After many months of almost complete quarantine, we sent my 10-year old son to an outdoor day camp last week in a town adjacent to our home in Oakland, California. We figured it was about as safe as things were going to get. They divided kids into cohorts of eight, and they kept them physically distanced while wearing masks. Two days after camp ended, my son woke up sick with a stuffy nose, sneezing, headache, and mild fever, so we thought we may need to get him a COVID-19 test.
I called my son’s pediatrician’s office and scheduled a same-day video visit. I explained the symptoms to the doctor from my computer and asked if he should be tested for COVID-19. Maybe, she said, but the local children’s hospital they’ve been sending the kids to is swamped and won’t see him for a testing appointment for one to two weeks. She then suggested a few community resources which might be able to see him sooner. She cautioned that our family needed to self-isolate for 10 days unless we could get confirmation of a negative test result. Once the call ended, I searched the locations she recommended. All listed either long delays (7-10 days for results) or significant barriers to entry (a $199 membership fee to join the health practice, in one case). In a phone call to yet another location, I listened to hold music for 25 minutes before I was told that they are only testing first responders and essential workers, given limited testing capacity.
I turned to NextDoor, where I recalled a recent post with a list of local resources. I researched them online and chose one that promised both relatively short lines and turnaround time (2-5 days). After making the required, and thankfully same-day, appointment online, I received an email indicating that I had to check in on the app once I arrived. Ah, an app. I downloaded it to my phone and created an account. I re-read the appointment confirmation email, which indicated that the person’s name on the app account needed to match the ID shown at the collection site. I returned to the app to edit the account, so it listed my son’s name instead of mine.
I had thought the site would be drive-through, but revised my expectations once we reached the outdoor tent area next to a community urgent care center, noting the long line of masked individuals. Still unsure how the process worked, we joined the line, because that’s what you do with queues in front of the services you need. While there, I tapped through and filled out the five pages of required information for check-in on the app. Upon hitting submit, I received an error message that my address information was missing. It wasn’t. I checked and rechecked, submitted and re-submitted, to no avail. During that time, my son and I remained in line, as our appointment time came and went. Well, I’ll at least try to talk them into getting him tested once we reach the front, I reasoned.
As we stood waiting, the line behind us lengthened. The woman behind me asked, “excuse me?” and I turned toward her. She was young, maybe 20, with a mask strapped across a flushed face. She was on her own, looking confused, with glazed, feverish eyes.
“Do they need a signature?” she asked me quietly in Spanish.
“Sorry, what?” I asked in English.
She pointed to the front of the line. “A signature, do you think?” she inquired again in Spanish, gesturing with her arms. She clearly spoke almost no English.
I switched to my limited Spanish. “I’m sorry, say again?” I asked her. Was she concerned if they were going to ask about her immigration status?
She replied in a muffled response that I had trouble deciphering.
I grasped at words, wanting to help, but unable to decipher or convey much of value. “I’m really sorry, I don’t know, I don’t know how this works,” I said again in Spanish. “Maybe just wait?”
She nodded and stepped back again.
Eventually, my son and I reached the front of the line, and we were beckoned to the check-in area with a quick wave. As I had hoped, I explained my trouble with the app and talked us into being seen anyway, given that we did have an appointment (look, see my phone, I implored) and were in line at the appointed time.
As I handed over our insurance and ID card, the woman behind me approached the check-in station beside me. Shortly after, I heard someone call for a “translator,” and another woman came over and began speaking in Spanish. My Spanish skills are such that I am somewhat able to understand what is said, if spoken directly and clearly. The woman from the line shook her head, no, when the translator asked if she had an appointment. Ah, “cita,” I thought. Appointment. Not “firma,” or signature.
In Spanish, the translator told her, “I’m sorry, but you can’t have a test without an appointment.”
The woman began wringing her hands and asked another question.
“No, there are no more available today,” the translator told her. “There are some open for tomorrow.”
This I heard clearly: “But I can’t come tomorrow,” the woman responded. She began to cry, tears pooling at the corner of her eyes.
At that point, the clinic staff ushered my son and me toward the testing area. As we walked, I turned and watched the woman behind me. She wrapped her arms around her torso and turned away from the set of tents. She rubbed at her eyes and slowly began walking away.
After we answered the requisite screening questions, my son promptly sat in a chair and was swabbed in both nostrils. He began crying immediately, as his sinus passages were already swollen with illness. I wrapped him in my arms as we walked back to the car, shushing his sobs, which eventually subsided. My attention was divided, however. I glanced around for the woman from the line, haunted by her despair, but she had clearly left.
This is who we’re failing by not having a simple, accessible testing strategy. I encountered multiple barriers to testing, as did everyone else in that line: following the fine print from the email, having access to a phone and plan capable of downloading and using new apps, filling out the required information in English only, to name just a few. Ultimately, I successfully got my son a test because I could speak the language and could speak it persuasively. The woman behind us in line, clearly quite ill and in need of help, could not. I don’t know where she lives, but know that COVID-19 has hit the Black and Latino communities in our county the hardest.
Because I conveyed to the screener that my son both had symptoms and a three-year history of asthma, he could get the quick turnaround antigen test, which they were rationing, instead of the default PCR test, which would have taken 2-5 days for results.
I answered a call half an hour after we returned home and was informed that my son’s test was negative for COVID-19.