Experts say longer opening hours for Covid-19 testing centres will make testing for people with symptoms more accessible, as Omicron takes hold across the motu.
University of Auckland public health associate professor Dr Collin Tukuitonga said the short hours of some walk-in testing centres could be inaccessible for people like shift workers.
“In these smaller centres, if they close at one or four and they have shift work that finishes at 10, you know, it’s not particularly easy for them.”
1News found short hours at some regional no-appointment testing sites through surveying centres on Healthpoint and enquiries to local testing providers.
In Gisborne, the city’s sole community testing centre closed at 1pm on both weekdays and weekends. Meanwhile, in others like Napier, no-appointment testing centres closed in the middle of the afternoon.
Auckland, Wellington, Christchurch and Dunedin were the only cities in the country which had walk-in or drive-through testing centres consistently open past 6pm on weekdays.
Long queues in the past week have also meant it’s often taken people hours to get tested at no-appointment community testing centres.
Tukuitonga said organising self-isolation and testing at GPs would likely be easier for people who had greater means.
“Office workers or civil servants have flexibility — they can pop off and get tested during the day.
“But, I suspect that supermarket workers, service workers and people like that probably don’t have that level of flexibility.”
Tukuitonga said Auckland DHBs had set up pop-up testing and enabled mobile testing during last August’s outbreak, which he said helped boost uptake among hard-to-reach communities.
“It will improve testing if there are more options, if they’re more local, if they have extended hours. All of those things will make a difference.”
Testing if you have symptoms is expected to get easier as Omicron continues to spread and rapid antigen testing is phased in.
But, while rapid antigen test kits are expected to be widespread at Phase 3 of the Government’s Omicron response, testing centres still remain the primary method of screening symptomatic people for Covid-19 at Phase 2.
Until then, Tukuitonga was worried that harder-to-reach communities who find existing testing inaccessible may be left without the support they need.
“The privileged will … be able to pick up the infection earlier and therefore isolate and reduce the risk of transmitting to others. You may well aggravate the inequities that already exist.
“If service workers can’t get tested promptly, if they have large families, if there’s lots of people in the house — there’s potentially more likelihood of infection being spread around in service workers, low-income groups,” he said.
Tukuitonga said less accessible testing would affect the groups health officials should show more concern about catching the virus.
“I suspect it would affect more Māori, Pacific people, disabled people, people who might be working.
“It would primarily affect the people that we want to get tested the most.”
Researchers: Testing accessibility key to uptake of testing in all communities — but rates can be complex to measure
Te Pūnaha Matatini researchers Emily Harvey and Dion O’Neale helped author a paper looking into the likelihood of undetected Covid-19 spread using Flutracking survey data last October.
The Flutracking project, supported by ESR and the Ministry of Health, surveys tens of thousands people weekly about whether they had cold and flu symptoms. It was originally created to allow researchers to track the spread of influenza.
TPM researchers found they could look at how many people reported having a new onset of Covid-like symptoms and compare that against DHB testing numbers — excluding non-symptom-related testing, such as close contacts and border workers.
This could then give an estimate as to what proportion of people who developed Covid-like symptoms went and got a test.
They found that while the Auckland-centred outbreak had led to very high rates of testing in the city, there had been significant differences in the rates of testing between different district health board areas nationwide.
“In that chart, you’d be worried about the regions that have a purple bar that’s significantly shorter than the orange bar, which represents [the] onset of two or more Covid-like symptoms and purple bar, the proportion of people that got tested,” O’Neale said.
Harvey and O’Neale said that accessibility of tests between different regions could be a contributor to how often people got tested
As Omicron spread widely in the community, Harvey said it was a place where rapid antigen testing would be an improvement over existing PCR testing for some communities.
“There’s a lot of places that don’t have very good availability [of PCR testing], but that means that there is a place for these rapid antigen tests,” she said.
“It’s just that the messaging has to be much more nuanced with them because there’s a false negative rate that people need to be aware of.”
O’Neale said the lack of perceived social support for people in self-isolation awaiting results, alongside poor accessibility of testing, could act as disincentives towards people getting tested.
“You’d really hope for something like what the UK did, where they just mail out [rapid antigen] tests to every household. You want people to be able to test, even if not reporting that information back, but they’re hopefully modifying their own behaviour internally.
“Even if it means they don’t go and visit grandma, and that’s the only way they change their behaviour. And to make that happen, you need to have really easy access [to testing].
“If you really want people to do the right thing and modify their behaviour, when they test positive, then having that social support again like so many other countries,” O’Neale said.
The researchers said health authorities should look to other countries that provide direct financial support to people in isolation, as well as essentials like food by default.
In contrast to some media reports on testing, the researchers said overall testing rates of people with symptoms hadn’t clearly dropped over the summer break as compared to previous months.
Instead, they said cold and flu-like symptoms varied significantly throughout the year, with especially low rates over the holiday break as school children stayed home.
“Whenever kids aren’t at school, [new onset of symptoms] goes way down across the whole country,” O’Neale said.
“About one week later and a week after they go back to school, new onset of symptoms goes up and then you modulate that by your seasons.”
Harvey added that reduced surveillance testing in workplaces and testing availability over Christmas could also contribute to lower testing numbers over the holiday period.
Speaking in early February, they said testing had been roughly keeping up with the new onset of Covid-like symptoms in the community prior to the beginning of the school term.
Both researchers said more could be done to provide detailed testing information that identifies the reasons why people take tests.
The researchers said while Aucklanders were likely more pre-dispositioned to get testing if they had symptoms, overall rates had risen across the country since prior to the last August outbreak.
Separate from TPM’s research, the Flutracking project also reports the percentage of respondents who have cough and fever symptoms and have also been tested for Covid.
Harvey added as a caveat that a significant proportion of Flutracking participants with cold and flu-like symptoms were under five and may be less likely to get a Covid-19 test. But she said participants of the survey would also be more inclined to get a test in general.
In a statement, a Ministry of Health spokesperson said more New Zealanders were now able to access Covid-19 rapid antigen tests than ever before.
“The launch of the Close Contact Exemption Scheme will also enable more people to access rapid antigen testing thus reducing the demand on our testing centres.
“We are also working with more than a 1000 community providers to ensure we reach our priority populations.”
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