Googling Covid tests in poor America
Googling Covid tests in poor America
Joe Biden sez: Just Google it. So I did.
Tomorrow is a long-awaited day: The White House’s website for ordering Covid-19 rapid tests will go live. It will mark the first time that the federal government has attempted to provide Americans free rapid tests—not to just stop providers from billing you for them, or insurers from making you pay a co-pay, but to actually send them directly to you, as is the case in other countries. Boris Johnson, a man currently embroiled in a teenager’s scandal—he had a party and lied about it—managed to oversee sending free rapid tests. (It helps when you have a healthcare system.)
Among all the failures of the United States’ response to Covid-19—the nursing home deaths; burning through a generation of healthcare workers; the masking guidance flip-flops; the vaccine hoarding; dropping the expanded welfare and protections; 850,000 dead—the failure to secure enough tests for the current explosion in cases stands out as perhaps the most tiring. How could they not plan for the possibility of another winter surge? How could Joe Biden casually tell a reporter that ah, rats, he really wished he thought about ordering enough rapid tests for us all two months ago—and then just carry on, as if that wasn’t an admission of incredible and deadly failure? How could Kamala Harris say that it “turns out [Covid] has mutations and variants,” and not get pelted with tomatoes everywhere she goes?
With that context, recent comments by the president and vice president about how to find Covid testing graduate from mildly irritating to fully Jokerfying. Joe Biden said to reporters on January 4th that people should “Google ‘COVID test near me’ — go there. Google — excuse me — ‘COVID test near me’ on Google to find the nearest site where you can get a test most often and free.” As the New York Post noted, Biden “offered no guidance” on how to get free tests from state and local governments, other than “just find out where they are.” Just last week, Kamala Harris said in an NBC interview that Americans “can Google it and find out where a free testing site is available.” After pushback from NBC’s Craig Melvin, Harris defended herself, saying: “If you want to figure out how to get across town to some restaurant that is great, you usually do Google.”
The casual laziness of telling us all to Google it is reminiscent of the times our politicians tell us to ‘talk to your doctor’ about Covid, or vaccines, or anything else. Talk to my who? In 2015, only 75 percent of Americans had a primary care provider; for 30 year olds, it was just 64 percent. Everyone should have a doctor, but not everyone does. Millions of people use the emergency room or urgent care instead of having a doctor; millions are uninsured; millions couldn’t afford the bill for even a simple check-up, or believe they couldn’t. There is a sickening presumptuousness of the people in charge of ensuring we have necessary things, having failed at that task, addressing us as if they aced it. It’s insulting and dismissive of the very people they’ve let down most.
That same disdain was apparent in early December, before omicron swept the country, when White House press secretary Jen Psaki ridiculed the idea of sending a free test to everyone. The very idea seemed to catch her off guard. Her objections included the classic “and how much will that cost,” and my personal favorite: “And then what happens after that?”
So, to channel Psaki: If you Google free Covid testing, as the administration wants you to do, what happens after that?
The implication is that if you simply Google it, you will find the free tests, which exist. In DC, where Harris, Biden and I live, testing availability is comparatively good; eight libraries around the city will hand out two free rapid tests per resident each day, until they run out. Lines can be long, but staff get you in and out fast, and there’s even a live map of inventory. There could absolutely be more locations, particularly in poorer parts of the city, and requiring proof of residency is stupid, but at least there are places to pick up rapid tests every day.
But what about elsewhere in the country? What about cities with fewer rich liberals and small plates restaurants and more poverty? What about small cities that never had much healthcare infrastructure in the first place?
I looked at Covid testing results on Google Maps and regular Google for some of the poorest cities in the country, a mix of smaller cities (with a population under 25,000) and larger, using reports from 24/7 Wall Street compiled using Census Bureau data. I picked a few cities around the country, trying to represent different regions and types of city, to get a sense for what happens when Americans follow the president’s advice. (This is also generously pretending people in poverty have adequate access to the internet, which is a whole other thing.) Is it as simple as doing Google and finding a test?1 The answer may not surprise you.
In the South, let’s go to Natchitoches, Louisiana, a town of just under 18,000 people and home to the Louisiana Sports Hall of Fame. The median income is just $21,715 and a staggering 44 percent of the population live in poverty. Searching Google Maps for Covid testing, there are two results. One is Walgreens, which according to its website has “some appointments” available, both PCR and ID NOW (not antigen) rapid tests. The other is an urgent care, Fast Pace Health, offers only walk-ins and it costs $135 without insurance. “We accept most major insurance providers and offer competitive self-pay prices,” the website reads.
You’ll have to drive to nearby Leesville or Alexandria to find a Walgreens with “many” appointments. But 18 percent of households don’t have a car, according to Census bureau data, and half of all households in Natchitoches have no workers at all.2 A result you see on regular Google and not Maps is the regional hospital, which holds testing—but only “Monday and Thursday from 1:00 pm to 5:00 pm.” Eight hours a week, all during normal working hours. Their website says their Tuesday and Wednesday drive-thru testing center is “suspended due to rapid-test testing supplies being low and new supplies being on back-order.”
What about Selma, Alabama, famous for its place in the civil rights marches of the 1960s? The city now has a population of 18,000 and a poverty rate of 37 percent, with a median income of $27,030. There’s one Walgreens drive-thru clinic, with “many appointments” available—Walgreens, RiteAid and Walmart won’t let you see specific times until you register for an appointment—although it only has PCR tests, and the results of those take several days. Same goes for the sole CVS location, which has appointments as of tomorrow (only during the day, though). There’s an urgent care clinic, MainStreet Family Care, that offers walk-in only rapid testing. That’s free if you’re uninsured, but its website warns that if “for any reason” the government doesn’t reimburse them, you owe $125. The county health department also has testing available Monday-Friday from 9-3; Google Maps has no suggestions for public transit that would get you there from anywhere in Selma. 21 percent of households don’t have a car, per the Census bureau. Not a terrible set of options, if you can drive or find someone to drive you, and get there during the day.
Moving north, we’ll go to East Cleveland. East Cleveland is the poorest city in Ohio, with a population of around 17,000. It has a poverty rate of 37.5 percent, and a median income of just $20,743. Health outcomes in this suburb of Cleveland, and other neighborhoods on the east side of the city, are very bad. This is particularly galling given its proximity to the incredibly well-funded Cleveland Clinic, as detailed in an excellent Politico piece from 2017. In East Cleveland itself, Google Maps returns no results for Covid testing. The Cleveland Clinic is accessibly by public transit, but its website says it only has drive-thru testing, and 35 percent of East Cleveland households have no access to a vehicle. Google returns a top result for this tiny-texted PDF, which has no indication of how recent it is, and says it requires a primary care appointment too. But CVS and Walgreens sites, both drive-thru, near East Cleveland have many available appointments this week, including for rapid testing—great, if you have a car. The state of Ohio has a website where you can see rapid test locations, but only by typing in individual zip codes; the first few rapid test locations I found by doing so were out of stock.
A city I had to look at just because of its name is Hamtramck, MI. This is a city within Detroit, with a population of 21,000 and a poverty rate of 46 percent. On Google Maps, we see one Center for Covid Control site, which is now closed because the whole thing was maybe a big scam. There’s also a Maps listing for something called “Yes No Covid,” which is not accurate; all their locations are in Texas. One review: "Went there, the building was empty. Nothing there. The phone number doesn't work either. Waste of time.” I wouldn’t advise heading there, Hamtramckians.
There is a community health clinic with a good website, Wayne County Healthy Communities. But the testing only happens 1-5pm on Monday, Wednesday and Friday. Henry Ford Health System has Covid testing at its locations, including in Hamtramck, but it requires you to already be a patient and have a physicians’ order. Outside the city limits, Joseph Walker Williams Community Center offers rapid testing 9-5 Monday-Friday. IntelliRide provides $2 car rides for those with a Detroit address (why not just make it free!), which is good, because 22 percent of Detroit residents don’t have a car. For those that do, there’s a drive-thru Rite Aid, about 7 miles from Hamtramck. (Only 63 percent of Detroit households have a computer and broadband.)
Let’s head someplace warm, to a big city: El Paso, TX. Not among the very poorest cities overall, but still poor, with a population of 681,729. Its median income of $48,542 is lower than the national median income, and 19 percent of its residents live in poverty. None of its CVS drive-thru testing locations have any appointments available this week. All its Walgreens locations have few or no appointments available. The city has a good website with information on public and private Covid test sites, and even a map. But as of a couple weeks ago, KFox14 was reporting long waits at the city’s drive-up sites, of up to three hours. Many sites only have PCR tests, too. The site lists a place called Revive Medical as an option, but notes that uninsured patients “must provide their social security number, or a copy of their driver’s license or state issued ID.” (Undocumented people, who make up around 11 percent of the population in this border city, are far more likely to be uninsured, and most wary of handing over documents that they may not even have.) Walmart has testing, but only on Tuesdays and Thursdays. Only 7.5 percent of El Paso households have no access to a car, though that’s still over 17,000 households.
Continuing west, we’ll stop in the small town of Orange Cove, California, a city of 10,274 people. An agricultural town with an almost entirely Hispanic population, it’s the poorest city in the state, with a median income of $25,000. Almost half of households live in poverty. There are no Google Maps results for Covid testing in that little town; the nearest result is a RiteAid in Reedley, eight miles away. (For RiteAid sites, it’s impossible to find out if there are appointments available without signing up.) Every nearby Walgreens is listed as having “few appointments” available, and they only have PCR tests. On regular Google, you’ll see there’s a community health center in Orange Cove that offers no-cost Covid testing, and is open til 8pm. It even offers free transportation. Community health centers rule and should have approximately 50 times their current budgets. Hopefully Orange Cove residents are Doing Regular Google and not Doing Google Maps.
The nearest big city is Fresno, which has the highest rate of “concentrated poverty” in California: 33 percent live in neighborhoods where more than 40 percent of the population lives in poverty. A large drive-thru testing site, Covid Clinic, has appointments, though only PCR tests are free. None of the area CVS locations appear to have any appointments available this week. Clovis Urgent Care is listed on Google Maps as performing Covid testing, but there’s no information about it on their website. Around 10 percent of Fresno households have no vehicle available.
The county of Fresno has some testing sites run in partnership with OptumServe, but their website requires you to register before you can see whether there are appointments available, with a multi-page form. The county’s testing website says “medically necessary” testing is free—I would argue that is all testing during a pandemic unless you are testing a cat or something—but the link that explains what that means is broken. The county has an at-home rapid testing program, but the website says they’re out of stock. Please check back for updates, they say.
Staying west of the Rockies, we’ll go finally to Idaho. Rexburg is the poorest non-tiny town, with 28,000 people. It has a median income of $31,128 and a poverty rate of 39 percent. There were no Google Maps results for Covid testing in Rexburg, but Walgreens does have a location there, with “some” appointments and both PCR and rapid testing. Express Labs Idaho has a Covid test center in Rexburg, but it charges $155 for a PCR test, plus a $30 “collection fee,” for the uninsured. It requires a doctor’s order, too, adding to the cost. (This is a pattern: Results that show up on regular-Google but not Google Maps.)
The closest Walgreens with “many” appointments is in Blackfoot, almost an hour away from Rexburg. Idaho Falls also has a VA clinic, only for veterans enrolled in VA healthcare, and an urgent care, which only allows booking the day of and the day before online; the website also warns that “all COVID-19 testing requires a Sterling provider consultation with co-pay.” That means you’re paying, even if the insurance company pays for the test itself. The Idaho Falls Community Hospital has drive-thru testing, but only for symptomatic patients, and it’s $138 without insurance.
In summary, then:
In the cities I looked at, results were mixed at best. Some bigger cities had a good provision of large public testing sites, but others didn’t. Some cities had very few testing options at all.
Availability of rapid, at-home tests—which is what Biden and Harris were actually talking about when they told us to Google it—is still extremely limited and not easy to find on Google. The main place to get those in most of the country is on the shelves of big chain pharmacies, and Googling does nothing to help you figure out if they’re in stock near you.
I didn’t even talk about the asinine plan to have insurance companies reimburse you for over-the-counter rapid tests, but it’s obviously a huge hassle.
I also didn’t even talk much about uneven internet access and literacy, which makes the whole thing doubly insulting.
Even expanding the search criteria to include PCR tests, which take days to return results, it’s still hard to find free testing in a lot of places. Many urgent cares require a doctor’s order or even a visit, adding a co-pay that wouldn’t be covered by insurance.
Many cities’ offerings are largely drive-thru, even in places where a significant number of residents don’t have a car.
The point of freely available rapid testing would be to allow people who have to go to work in person, which is what essentially every leader in the country wants to happen, to quickly check if they are infectious before heading to work. Same could go for children heading to school. If everyone could do that regularly (and quarantine without losing their job or income, but let’s put that aside), the spread of Covid-19 would be dramatically limited—or, at least, it would have been, had that been true before omicron started spreading.
Without this testing, it’s impossible for workers to know whether they’re spreading Covid to their colleagues. Of course, with the CDC’s recent decision to shorten the recommended isolation period to five days, we know that they do not give a shit if people are spreading Covid to their colleagues or even if they have good, recent science to back that decision up.
I’d love to hear from you about what sorts of results you get for Covid tests in your city, or your experience trying to find rapid testing. In the meantime, good luck getting your JoeTests from BidenTestingNowDotGeocitiesDotCom, and try to stay safe out there, because as the administration will repeatedly remind you: You’re on your own.
Caveats: I picked these cities arbitrarily so don’t get mad at me for ones I did or didn’t pick. I did my best to look at the options in each city but also didn’t want to spend hours going down rabbit holes looking for every site, because I wanted to best represent what the administration is telling us is possible: A simple Google search, like you would for a taco place, that shows you free and available testing.
For all the households with cars figures, the source is ACS Community Survey data, 5 year estimates, available at data.census.gov. Table B08203 if you want to get nasty with it.
Thank you Libby. My family just had covid blow through and we had our own fun time finding tests in our smallish Oklahoma town. It was truly infuriating, and your piece makes it clear that it wasn't a unique experience.