was recently exposed to the virus.
But for many, the trouble was simply getting into a clinic.
At 10 a.m., Avi Weinstein, 31, was waiting in line under a light rain on West 88th Street on Manhattan’s Upper West Side, inching his way toward a CityMD urgent care center where he hoped to get tested. “I’ve been here for an hour and a half,” he said.
Mr. Weinstein said he had come down with a fever the previous night and was worried that he might have been infected while celebrating the election results last week with friends.
“I was expecting a long line,” he said, “but not this long.”
The line would grow longer over the morning, with some people waiting nearly three hours before they reached the clinic’s door.
“We want to see our grandchildren at Thanksgiving, and we hope if everyone tests negative that can happen,” said Erica Eisinger, 76, who was waiting with her husband, Peter.
The scene was the same at CityMD clinics across New York: long lines and varying levels of frustration and bafflement as to why getting a timely, convenient virus test was a struggle so many months into the pandemic.
In the Williamsburg section of Brooklyn, Arjun Mocherla waited outside a CityMD clinic for nearly an hour, advancing maybe 15 feet in a socially distanced line. Mr. Mocherla, a New York University law student, had been tested through the university in the past.
“This is my first line,” he said. “I’m starting to regret it already.”
Then someone told him the wait might be four hours. He left.
Elisha Brown and Matthew Sedacca contributed reporting.