Coronavirus testing sites in Los Angeles County were overrun in January. Within minutes of opening online, appointments for the entire day would be fully booked. The lines outside testing sites stretched for blocks.

But demand for testing has dropped so dramatically that anyone walking off the street nowadays can almost instantly get a test.

“It’s crazy how fast and far the drop in testing has been,” said Clemens Hong, a physician leading the county’s testing efforts. “It’s worrisome.”

The average number of tests being conducted every day in America has plummeted by 33.6% since January, according to the COVID Tracking Project. That statistic has many experts deeply concerned because it comes just as America’s recent decrease in infections and deaths is stalling at a worrisome high level. Testing is a key tool to stopping coronavirus transmission; without it, the virus has the potential to spread unchecked.

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Some of those declines can be attributed to the overall improvement of the pandemic in America. With decreased cases and less transmission, fewer people have been experiencing symptoms. But there are other factors at play as the U.S. pandemic now drags on for a year: getting tested is time-consuming. Some people also do not want to isolate or miss work because of a pending or positive test, according to testing coordinators and experts.

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Only a small fraction of the U.S. population — about 54 million people — has been vaccinated. Until more people receive their shots, testing remains one of the country’s main tools for stopping the chain of transmission.

At the same time, more-transmissible variants of the virus are spreading and officials are repealing restrictions, making a spring resurgence of the virus possible.

“We have to remain vigilant,” Hong said. “We’ve seen what happens when we don’t and we really can’t drop our guard now.”

The country’s rolling daily average of tests conducted peaked on Jan. 15 at roughly 2,270,000 tests. Since then it has dipped as low as 1,290,000 on Feb. 21, likely affected by the winter storms. By Wednesday, the average had increased slightly to 1,510,000.

The storms that caused many to lose power and water in Texas, Mississippi and Louisiana have also disrupted testing in many of those states, likely contributing to the drop.

“Some of that is weather and power outages. It’s been so horrible, we’ve had many days where our outdoor testing sites were canceled,” said Richard Pescatore, chief physician for Delaware’s public health division. “But a lot of it is sheer fatigue. People think that because we have vaccines now testing isn’t important. But that’s not true. We’re not in the end zone yet. We can’t be celebrating prematurely.”

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Pescatore said he is growing increasingly worried about the coming months as students return to schools and colleges and people are tempted to gather with the warmer weather.

Testing coordinators in multiple states said they are seeing a growing reluctance among people to get tested. Many worry that the emergence and recent emphasis on how vaccines will eventually end the pandemic have caused people to forget the danger still present.

In Michigan, the number of tests conducted fell to roughly half the level in November. Several test providers in South Carolina began limiting the hours they offer testing. Prisma Health, a South Carolina nonprofit, recently said on Twitter that it would no longer operate community testing sites.

Delaware saw demand for testing soar during Thanksgiving and Christmas, with many people hoping for a negative result before visiting family, Pescatore said. Testing fell 30% in January and has fallen yet another 30% since, he said.

Some health departments — already underfunded and overworked — are struggling to maintain testing sites even as they try to scale up vaccinations. The Northwest Georgia Health District recently announced it was closing its test sites and would no longer offer free testing.

Despite the drastic drop in demand In Los Angeles County, officials there are adding more testing sites in the face of decreasing demand.

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“We have to make it more convenient to get tested, so people can get tested as they go grocery shopping, walk to the park or take the subway,” said Hong, who is leading the effort.

With the pandemic beginning to shift more toward endgame scenarios, Hong and others said, officials have to change their strategy to remain effective.

“We were in a raging wildfire this winter, where you throw everything you have against it,” he said. “As we shift into this next phase of suppressing smaller pocket fires, it can get harder to make progress.”

Navigating the pandemic
(Jennifer Luxton / The Seattle Times)

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