The Atlanta Journal-Constitution
Limited COVID-19 testing for kids creates ‘blind spot’
Lack of tests makes it hard to trace infection; some sites lower age.
When Audrey Blute’s almost 2-year-old son, George, had a runny nose in July, she wanted to do what she felt was responsible: get him tested for coronavirus. It wasn’t easy.
Blute, 34, planned to walk to one of Washington, D.C.’s free testing sites — until she learned they do not test children younger than 6. She called her pediatrician’s office, which also declined to test George.
What’s happening
As child care centers and schools reopen, parents are encountering another coronavirus testing bottleneck: Few sites will test children. Even in large cities with dozens of test sites, parents are driving long distances and calling multiple centers to track down one accepting children.
The age policies at testing sites reflect a range of concerns, including differences in health insurance, medical privacy rules, holes in test approval and fears of squirmy or shrieking children.
What it means
The limited testing hampers schools’ ability to quickly isolate and trace coronavirus cases among students. It could also create a new burden on working parents, with some schools and child care centers requiring symptomatic children to test negative for coronavirus before rejoining class.
“There is no good reason not to do it in kids,” said Sean O’Leary, a Colorado pediatrician who sits on the American Academy of Pediatrics’ committee on infectious diseases. “It’s a matter of people not being comfortable with doing it.”
Many testing sites, including those run by cities and states, do not test any children, or they set age minimums that exclude young children. The age limits vary widely from place to place. Los Angeles offers public testing without any age minimum, while San Francisco, which initially saw only adults, recently began offering tests to children 13 and older. Dallas sets a cutoff at 5 years old.
Why it’s happening
The District of Columbia decided not to test young children at its public sites because children have nearly universal health coverage in the city, meaning they could be tested at a pediatrician’s office.
Parents like Blute, however, are finding that pediatricians’ offices appear to have limited testing capacities. George never got a test for his runny nose. Instead, Blute and her husband kept him isolated at home while they tried to work their full-time jobs.
“We were told to assume that everyone in the household has it, which didn’t seem like the best information — we’re both big believers in contributing to the data pool,” she said. “We think that’s really important.”
In Florida, the Division of Emergency Management announced last month that it would “prioritize” pediatric testing as students there begin to return to in-person school. Still, only a quarter of the 60 testing sites the agency supports will see children of all ages. The state’s 18 drive-through sites are limited to patients 5 and older, but did recently add priority lanes for symptomatic children.
“When we first started, and there was a lack of access to testing, this kind of triage might have made sense,” said Daniella Levine Cava, a county commissioner in MiamiDade. “Clearly it doesn’t make sense in the current environment. We know that children contract the disease, we know that children spread the disease, and just because they are less likely to show symptoms, that doesn’t mean they pose any less of a risk to others.”
Pediatricians say the test itself is the same when administered to a child, although it can sometimes require additional supplies. Not all coronavirus tests have gone through safety testing in children, and sometimes providers use smaller swabs on toddlers.
The nonprofit group CORE runs free testing clinics in Atlanta for anyone 2 and older. Olivia Boyd helps run the clinic’s testing program and said that, as camps and day cares began reopening this summer, she began fielding numerous calls confirming that the clinic could test children.
“‘I heard you test under 18. Is that true?’” she said, recounting a typical query. “And we’d say yes. Then, ‘Thank goodness.’”
Large pharmacy chains, which have set up thousands of testing sites across the country, have generally catered to adults. Walgreens does not see children at its drive-through clinics.
CVS Health has slowly dropped the age minimum at its 1,944 drivethrough testing sites across the country. The pharmacies initially accepted only adult patients but dropped the age minimum to 16 in August, and are in the process of lowering it to 12 this month.
“Because we use self-administered swabs, we’ve been evolving our testing protocols as we learn more about what’s possible,” said William Durling, a CVS spokesman. “Twelve years old is the age that our team felt a child could likely swab themselves.”