There are two big challenges in testing in NYC right now:
* results are taking as long 10 days in some cases
* too few people are getting tested in low-income neighborhoods
To fix this log jam we need to focus testing on the people—and communities—at greatest risk. 1/
* results are taking as long 10 days in some cases
* too few people are getting tested in low-income neighborhoods
To fix this log jam we need to focus testing on the people—and communities—at greatest risk. 1/
There continues to be inequality in testing in NYC, with higher rates in upper-income areas than in Black&brown communities which have been hardest hit by the pandemic.
This is reflected in positivity rates: under 1% in wealthier zip codes, and over 15% in some poorer ones. 2/
This is reflected in positivity rates: under 1% in wealthier zip codes, and over 15% in some poorer ones. 2/
The single largest source of testing in NYC is CityMD, which through its partnership with the City has been offering tests to all patients, regardless of why they come in. This program is reaching few uninsured NYers. It is also using up an inordinate amount of lab resources. 3/
Private labs--especially Quest--are now overwhelmed by the # of tests coming in from CityMD and elsewhere, at a time when there is a national shortage of testing equipment & supplies.
That’s why it can take 7-14 days to get results--defeating the purpose of the test. 4/
That’s why it can take 7-14 days to get results--defeating the purpose of the test. 4/
We need to fight for the federal gov’t to once and for all do its job and use the Defense Production Action to mobilize production of testing equipment and supplies (especially reagents), so that labs in NYC have the capacity to turn around more tests more quickly. 5/
But we also need to be realistic that the lab crunch is likely to continue--and may even get worse as the # of cases rebounds in the fall, and as large employers and universities grab more and more lab capacity to repeatedly test returning employees & students.
6/
6/
We need to negotiate the agreement with CityMD so that patients who come in for purposes other than getting a covid diagnostic test are no longer automatically offered one. This move alone would free up 1000s of lab tests every day. 7/
We need to update our guidance for the public, to give clear priorities on who should be tested:
--> Those with covid symptoms
--> Those exposed to someone w/ covid
--> Essential workers in contact w/ the public
California has just done this:
cdph.ca.gov/Programs/CID/D…
8/
--> Those with covid symptoms
--> Those exposed to someone w/ covid
--> Essential workers in contact w/ the public
California has just done this:
cdph.ca.gov/Programs/CID/D…
8/
We also need to focus testing on the neighbs now getting left behind.
NYC’s Dept of Health has started this in the Tremont section of Bronx, setting up rapid on-site testing (results in under an hour!) and extensive local outreach. Let’s take this to more low-income neighbs. 9/
NYC’s Dept of Health has started this in the Tremont section of Bronx, setting up rapid on-site testing (results in under an hour!) and extensive local outreach. Let’s take this to more low-income neighbs. 9/
As NYC adds more rapid testing capacity, and if/when the national lab shortages start to improve, we can move closer to the goal of mass testing of asymptomatic NYers. We’ll know we have gotten to that point when the turn-around time is reliably no more than 24-48 hours. 10/
But today, thanks to an epic national failure of leadership, testing resources remain inadequate. We have no choice but to use these resources judiciously.
11/
11/
To recap: The measure of success of NYC’s testing program can’t just be how many are getting tested--especially when labs are overwhelmed and delays are unacceptably long. We need the *right* people to be tested: those at higher risk and those in neglected neighborhoods. 12/12
