California’s summer case spike has driven up demand for the once-scarce, then-ubiquitous COVID-19 tests — resulting in long lines, long wait times for results, and lots of frustrated folks anxious to learn if the delta variant has infected them.

New rules for testing at schools, workplaces and large events are contributing to a crush of demand at testing sites like the Santa Clara County Fairgrounds, and leading some of the Bay Area’s biggest health providers like Kaiser to warn results could take three days.

“We got the earliest appointment we could,” said Christine King, 50, from San Jose, who came to the fairgrounds with her family the day after a friend told them they had caught COVID-19. King and her son also got swabbed a few weeks ago, after her son’s friend had a mild fever following a sleepover. They tested negative that time, but she noticed a difference: The testing site was busier since her last visit.

SAN JOSE, CALIFORNIA – AUGUST 25: Patrick Garcia, right, an LVN, licensed vocational nurse, administers a COVID-19 test to Christine King at the free COVID-19 testing site in Expo Hall at the Santa Clara County Fairgrounds in San Jose, Calif., on Wednesday, Aug. 25, 2021. (Nhat V. Meyer/Bay Area News Group) 

“We just figured testing is going to be part of life for a little bit of time now,” King said.

California’s COVID-19 testing rate per 100,000 people had dropped from a high of 895.7 on Jan. 18 to a low of 252.6 on July 4 before climbing again to 752 as of Aug. 25, roughly mirroring the state’s fall and rise of infections through the year, according to the California Department of Public Health. Tests, which were in high demand but short supply in the early months of the pandemic, were so little-used by mid-summer that experts worried we were losing our ability to track the virus. But now demand is back with a vengeance.

The recent testing increase is straining the network of health care systems and laboratories processing the samples for evidence of the virus. The California Department of Public Health shows average weekly turnaround times for test results that dipped from 0.9 days in late March to 0.7 days in June have since climbed to 1.2 days. The department says results for the most reliable and commonly used molecular tests are “most effective” when turnaround times are within two days.

While most of the commercial, public health and medical center affiliated labs are meeting that turnaround time in the vast majority of cases, there are several others with a significant percentage of results coming after three or more days.

Among them is Kaiser in Northern California, where state health department data show 21% of results in the past week took three days or more.

“While current volume may not always lead to same day or next day results for every person, we expedite testing when needed for more urgent circumstances,” Kaiser said.

SAN JOSE, CALIFORNIA – AUGUST 25: Arielle Navarro, left, an LVN, licensed vocational nurse, administers a COVID-19 test to Elias Sinclair, 15, at the free COVID-19 testing site in Expo Hall at the Santa Clara County Fairgrounds in San Jose, Calif., on Wednesday, Aug. 25, 2021. (Nhat V. Meyer/Bay Area News Group) 

Some providers took issue with the state health department’s assessment of their performance. The state said commercial lab MiraDx delivered 37% of its results in three or more days over the past week, but the company, which recently moved from five to seven-day operation, said its turnaround time “remains at less than 24 hours for all sites and we have not experienced any deterioration.”

In any case, there’s little dispute that testing needs have soared, and with it, some frustrations.

Dr. Ann Petru, an infectious disease specialist at UCSF Benioff Children’s Hospital Oakland, said her hospital prioritizes turnaround times by the need for urgency — a new patient needing admission to a shared room will need results within hours, but a patient scheduled for surgery later in the week can wait a few days.

But demand has grown with the list of new requirements and spread of the disease, and everyone who needs a test wants the results as soon as possible.

“It’s super complicated because almost everybody needs to be tested fairly frequently,” Petru said. “You can’t do anything without being tested.”

For starters, the list of those needing a COVID-19 test includes anyone with symptoms — fever, cough, loss of taste and smell — a group that has grown as infections have risen. It also includes close contacts — people who were within six feet of the infected for at least 15 minutes over a 24-hour period — even if symptom-free. Those who are ill need a negative test to come out of quarantine and return to work or school, and even the vaccinated and asymptomatic are advised to get a test after exposure.

But the list has expanded further with new worries over rapid spread of the highly contagious delta variant mostly — but not entirely — among those not fully vaccinated. Nearly 45% of all Californians remain unvaccinated, among them children younger than 12 who aren’t authorized for the shots.

Many companies and government agencies are requiring tests for unvaccinated workers. California next month will require a negative COVID test from the unvaccinated for indoor events of 1,000 or more. It’s required for many international travelers and inpatient hospital surgeries.

And then there are schools, where some 6 million California kids returned to classrooms this month. Dozens of students and staff have tested positive in districts throughout the state since, and both they and their close contacts need tests to return to classrooms or extracurricular activities.

“You have all the school kids who have a slight runny nose or cold symptoms,” Petru said. “If you’re a parent, to take a kid for a test and have to wait three days for results before you can send your kids back is frustrating. Some go to the emergency room because they want an answer. The emergency room gets inundated with healthy kids who just want a COVID test.”

SAN JOSE, CALIFORNIA – AUGUST 25: Arielle Navarro, far left, an LVN, licensed vocational nurse, registers the Sinclair family, from left to right, Judy, Adeline, 17, Elias, 15, and Steven, at the free COVID-19 testing site in Expo Hall at the Santa Clara County Fairgrounds in San Jose, Calif., on Wednesday, Aug. 25, 2021. (Nhat V. Meyer/Bay Area News Group) 

The state recommends that vaccinated people without symptoms be tested three to five days after exposure.

Siblings Adeline Sinclair, 17, and Elias Sinclair, 15, are both vaccinated but came with their parents to the fairgrounds to get tested because Elias was in classes with a student who tested positive. It was their second trip there in a week. The first time, they got their negative results back in a day after Adeline had an exposure at school.

Their mom, Judy Sinclair, was once again anxious for the results.

“Hopefully it will be fast again,” she said, “for the peace of mind.”

A day later, thankfully, she got her answer — and quicker than the long line suggested: negative.

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