“We don’t have the luxury of space to do separate sick areas or swabbing areas,” said Dr. Hai Cao, a pediatrician at South Slope Pediatrics in Brooklyn. “It would be nice if we did. But in our limited space, I don’t see that as being a prudent move.”
To complicate matters further, not all Americans have a doctor to consult, said Dr. Utibe Essien, a physician and health services researcher at the University of Pittsburgh’s School of Medicine. Coronavirus testing is covered under insurance in the United States, but about 28 million people in the country remain uninsured. The federal government has set aside money to foot the bill for these patients, but some could still be saddled with unanticipated costs. Fear of an enormous medical bill can be enough to drive someone away from a testing site altogether, said Dr. Maradiaga Panayotti.
On the whole, testing still is not reaching some communities that need it most.
Dr. Brittani James, a family medicine doctor at Mile Square Health Center in Chicago, said the testing center in the parking lot outside her practice is not even close to testing at capacity. In her community, where many residents are African-American, rates of employment and housing security are low; people often cannot afford the car or bus fare that would ferry them to a testing site. Some of Dr. James’s patients, disillusioned by decades of institutional racism, are also hesitant to visit testing sites with ties to the government, she said.
The barriers to getting a test are so high that “we can’t even get to the point of, ‘Are there enough tests?’” Dr. James said.
Existing disparities may only be exacerbated by the approach of the fall season, when other respiratory illnesses that share symptoms with Covid-19, such as the flu, reappear, and schools invite students back to campus.
While coronavirus case numbers continue to balloon, many American cities are reopening — among them, St. Louis, where Dr. Hooks-Anderson is dreading what’s to come.
“I think it’s only going to get worse,” she said. “I would love to be wrong.”