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A Day at Urgent Care: How Are We Still Getting Covid Testing So Wrong?
I’m about as far from a public health official as one can get; I have no medical, health, or policy education or training. However, I consider myself observant and always curious. After a six-hour wait at an urgent care clinic in metro Atlanta the day after Christmas, I’ve got some questions for public health officials, the current administration, and the politicians setting Covid policy and directives.
I arrived at the local urgent care 35 minutes before opening. Not exactly how I wanted to spend a morning (and afternoon) of our holiday trip back east to visit family, but I felt crummy enough to justify a visit and mostly wanted to rule out strep throat. The line wrapped around the building at this point, but I was moderately optimistic hoping to see it move quickly and half expecting a triaging of patients based on need.
Move quickly it did not.
Nearly three hours passed before I made it into the building to check in and this left plenty of time to eavesdrop on the conversations in front of and behind me. I was in no condition for small talk myself, as my cough and little-to-no-voice necessitated mostly silence. After a couple of hours, I gathered that essentially all the individuals near me in line were there for a Covid test. Most were asymptomatic and getting a test “to be safe” (their words) or in preparation for travel. The family of seven a few spaces ahead were driving to Chicago the following day and getting tested “just in case” (their words).
Still, I was hopeful. I figured once I checked in and asked for a strep test, I’d be placed in a different queue outside of the Covid testing.
Wrong again.
I was told to come back an hour and a half later to be seen (a wait that ultimately doubled). I inquired as to whether they were triaging based on need and while the clinic worker was kind, the answer was “no.” She mentioned they were short-staffed and said they’re seeing patients as quickly as possible (I believed her on both accounts). She seemed to take pity on my sickly self, but rules are rules.
Post-visit and after a conversation with my working nurse sister, I learned this is standard for urgent care clinics — they do not triage, they simply see patients in the order they arrive. Perhaps this worked pre-Covid, but it clearly does not work post-Covid, or at least not right now.
And really, my frustration wasn’t so much with the wait itself but the reason for the wait. I’d venture to guess nearly 90% of those in line were asymptomatic and there for Covid testing. Some for exposure (two ladies behind me, both, admittedly asymptomatic), others for travel (multiple families ahead of me, at least three of which were traveling domestically), and finally, the “just to be safe” contingent. I should note, I counted one woman who coughed and sneezed occasionally and one man in the waiting room who was also coughing, but again, the vast majority of those in line appeared to be there for Covid testing only.
After an hour or so nap in the car later, I returned to the waiting room. As the line outside the clinic dwindled, I sat close to the front desk in a lone chair away from the rest of the waiting area. Not long after, the clinic staff began turning away walk-ins and informed patient after patient that they were booked for the rest of the day — for Covid testing or otherwise. They were welcome to come back and get in line at 7 a.m. the next day, or, to the few who asked questions because they were sick, they were told to go to the emergency room. At this point, it wasn’t even noon.
To be clear, this is not a critique of this specific urgent care or the staff. And more broadly, I realize and appreciate the effort of the hundreds of thousands of frontline healthcare workers across the country who have been slammed since the start of the pandemic. They’re doing the best they can with what they’re given and within the policies set by the powers that be.
But how is it, nearly two years into this thing, we are failing spectacularly in ways even I can see?
By definition, urgent care clinics are intended to provide care for illnesses or injuries requiring prompt attention but are typically not serious enough to require the services of an emergency room. So why are they allowing nearly all available times to be taken by people testing “just in case” or for travel? Why aren’t those people redirected to dedicated Covid testing sites? Or at a minimum, why aren’t urgent care clinics staffed appropriately to handle those in need of urgent care as well those wanting a Covid test?
Six hours in line was merely an inconvenience for me, but one can gather this poses a greater challenge to single parents with two kids working an hourly retail job with no available childcare.
Clinics aside, why aren’t affordable at-home Covid tests readily available and handed out like candy to anyone and everyone who wants one? Two at-home rapid tests from CVS will run you close to $25. This is cost-prohibitive for many, especially as Omicron makes its rounds resulting in increased exposures leading the cautious to test more frequently. Availability and testing programs likely vary by state, but it seems if you’re traveling and need a negative test to make it to your destination or want one because of believed exposure, this is a different type of need and testing and should be categorized as such.
In fact, back in October, a group of COVID-19 testing experts presented a strategy to the Biden administration for “overhauling America’s approach to testing.” The plan called for getting rapid at-home tests in the hands of Americans and a major ramp-up of manufacturing capacity to produce 732 million tests per month.
The plan went nowhere.
And yet, just last week, in an interview with David Muir of ABC News, Biden said that he wishes he had ordered 500 million free, at-home Covid tests two months ago.
Does he though? He had the opportunity back in October and instead did nothing.
And in November, White House press secretary Jen Psaki mocked the idea that the government should send Americans free Covid tests.
The administration did announce plans to order 500 million at-home test kits and better late than never, but to how many levels of incompetence and failure must we be subject?
It seems we’re losing sight of the forest through the trees with this end-all-be-all focus on vaccinations.
Finally, as more and more doctors publicly state the obvious, this last point cannot be stressed enough. Covid, as a virus, is here to stay. We’re approaching the end of the pandemic and entering an endemic as the virus mutates down and population immunity increases. This is good news.
Marty Makary, MD, in a piece for the New York Post asks, “Why are we closing society and destroying the economy for 300 million Americans who are at risk only of a mild common-cold illness?
Yes, why?
It’s not a question of whether you’ll be exposed and infected, but a matter of when. Vaccines and boosters are readily available and at this point, the public discourse and acceptance around individual risk assessment and informed medical decisions need to shift.
At this point, the laboratory and epidemiological data show the Omicron strain results in a milder illness and the vast majority of Omicron-infected people get common-cold symptoms. Better yet, we’re seeing the inverse of what we saw with previous waves, a continuing decline in death rates, despite a rapid increase in the number of cases.
So why does it seem that such a large percentage of the population is genuinely terrified of what is now amounting to the common cold?
And all this being the case, wouldn’t it make sense to distinguish between the asymptomatic, mildly symptomatic, and very sick when treating? My educated guess is that urgent care clinics are among the first line of resources for the sick. Policy and directives focused on a tiered and targeted approach to handling the virus seem prudent. Asymptomatic? Test at home if you must. Mildly symptomatic? Stay home until you feel better. Immune compromised or have high-risk factors? Get yourself to a doctor, or at a minimum, monitor symptoms closely and keep your doctor in the loop.
Public health officials, the Biden administration, and politicians setting policy around masks, vaccinations, and Covid generally must be held accountable for answering these questions and for the overarching narrative surrounding the pandemic. And more importantly, it is time to face the unintended consequences of senseless Covid policies on an individual level and on our healthcare system generally.
Published in Culture
Where the heck are you living to see such lines like that? Tests are everywhere I’ve seen and I have never seen a line since the corona first started.
I’ve been an ER physician for over 30 years. The last 3 I’ve been working exclusively Urgent Care because I’m old.
The urgent care I work at is seeing volumes recently about 2 1/2 times what we would see in normal times.
For example, Sunday we saw 125 patients in 12 hours. Me. A nurse. An X-ray tech. A front desk clerk. One extra person on phones. One doc, 125 patients. If you had asked me if I could see over 100 patients in a day 2 years ago I would have looked at you like you had 3 eyes. 40 patients was a busy day.
We are fried. Done. Toast. This third wave is killing us.
The company I work for has tried to hire more staff. None is available. Who wants to get beat up like that, day after day? Oh, and we haven’t seen any increase in pay to balance the giant leap in numbers, so great for the owners, but the staff? Suck it. And when the numbers drop back to normal ( please God) whats gonna happen to that extra staff? ( When the pandemic started I was laid off for the first time in my career as volume cratered).
Everyone justifies their reason for coming in as urgent. We are also at the mercy of the idiot “customer service model” of modern medicine. Customers get what they want. Patients get what they need. So we are pretty much helpless in the face of that and the all mighty Online Reviews ( “Doctor X was rude. I needed an antibiotic for my Sinusitis and he wouldn’t write me the prescription”. In reality it was a viral infection, and an antibiotic wouldn’t help and could cause real harm, but thats not going to be in that online review).
So. Strep. You aren’t going to like this. We treat strep not to cure the sore throat, but to prevent complications like Rheumatic Fever and Glomerulonephritis. But. Those almost never happen anymore in the US. Something has changed. There is even talk of no longer prescribing antibiotics for Strep throat. This will go over with patients like a lead balloon.
If you want to check for Strep (or Covid or Flu) you can get a home test kit which is pretty much identical to the testing we do in UC.
Yeah, I’ll find a doctor or go to Mexico for it. Amazing that we will have to go to a third world country for medicine.
Manage the ill and carry on.
I’m in metro Atlanta, as stated in the piece, visiting family for the holidays. Idk what the situation here is with testing sites, but it seems everyone goes to urgent care to get a COVID test.
Biden was caught with his pants down on getting Covid test kits made. The burden was on the federal government to getting them made. He made a specific promise. Biden is a spectacular failure in every aspect of the presidency.
And early in the pandemic…
https://marginalrevolution.com/marginalrevolution/2021/12/propublica-on-the-fda-and-rapid-tests.html
On the other hand, I used to get strep quite often but I’ve not had it for years now, maybe more than 10 years. Maybe something has changed?
I’m guessing that this is similar to the Ford Pinto memo, wherein Ford correctly assessed that the cost of a recall for a (mildly) defective product would far outstrip the cost of settlements and judgements. If patients are triaged and something bad happens, the provider owns the results of the triage. On the other hand, if patients self-triage by ER or not, then well, you can’t argue with first-come-first-served (FIFO). At least you can’t sue on it. Or suits tend to let FIFO models win over medical judgment.
Just a hunch.
In general, you get the [x] you deserve in the aggregate, but not in the individual case. Insert lecture on “average person” being 51% female.
The police department was called to direct traffic today in my town because of the backup around the testing center. They were only supposed to be by appointment, but since everybody is told to get a test, people want a test whether they are sick or not.
So you’re more knowledgeable than a public health expert.
Seriously though I don’t understand the point of testing and further feeding this monster. I catch a cold around this time every year and it never once crossed my mind to catalog which strain of the corona virus it is. I also know my body well enough to tell if something is a run of the mill illness, or something that I should be concerned about.
So the 3rd wave isn’t killing you, it’s bad management and insufficient local facilities to meet demand ginned up by unnecessary hysteria and onerous “emergency” response requirements imposed by various levels of government.
What would happen to medicine if patients had to pay as you go? No government supplied “free” anything. Oh but compassion, you say….
It didn’t take that long to go from Medicare to Hillarycare to Obamacare to spending your day at the now-ubiquitous urgent care and expecting a miracle cure for free. When healthcare is a right, prepare to be underwhelmed. Welcome to Canada.
You get what you pay for. The other side of this is that as the gummint sucks up more cash to provide “equal” service to those who do not pay, unemployment is becoming competitive to employment. We all know where this leads. Well, we who vote R anyway.
Anecdotal friend-of-a-friend stories of someone who just got it and has pneumonia; media drumbeat (if they keep talking about it, it must be serious), fear of being a bad person who gets it and a worse person who passes it on; having COVID concerns foremost in their brainpan since March 2020, with the throat-constricting fear that it has turned its baleful eye to them, at last.
Jim Geraghty, who does National Review’s “Morning Jolt,” just recently discovered that it is not the number of Covid cases that is important, but the number of people who are dying or being hospitalized. Well, DUH! This should have been the overriding concern from the beginning. Even a conservative writer was not smart enough to figure that out two years ago.
Because the government sucks at everything. Even the stuff it does well it sucks at.
I was recently sent home from work due to “exposure” to a co-worker who had tested positive for the WuFlu. In conversation with another co-worker (someone not impacted by the workplace exposure), I learned she was going to get tested due to exposure to a friend who had recently tested positive. “Are you feeling unwell?” I asked. No, she replied. She felt fine. She said she just didn’t want to be “reckless” with other people’s health. Now, I have to wonder if my infected co-worker was also asymptomatic and had merely been tested because of exposure to someone who had tested positive . . . sort of an infinite regression of the overly-cautious.
That would be disappointing, Jim.
They’ve switched the narrative. It’s no longer deaths, since from Omicron it’s close to zero (and they’re including the “dying with Omicron, not with Omicron being the cause of death). So it’s cases and hospitalizations now. Cases first, since we’re testing like never before, everyone will get Covid at some point, so the number of cases will shock and scare people.
All of this is screamingly obvious and has been for about a year and a half. Politicians use the pandemic for their own career gains, including our drool-cup sporting Prezzie, Pfizer shovels in record revenues and profits, the MSM gobbles up Pfizer advertising (why does a life-saving drug need a billion in marketing?), and we’re left with chaotic mandates at work, travel, and prevented from accessing proven remediations that are cheap and ubiquitous.
We have a Jan. 6 commission. We need a Covid commission. Unfortunately it would be staffed and run by the idiots mentioned above.
Does anyone in the federal gov’t do lessons learned? Because even going back to the AIDS crisis, they have nearly ruined everything they touch.
Hopefully you’ve had better days since . . .
The purpose of Covid policy is to centralize power as much as possible. It is minimally focused on the disease itself but the disease wasn’t behaving as expected, mutated too quickly and lost power to kill so many old people. They’re rethinking how to continue the centralization to finally be done with this silly business of letting people elect their leadership.
I understand wanting to get a test if you’re going to do something on the riskier side, like go to a big party, to make sure you don’t infect anyone else. Or if you feel sick. But a test is just a snapshot in time. You could get infected 5 minutes after you get it. So in many cases…the “just to be safe” people…the result of the test doesn’t change your behavior, which means you shouldn’t waste your time getting one.
Not to mention that there’s no way I’m going to let someone stick a swab up my nose who just did the same thing to the 100 people in line before me. I know they change their gloves and take precautions, but no thank you.
Interesting.
I never ever dreamed we could screw up public health so bad.
As to why we should be afraid of a common cold… Maybe it doesn’t make a lot of sense, but I don’t like the idea of getting infected with something concocted in a CCP lab. I know that’s racist or something, but that’s ultimately why I still take precautions.
I have said it before and I will say it again. You can’t create more medical resources by invoking the word “liberty” in an actual pandemic. Particularly medical labor.
what was the outcome? Did they determine what you had? Did you get treatment?
This is some good criticism. Start at 7:30. It goes for about seven minutes. Supposedly the private sector asked him if they wanted more tests and he said no. I don’t get why the government didn’t assume the risk for more tests and this new drug and force them through just like vaccines. The analyst says it’s just because all they think about is the vaccine.
https://omny.fm/shows/red-eye-radio/red-eye-radio-12-28-21-part-2
If you go back to the beginning I thought there was some pretty good analysis of Kamala Harris.