Some U.S. States Close Testing Sites Despite Fears of Surge

Some states will close mass coronavirus testing sites in the coming weeks, as many did before the recent Omicron surge, despite concerns among some public health experts that the United States may be unprepared for a new wave of cases.

The closures arrive only a few months after Americans were forced to wait hours in long lines for free tests or to pay for testing. New Hampshire closed all state-run sites on Tuesday. Massachusetts will have closed a majority by April 1. South Carolina has been gradually closing them this month; Utah has been doing so since February.

State health departments have cited sharp drops in demand for testing as a critical factor in their decisions, as well as a significant improvement in the availability of at-home rapid tests and declines in daily cases and hospitalizations, which have been recorded in nearly every state.

Many states have shifted testing efforts back to traditional health care providers, like hospitals and pharmacies.But some public health experts say that closing mass testing sites without taking other steps to address potential gaps in virus surveillance and testing access, especially while other mitigation measures like mask mandates are dropped, could leave the country scrambling in the face of another potential surge.

Testing sites provide health officials with data to anticipate new surges and variants in a way that at-home rapid tests cannot. (Though a critical tool in fighting the pandemic, at-home results are not always reported to official authorities.)

Once a new surge or variant arrives and starts driving up testing demand, no rush to reopen mass testing sites, no matter how expedited, can make up for the lost time, said Cassandra Pierre, the medical director of public health programs at Boston Medical Center.

For instance, Colorado health officials have said they could reopen mass testing sites within four to five weeks. In that time, Dr. Pierre said, the peak of a surge may have already passed and left hospitals overwhelmed with severely ill patients.

Even reopening testing sites in as little as one to two weeks would not be sufficient, Dr. Pierre said.

Closing state-run sites also requires local hospitals, pharmacies and community-based groups to absorb the additional demand. Those that are already straining to serve populations most in need may not be able to do so, Dr. Pierre said.

Still, state health departments have been under unsustainable strain. Federal funding is dwindling, and more money may not be coming. Staff shortages and death threats have become commonplace.

The testing site closures may have been inevitable given the enormous stressors on the public health work force, said Gigi Gronvall, a testing expert at Johns Hopkins University.

There are positive signs. Private providers are better prepared than they previously have been, Dr. Gronvall said, and increased immunity in the general population and the widespread availability of rapid tests will help.

She added that the sites are not the only way for health departments to monitor or address a potential surge. But the question remains: What happens if the virus takes a turn for the worse? Or if a variant emerges for which existing vaccines aren’t protective?

“You don’t want to fearmonger, but this is part of planning,” Dr. Gronvall said. “This is the kind of thing that public health departments need to be thinking about.”

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