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Amid omicron, Maryland must ensure convenient COVID testing on a mass scale | GUEST COMMENTARY

An employee at the ExpressCare Urgent Care Center in Forest Hill announces to the line of people waiting that the first 20 people in line are able to be tested Wednesday, Dec. 29, 2021 as the facility opens at 9am. Some people lined up as early as 6am hoping to get a COVID-19 test at the facility. (Matt Button / The Aegis)
An employee at the ExpressCare Urgent Care Center in Forest Hill announces to the line of people waiting that the first 20 people in line are able to be tested Wednesday, Dec. 29, 2021 as the facility opens at 9am. Some people lined up as early as 6am hoping to get a COVID-19 test at the facility. (Matt Button / The Aegis) (Matt Button / The Aegis/Baltimore Sun Media)

As a graduate student at Johns Hopkins University, I was required to test for COVID-19 weekly throughout this past semester. Hopkins uses a saliva PCR testing system for asymptomatic screening: participants make same-day appointments, deposit saliva into test tubes, and receive lab results through MyChart — often all within a day. As cases rose in Maryland, what initially felt like a mild annoyance in my week quickly became a welcome reassurance: The testing was fast, free, noninvasive, and I could be around loved ones and feel reasonably confident that I was likely not passing COVID-19 onto them.

It is an incredible privilege to be a part of this system, especially as testing has become so difficult to access. The current CDC testing guidance calls for a person to be tested when experiencing any COVID-19 symptoms and to be tested five days after any known exposure. Some health experts have also recommended testing before gatherings. However, at time of writing, there are no CVS testing appointments within 100 miles of my ZIP code. My health department offers only a few weekly clinics in far-flung locations, and does not return results for two to three days. The closest pharmacies are sold out of (pricey!) at-home testing kits, and distribution of free kits at my local library recently lasted only minutes before the supply ran out.

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When my husband needed a test on a Sunday at the beginning of December, he waited for hours at an urgent care facility — a luxury of time that most people simply do not have. The problem only worsened throughout the month as the spread of the omicron variant hastened and holidays neared.

It is not reasonable to expect compliance with CDC testing guidelines or for people to screen before social gatherings when getting tested is this difficult. It is crucial that testing be easy, free and accessible, or some people will not have the time, resources or ability to comply, exacerbating existing COVID-19 disparities. In foregoing testing, these individuals may be unaware of their infection, may not seek medical attention until their symptoms are severe and, of course, may also spread the virus to others.

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As a student of health behavior, I have learned that people are more likely to follow health guidance when it is convenient and when they already have a plan in place for how they will do so. In an ideal scenario, people would already know where to get an at-home test before they need it, or where to go for testing and what to expect once there. It would be local and efficient, such as drive-through testing that has you in and out in minutes. Testing that can be done as quickly as a Starbucks run, that can fit in between school drop-offs and commuting to work, that is reliable and culturally competent and that reports results quickly. And of paramount importance: It would be free.

In fact, Marylanders already experienced this sort of testing system earlier in the pandemic, when governing public health bodies had the political will and resources to make this ideal scenario a reality. In January 2021, I witnessed it myself: I received a PCR test at the Timonium Fairgrounds with a next-day appointment and without having to leave my car. When did Maryland abandon these large-scale testing efforts as one of our many resources to end this pandemic? What lessons have we learned since that could help us build out from and improve upon them?

Several state-run COVID-19 testing sites have now opened. More are needed. Together with vaccinations and masking, scaling up testing is a crucial step in the fight against the spread of the omicron variant and beyond. Maryland needs to expand large-scale, accessible, convenient COVID-19 testing. We owe it to ourselves and all the time together we have lost over the past two years to fully employ every tool at our disposal if we are ever to put the worst waves of COVID-19 behind us.

Laura E. Kroart (lkroart1@jhu.edu) is a doctoral candidate in the Department of Health, Behavior & Society at the Johns Hopkins Bloomberg School of Public Health.

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