PROVIDENCE, R.I. - Drive-thru sites have been opening around the United States to make it quicker and safer to test people for the new coronavirus. But much like the rest of the U.S. response to the pandemic, the system has been marked by inconsistencies, delays, and shortages. Many people who have symptoms and a doctor's order have waited hours or days for a test.
More than a week after President Donald Trump promised that states and retail stores such as Walmart and CVS would open drive-thru test centers, few sites are up and running, and they're not yet open to the general public. Some states are leaving it to the private sector to open test locations; others are coordinating the effort through state health departments.
Patients have complained that they had to jump through cumbersome bureaucratic hoops and wait days to get tested, then wait even longer for a result. Testing centers opened in some places only to be shut down shortly afterward because of shortages of supplies and staff. And while the drive-thru test centers that have opened are generally orderly, there have been long lines at some.
The slow ramp-up of the COVID-19 testing and the spotty nature now of the system makes it hard for public health officials to track the spread of the disease and bring it under control.
"We need to be testing more broadly to fully understand the scope of the public health situation we are facing," said Joseph Wendelken, a spokesman for the Rhode Island Department of Health.
Dr. Brett Giroir, the federal health official tasked with overseeing testing, said at a White House briefing Saturday that so far about 195,000 people have been tested in the U.S. That figure does not include some people who have been tested in private labs.
For most people, the new coronavirus causes only mild or moderate symptoms, such as fever and cough. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia. The vast majority of people recover from the new virus. According to the World Health Organization, people with mild illness recover in about two weeks, while those with more severe illness may take three weeks to six weeks to recover.
Drive-thru test sites have popped up in locations in more than 30 states -- in state parks and parking lots, next to medical centers and universities, at the Mississippi state fairgrounds and near where the Jacksonville Jaguars play. The governor of Maryland this past week ordered vehicle emission inspection programs across the state to stop so that the locations can be used as drive-thru centers to test for the virus.
But as of Friday there were no open drive-thru tests available in Maryland's inspection centers.
The Utah health department said it isn't in charge of the sites and isn't tracking them. North Carolina's health director said the state is leaving testing to the private sector and declined to say how many sites there are. By contrast, in Rhode Island, health care organizations are running the sites in partnership with the state health department.
In Houston on Thursday, cars lined up for more than a mile outside a hospital when the city's first drive-thru testing site opened. U.S. Rep. Sheila Jackson Lee said they administered fewer than 200 tests in the first six hours.
Elsewhere, at several sites visited by Associated Press journalists, the scenes were well-controlled and sometimes downright quiet.
Dozens of people waiting in cars at a center in Homestead, Florida, on Wednesday, waited their turn to speak with a screener wearing a gown and mask and carrying a clipboard. Some were apparently turned away. Others were waved through, had their temperatures checked and were swabbed for samples.
But supply shortages have shut down drive-thrus in several states, including Colorado, New Mexico, Virginia, Florida, Louisiana, Alabama, North Carolina, and Utah. One Las Vegas site was closed because it didn't have enough workers.
New York state opened several centers to great fanfare on Tuesday. By Friday, however, New York City's health department issued an alert saying only people who require hospitalization should be tested, due to shortages of protective equipment such as face masks.
Nevada Gov. Steve Sisolak said he has begged the federal government for additional test kits and supplies, but the state received a notice Thursday that all of its requests for drive-thru testing pods and testing kits "are on an indefinite backlog, without any estimate of a timeline for delivery."
"This is our unfortunate reality Nevada. It's up to us," he said.
The sites themselves are dotted with tents and traffic cones. The most notable features are medical personnel wearing masks, gloves and protective smocks or other clothing. They take nose and throat swabs from people sitting in their cars or help people go inside for the test.
Some states have as few as one drive-thru site. Montana's sole site is in Billings, the state's largest city. Others have a few dozen.
Security guards were reported at many sites, but a survey of states by the AP did not uncover any security problems. In Rhode Island, the National Guard have been on hand to set up the state's three drive-thru sites and even to swab patients.
The vast network of drive-thru sites at retail chains that Trump said more than a week ago was coming has so far failed to materialize. CVS has opened one site in Massachusetts, which it calls a "model for testing." Walmart said its launching two sites and Walgreens said it's launching one, all three around Chicago. Only health care workers and first responders are allowed.
The patchwork of approaches has caused confusion for patients. Caroline Mauldin was ordered to get a test by her doctor in Charleston, South Carolina, on Tuesday, after experiencing aches and chills for several days.
To get an appointment at a drive-thru site at a medical center, she had to fill out a lengthy online questionnaire and she spent two days calling a number that rolled to voicemail and wouldn't take messages. She resorted to tweeting at the hospital several times just to move things forward.
Finally, on Thursday, she got an appointment for Monday. And she was told the results would not come back until four to five days after that. The visit will cost her $25, she said. Complicating matters, she doesn't have a car and has to borrow one from a friend.
"We have a lot of elderly, low-income people here who don't have access to the internet and who don't have access to transportation. And given that they're the highest risk population, how are we getting tests to them?" she asked.
In urban area such as New York and Philadelphia, some sites are providing "walk-up" appointments for people with no cars.
At the Penn Medicine testing site in West Philadelphia, two security officers late Thursday stood outside to make sure people who arrived by car or foot had an appointment. For about 40 minutes that evening, the line of cars never grew to more than six or seven. But Patricia Sullivan, chief quality officer of Penn Medicine, said every morning this past week, 25 to 35 cars have been lined up and six or seven walk-up patients have stood 6 feet apart under a portico waiting to be seen.
The 20 sites in greater Philadelphia are testing about 1,000 people a day, but that hasn't cleared the pent-up demand.
Rosanne Tanner's 79-year-old mother has been sick with a fever and chest pain since returning from visiting Tanner's brother and his wife, who had recently been on a cruise ship.
Her doctor ordered a test on Tuesday, but when she tried to get an appointment at a drive-thru site at a hospital outside Philadelphia, they were told "they are overloaded, they're bogged down," Tanner said.
Medical staff told her they're scheduling 15 minutes apart so there aren't bottlenecks at the test site.
Finally on Thursday her mother secured an appointment for the following Tuesday. Then, she will have to wait five more days for a result.
"The lag time on these tests, it's putting people at risk," Tanner said.
In Rhode Island, state officials said they are testing around 100 to 200 people a day at all testing sites, including three drive-thrus.
Gov. Gina Raimondo said they want to perform 500 to 600 per day, but they don't have the supplies they need.
"It is our absolute top priority to get to a place where everyone who needs it can be tested and you'll get the results very quickly," Raimondo said at a news conference held via Facebook Live on Friday. "Then if you're positive, we can get you quarantined."