“We don’t have the luxury of space to separate diseased areas or cleaning areas,” said Dr. Hai Cao, a pediatrician at South Slope Pediatrics in Brooklyn. “It would be nice if we did. But in our limited space, I don’t see that as a prudent move. “
To further complicate matters, not all Americans have a doctor to see, said Dr. Utibe Essien, a physician and health services researcher at the University of Pittsburgh School of Medicine. Coronavirus testing is covered by insurance in the United States, but about 28 million people in the country remain uninsured. The federal government has set aside money to pay the bill for these patients, but some may still bear unforeseen costs. Fear of a huge medical bill may be enough to drive someone away from a testing site entirely, said Dr. Maradiaga Panayotti.
Overall, the tests have yet to reach some communities that need it most.
Dr. Brittani James, a family medicine doctor at the Mile Square Health Center in Chicago, said the test center in the parking lot outside her office is not even close to capacity testing. In her community, where many residents are African American, employment and home security rates are low; People often cannot afford the car or bus fare that would transport them to a test site. Some of Dr. James’ patients, disappointed by decades of institutional racism, also hesitate to visit government-linked test sites, he said.
The barriers to getting tested are so high that “we can’t even get to the point of ‘Is there enough evidence?'” Dr. James said.
Existing disparities can only be exacerbated by the approach of the fall season, when other respiratory diseases that share symptoms with Covid-19, such as the flu, reappear, and schools invite students to return to campus.
As coronavirus case numbers continue to rise, many American cities are reopening, including St. Louis, where Dr. Hooks-Anderson fears what’s to come.
“I think it will only get worse,” he said. “I would love to be wrong.”
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