President Joe Biden promised to distribute hundreds of millions of free COVID-19 tests and to open more testing sites to fight surging infections, but the stepped-up efforts will not come in time for people who want to find out if they are infected before the holidays.
Americans have been searching drugstores for scarce home tests or waiting hours in chilly temperatures at testing facilities across the country.
"Not everyone can take three hours off work to get tested, but it feels like it's the only thing we have the power to do," said Jordan Thomas, who waited nearly four hours for a test this week in the Brooklyn borough of New York City.
In Atlanta, drugstores ran out of home tests, and police shut down testing sites as traffic backed up a half-mile or more. A drive-thru testing site in Columbia, South Carolina, that for months had quicker lines than some nearby Chick-fil-A restaurants had waits of an hour or more days before Christmas. Workers warned that results could take longer than the typical 24 to 36 hours.
Fueling the surging demand for tests is a mix of factors, including families seeking to keep holiday gatherings safe and people needing to prove they are virus-free for travel, work or school. Adding to the pressure is the extra-contagious omicron variant, which has a multiplying effect on the number of people seeking tests after being exposed to an infected person.
In the United States, infections average around 149,000 a day, up from 75,000 a day at the start of November.
"The rise in infections is pretty dramatic," said Gigi Gronvall, a senior scholar at the Johns Hopkins Bloomberg School of Public Health who has tracked COVID-19 testing efforts during the pandemic.
Testing can help ensure safety at gatherings, even if people do not have symptoms and were not exposed to the virus, according to the Centers for Disease Control and Prevention.
"Take a test before you gather," the agency's director, Dr. Rochelle Walensky, said this week as omicron led to spiking cases ahead of the holidays.
But efforts to follow that guidance and to meet the requirements of some employers and schools have strained testing capacity in many places.
Detjon Bushgjokaj was among hundreds of people seeking a test in Everett, Massachusetts, just north of Boston. He waited about 90 minutes after his 6-year-old daughter, who has not been vaccinated yet, tested positive after falling ill with a fever.
"As soon as my wife called, I left work and came right here. I work with a lot of people and in different places so I needed to make sure," said Bushgjokaj, who is vaccinated. He said his daughter's illness has added uncertainty to their holiday break.
In New York City, drugstores posted signs alerting customers that they sold out of tests. Lines wrapped around blocks at some testing sites, with some saying results could take three to four days.
For next-day results, one site listed a price of $150. For results in two hours, the price was $389.
Though the technology to process PCR lab tests takes less than a day, testing sites and labs face staffing struggles like many other businesses, said Mara Aspinall, who teaches biomedical diagnostics at Arizona State University and is on the board of OraSure, a COVID-19 test maker.
Manufacturers are working to increase supplies. Abbott said it's seeing "unprecedented demand" for its popular BinaxNOW tests and that it plans to expand production to 70 million tests in January, up from more than 50 million this month. The company said it can further boost production in coming months.
In the meantime, Walgreens said it's limiting people to four boxes per purchase in stores and online. CVS said it's limiting people to six kits per purchase.
In New York City, officials planned to hand out rapid home tests to people facing long waits at testing sites to help ease demand. But the city is having trouble securing the tests as well.
Biden announced Tuesday that the federal government would for the first time start mailing 500 million free rapid tests directly to Americans in January. Details have not yet been released, but officials say people will be able to use a new website to order their tests, which will be mailed to them at no charge.
The government will use the Defense Production Act to help manufacture more tests. New federal testing sites will also be set up, starting this week in New York.
The changes come after public health experts for months urged U.S. officials to make testing more accessible, pointing to countries such as the United Kingdom and Germany, which have distributed billions of tests to the public and recommended people test themselves twice a week.
Experts say the latest efforts still will not be enough for all Americans to test at that rate. The U.S. would need 2.3 billion tests per month for everyone 12 and older to do that, according to the nonprofit Kaiser Family Foundation.
The availability of tests varies around the country.
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At a city-run children's day camp in Fort Collins, Colorado, boxes of rapid tests were available for free this week. Staffers told parents to take as many as they needed.
Still, demand for testing is only set to increase after the holidays, when people will want to know if their travels and gatherings resulted in infections, noted Dr. Marcus Plescia, chief medical officer for the Association of State and Territorial Health Officials.
And high demand will likely to persist far into 2022 as people look to resume the activities they gave up during the pandemic, Aspinall said.
"The pandemic fatigue has moved into, 'I want to do what I want, when I want.' And tests provide that knowledge and power," she said.