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Colorado officials have asked anyone with a cough to get tested for COVID-19, but that can be harder for people who live outside a metro area or who start feeling sick on a weekend.

The number of Coloradans getting tested any given day dropped this summer, though it began to pick up again in late August as the virus’s more-contagious delta variant spread widely. Some county-run mass testing sites had shut down in spring or early summer, as more people got vaccinated.

Still, more than 5% of COVID-19 tests are coming back positive in Colorado, raising concerns among public health officials that the state is missing some infections, and people may be unknowingly exposing those around them to the virus.

While there are exceptions, Colorado counties with more testing available currently have lower positivity rates, indicating they have a better picture of how many people in their communities have COVID-19. In the 11 counties where the percentage of positive tests was more than twice the state’s goal, four had no testing sites, and five offered testing two or fewer days a week.

Research from other diseases, like HIV, has shown that if testing is easier, people are more likely to find out if they’re potentially contagious and seek care, said Dr. Nitika Pai, an associate professor of medicine at McGill University in Montreal. Unfortunately, testing plans don’t always take into account the needs of potential users, such as older people or those who don’t have transportation, she said.

“You have to make it easy to get tested,” Pai said.

In some parts of Colorado, it isn’t too difficult to find testing. Lisa Navarre, of Boulder, said it was “super quick and easy” to sign up online for a test at the city’s Stazio Ball Fields, and the results came in about two days.

“I was fairly sure it was allergies, but it would be unforgivable to choose not to know and possibly infect someone else,” she said.

While metro Denver has more than 100 possible testing spots available, not counting retail pharmacies, an analysis by The Denver Post found eight Colorado counties had no testing sites included in the state’s list of free sites or pharmacy partners, in the 2-1-1 Colorado database of services, or on local public health websites for those counties.

The counties with no apparent testing options were Cheyenne, Costilla, Custer, Dolores, Elbert, Jackson, Lake and Lincoln.

“We are committed to ensuring testing is convenient for all Coloradans, and while we do not have testing sites in every county, we are dedicated to making sure testing is available in as many locations as possible, based on demand and resources,” said Jessica Bralish, a spokeswoman for the Colorado Department of Public Health and Environment. “We are in regular communication with local public health agencies to ensure they have the testing resources they need.”

Self-testing could partially fill the gap, if rapid tests are available consistently and at an affordable price, Pai said. Universities and workplaces could set up kiosks with testing kits, for example, she said. Self-tests are less accurate than lab-based tests for people who don’t have symptoms, but studies have found they can cut down the virus’ spread if used regularly.

“Frequent and serial testing is the best way out,” she said.

Finding test sites and kits

Some Coloradans reported difficulty finding home tests, though.

David Mabry, of Littleton, said he tried to buy a self-testing kit, but gave up after three pharmacies that had listed the tests as available on their websites were out by the time he got there. Since his symptoms were mild, he decided to just avoid others until the infectious period would pass without confirming if it was COVID-19 or a cold, but said he’s concerned that the state may be missing out on important information.

“If other parts of the metropolitan area are experiencing a shortage of self-tests like we are in the Littleton area and what I have is indeed COVID, then it’s a certainty that the new cases are being dramatically underreported,” he said.

Scott Bookman, the state’s COVID-19 incident commander, said at a news conference this week that the state has plenty of capacity to do more testing, and urged people to get tested if they have symptoms, including:

“Testing is an absolutely critical part in keeping this under control,” he said.

But even within an area that’s relatively saturated with testing sites, some people reported confusion.

Melanie Rubalcaba, of Frederick, said when she searched online for a testing site, the first results were Walgreens and some nearby urgent care facilities, none of which had appointments available that day. It was only after she remembered that the Boulder County Fairgrounds had had a testing site until June that she found the county website and was able to book a test at Heart of Longmont United Methodist Church.

“I didn’t really know where to begin,” she said. “It’s been a learning experience.”

Others, like Breanne Hammett, of Denver, said it wasn’t any harder to get tested in the past few weeks than it was earlier this year. She and her daughter both got tested at the COVID Check site at George Washington High School on a Friday morning, and had their results by Saturday evening, she said.

“This seemed pretty in line with prior experiences, but there were fewer cars,” she said.

Testing speed is important, because if people learn their results within a few days, it increases the odds that they will isolate themselves until they get a negative result or pass the contagious period. A person with mild symptoms who can’t get tested might decide to assume they’re experiencing a cold or allergies, and a prolonged wait may not be feasible for people who can’t work from home.

The majority of people who responded to a request from The Post to talk about their testing experience reported they got their results relatively quickly. Of the 69 people who took a PCR test, which is more accurate than a rapid test but requires processing in a lab, about two-thirds had their results within 48 hours.

Bralish said that on average, labs are returning results within two days, even though the demand for testing has increased. Last week, Mako Medical Laboratories, which has a state contract to run some testing sites, had a technical issue with its patient portal that delayed some results, but that’s been fixed, she said.

Limited access to testing sites

Nearly all of those who told The Post they had trouble getting a test reported there were no appointments available in their area, because either sites were closed for the weekend, or they didn’t list any open slots on their websites. Two people said they couldn’t find a free site nearby, and one said she was told she couldn’t get tested if she didn’t have symptoms or a reason to believe she was exposed.

Colorado’s 10 largest counties all had at least one testing option every day of the week, though the weekend options sometimes include urgent care facilities or other providers that charged a fee. About one-third of the free testing sites have at least some weekend hours.

Smaller counties generally had less access to testing, though there were some exceptions: Ouray County, with about 5,000 residents, had testing available four mornings a week, while a few counties with twice as many people didn’t have any sites listed.

Heather Ruddy, of Centennial, said the lack of weekend hours was a hurdle when her daughter developed a sore throat on a Sunday. The COVID Check sites were closed and Walgreens didn’t have any appointments available, so she went looking for a home testing kit, eventually finding one at the second store she tried. The result was negative and her daughter’s throat felt better not long afterward, so they didn’t end up needing an appointment, she said.

Ruddy said she had an easier time when she developed symptoms on a weekday, and while there was a “steady stream” of people getting tested at the Littleton Park and Walk site, plenty of appointments were available.

Still, it’s a problem to not have more testing available on the weekend, she said. She works for a construction company, and some clients want workers on their job sites to get tested every 72 hours, leaving them little choice but to go to an urgent care facility and pay for a test out-of-pocket if they plan to work Mondays.

“If you get sick Friday night, you don’t want to wait until Monday to know what you’re dealing with,” Ruddy said.

To find free testing in your area, visit covid19.colorado.gov/testing.

Updated 4 p.m. Sept. 3, 2021 This story has been updated to remove Grand County from the list of counties that didn’t appear to have testing sites. Grand County Public Health offers rapid testing.

This content was originally published here.