Rapid and PCR test kits. Through a partnership with LabCorp, the Department of Health and Human Services now offers free at-home PCR tests by mail. Laura Lee / Carolina Public Press

by Anne Blythe, North Carolina Health News

Maybe your child plays on one of the middle or high school sports teams where North Carolina public health officials have seen an acute rise in COVID-19 clusters since July.

Perhaps you have an elementary school student in your household who is not eligible for a COVID vaccine but really wants to be in a classroom with their peers.

As more children become infected with the Delta variant, the testing and tracing of those with whom they were in close contact has been on the rise, too.

While you could once pull up to a drive-through clinic at some of the state’s larger hospitals and get a COVID-19 test, many of those sites have been closed. Health care workers who worked at such sites have been shifted to COVID wards now packed with a fourth wave of patients who’ve landed there, infected with the Delta variant of SARS CoV2.

That has sent many parents and others out to hunt for COVID tests.

“A number of the hospitals and emergency departments have told us that people are often going there for testing and we know that they are burdened now with sick people who are coming in,” said Gov. Roy Cooper at a recent briefing with reporters. “We have worked to set up special clinics and places people can go and get tested.”

A lot has changed in a year

Amir Barzin, a physician in family medicine at UNC Hospitals and director of the Carolina Together Testing Program, says the idea that a test is difficult to get could be another misconception in a pandemic that has dished up many.

“There’s a palpable difference between testing a year ago and testing now,” Barzin said during a recent phone interview.

More pharmacies, doctor’s offices and other independent sites provide COVID testing now, Barzan pointed out. What may be fueling some of the perception that testing is not widely available, he added, is how quickly test results are shared.

Anyone looking for testing can find free sites run by the state at Find My Testing Place.

“There’s this misconception that I need my test result right now,” Barzan said.

Though some testing sites are able to provide results within a day, some pharmacies estimate a three-day turnaround.

Nineteen months into the coronavirus pandemic, North Carolina has completed more than 16.4 million PCR and rapid COVID tests, according to the state DHHS dashboard.

The demand for COVID-19 tests more than tripled between the second week of August and the Labor Day weekend as public schools and college campuses welcomed back students and people made plans for the holiday.

The state continues to provide free testing. Want to order a free rapid test? Contact DHHS here.

“We are doing an enormous amount of testing in these testing sites, some of the highest amount of testing that we’ve done,” Mandy Cohen, secretary of the state Department of Health and Human Services, said during a briefing with reporters on Sept. 9. “I think it is why we are at a different moment in this pandemic than we were even a year ago.

“Our ability to do an enormous amount of tests, each and every day, with fast turn-around time, continues. I’m really grateful for our partnership with a lot of our labs that have really built up capacity and can handle even more capacity to do lab tests.”

Sports-related transmission

Nonetheless, many parents are still trying to figure out the testing issue as in-person classes and sports teams get back on the field or into the gym.

Between July 1 and Sept. 2, there were at least 42 COVID clusters related to athletic events, among dozens of school clusters, according to DHHS. Only four of those clusters occurred in July, showing how steep the increase was in August, when schools opened after summer break.

It’s not clear whether the cases came from play on the field or whether the student-athletes were infected during travel to away games, in the locker room or during meals on the road.

The numbers troubled NCDHHS Chief Medical Officer and State Health Director Elizabeth Cuervo Tilson so much that she quickly urged anyone 12 and older to get the Pfizer vaccine, the only one approved for children younger than 18.

“We need everyone, including our student athletes and their coaches, to increase layers of prevention to fight this more contagious Delta variant: Don’t wait to vaccinate and urge others to do the same,” Tilson said in a statement released on Sept. 8. “Tested, safe and effective COVID-19 vaccines are the best tool for preventing the spread of COVID-19. Student athletes who are fully vaccinated do not need to quarantine after a close contact with someone with COVID-19.”

In mid-August, DHHS launched TeenVaxFacts with hopes of providing young people, their families and friends with resources that might aid them as they consider the benefits of vaccines.

DHHS also has used TikTok stars and other social media influencers on platforms that draw teens to try to expand their vaccine education campaign.

Everyone 12 and older is eligible for a vaccine, but only 59 percent of that population is vaccinated against COVID-19, according to the DHHS dashboard. Only 35 percent of 12- to 17-year-olds have gotten a vaccine in this state.

“Our case rates are highest for children 17 and under,” Cohen said during the Sept. 9 briefing with reporters. “For the week ending September 4, they made up almost a third of the state’s COVID cases. That’s the highest percentage since the pandemic began.”

Using more rapid tests

During that week ending Sept. 4, more than 15,000 cases of COVID were confirmed in school-aged children.

That’s why the governor, Cohen and others hope to get more rapid COVID tests distributed to the schools. They can be used as screening tools to find asymptomatic children and staff before they come into contact with others.

Earlier in the pandemic, before the Delta variant was so prominent, researchers questioned whether the rapid tests, some of which take only 15 minutes before a result is available, were sensitive enough to pick up low levels of COVID especially among the asymptomatic.

shows the contents of a home COVID test, including swabs, small tubes and foil packets.
Home testing kits are more widely available at pharmacies and research shows their accuracy is improved. They cost about $10/ test. Photo credit: Rose Hoban

People infected with the Delta variant, though, carry a much higher viral load than earlier variants circulating in the pandemic, Barzin at UNC Health noted.

A study from China, not yet peer reviewed but often cited in reports about the ferocity of the Delta variant, found that people have 1,000 times as much virus in their nose and mouth in the early phases of infection compared to the virus strain first detected there in late 2019. Between improved rapid tests and with Delta producing a high viral load in patients, rapid tests have an easier time detecting the presence of the virus, increasing the accuracy.

That’s why, public health advocates say, the rapid tests are an important tool during this phase of the pandemic.

Finding the cases early and isolating the infected might help decrease the number of calls a parent gets from a school principal letting them know that their child was in close contact with someone with a lab-confirmed case of COVID-19. If that child is not vaccinated, that means a 10-day quarantine outside the classroom and a school day without classmates by their side.

“There are different testing modalities available,” Cohen said. “You can get home testing right now. You can order them free from us. …There’s lots of different options for folks to get testing, availability of testing. You can purchase testing for home as well. So we encourage everybody to take advantage of testing as another layer of protection.”

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