Even if they can find a test, not everyone wants to know they have COVID

Even if they can find a test, not everyone wants to know they have COVID

Transcript¹

A person swabs their nose as they receive testing for both rapid antigen and PCR COVID-19 tests at a Reliant Health Services testing site in Hawthorne, Calif., on Jan. 18.

Patrick T. Fallon/AFP via Getty Images

A major public health tenet is that testing is critical for controlling viral spread, but Cristina San Martin could have found plenty of reasons not to test for COVID-19.

At-home rapid tests have been sold out, and lines at lab testing sites have wrapped around the block and booked a week in advance. As a dog washer at a grooming² salon³, San Martin can't afford $150 to test at an urgent-care site.

And then there's the unpleasantness of the test itself. "I actually know a couple of people who specifically do not want to get tested, even if they think they're positive, because the nasal swab hurts," says San Martin, 28, who lives in Cypress⁴, Texas.

Nevertheless, at the first sign of sniffles and sore throat two weeks ago, San Martin, who identifies as nonbinary, sent a text to warn co-workers, missed work, and found someone with a car to drive them to get tested. But after the diagnosis⁵ was confirmed, the manager of the salon where they worked fired San Martin.

Now, not only is San Martin still feeling sick, but cash is also a problem. "I'm in no shape right now to apply for jobs or go get interviewed right now or anything like that," San Martin says between coughs.

In many parts of the country, finding a test can still be a challenge. But even if a test can be had, a positive result can bring stigma⁶ and isolation⁷. Plus, there's the cost of missing a paycheck or keeping children home from school. So some, like San Martin - who is fully⁸ vaccinated⁹ - wonder whether it's worth the trouble to get tested.

"It's easy to take a moral stand and say, 'You should always do the right thing,' " San Martin says. "But if I knew that my job was on the line, I don't know if I would've gotten tested, because anyone could say, 'Oh, this is a cold,' or 'I just have the flu.' "

Dr. Shantanu Nundy worries that these kinds of practical concerns are drowning out calls to test early and often in the name of the public good.

Nundy, who treats mostly low-income patients at a federally funded clinic in Arlington, Va., says many of them ask: "Hey, can you test me? But can you test me, you know, [with] the rapid tests so that it's not part of my record?"

That's because lab-based PCR tests are reported to health officials. But many patients prefer to fly under the radar¹⁰ of authorities, including bosses and school administrators¹¹, because of the disruptions a confirmed diagnosis brings, Nundy says.

"The patients and families who are the most marginalized people - who don't have steady employment, receive benefits, have limited child care and home support - are those who are most likely to not test, and who are probably the ones who we need to test the most," because they're also the most exposed to the virus, he says.

Across the country, doctors say they see more patients avoiding testing out of fear of the disruptions it might cause on their livelihoods¹² or on their families.

More people want to avoid testing, especially if they might be infectious but don't feel symptoms, says Jeanne Noble, an emergency room physician at the University of California, San Francisco Medical Center at Parnassus.

"I have heard many parents breathe a big sigh of relief when they say the school has run out of tests," says Noble. "Like, 'Oh good, there's no chance that I'm going to get a call at work that I'm going to have to come home.' "

This is a global phenomenon, says Francesco Fallucchi, a behavioral economist¹³ at the University of Parma in Italy who last year studied Americans' willingness to take COVID-19 tests.

A year ago, he found altruism¹⁴ was a big motivation for people to get tested; these days, people's concern for others bumps up against hard financial realities, especially because countries, including the U.S., have cut back on pandemic unemployment benefits.

"The disincentives to test are increasing and they are increasing because there is less financial security and because there is a greater perception that COVID is getting weaker," Fallucchi says.

It's a dilemma¹⁵ Fallucchi feels personally, as the parent of a daughter whose school required thrice-weekly at-home testing: "I have to admit - it's a bit shameful¹⁶ - but I met parents outside the school they said, 'Oh no, I'm not going to do it three times a week.'"

This reluctance¹⁷ to test puts employers, especially, in a tough spot. They face a dramatic labor¹⁸ shortage made worse by a surge of absences because of COVID-19. Yet testing is critical to containing that very problem.

Between COVID fatigue¹⁹ and pressures to return to work, Johnny Taylor Jr., CEO of the Society for Human Resource Management, says employers have a difficult task of returning workers to the office safely while not forcing them to comply with testing.

"The question is ... are [employees] willing to become tested?" he says. "I mean, like, do I really want the hassle?"

The fact that there is a choice is relatively²⁰ new for Americans, because of the recent rise of at-home testing. That is fundamentally changing how the virus can be tracked and traced, says anthropologist²¹ Hugh Gusterson, who teaches the culture of science at the University of British Columbia and George Washington University.

"That responsibility will increasingly be delegated to ordinary people to test themselves and to make their own judgments²² how to react to the test results that they get," Gusterson says.

More consumers, in other words, will be able to make their own choice about whether to test, or withhold²³ reporting the results, which in turn will make it much harder to measure the real number of COVID-19 cases, Gusterson says.

That's a worrisome prospect²⁴ for Stella Safo, an infectious disease doctor at the Icahn School of Medicine at Mount Sinai. Safo herself takes medications that suppress her immune system and fears the growing reluctance to test means she and her patients now know less about who's infected - leaving them more vulnerable than ever.

"I think the people who have chronic²⁵ illnesses, people who have preexisting conditions, people who are disabled are being driven truly underground," Safo says, especially because the public-health benefit of testing for the sake of those people isn't being emphasized.

"That messaging, I think, has been lost in this desire to kind of get back to normal living," she says. That leaves people to make their own risk calculations whether to test, based only on their personal circumstances - and can leave out the risks to the most vulnerable.

1 transcript   

n.抄本，誊本，副本，肄业证书

参考例句：

• A transcript of the tapes was presented as evidence in court.一份录音带的文字本作为证据被呈交法庭。
• They wouldn't let me have a transcript of the interview.他们拒绝给我一份采访的文字整理稿。

2 grooming   

n. 修饰, 美容，（动物）梳理毛发

参考例句：

• You should always pay attention to personal grooming. 你应随时注意个人仪容。
• We watched two apes grooming each other. 我们看两只猩猩在互相理毛。

3 salon   

n.[法]沙龙；客厅；营业性的高级服务室

参考例句：

• Do you go to the hairdresser or beauty salon more than twice a week?你每周去美容院或美容沙龙多过两次吗？
• You can hear a lot of dirt at a salon.你在沙龙上会听到很多流言蜚语。

4 cypress   

n.柏树

参考例句：

• The towering pine and cypress trees defy frost and snow.松柏参天傲霜雪。
• The pine and the cypress remain green all the year round.苍松翠柏，常绿不凋。

5 diagnosis   

n.诊断，诊断结果，调查分析，判断

参考例句：

• His symptoms gave no obvious pointer to a possible diagnosis.他的症状无法作出明确的诊断。
• The engineer made a complete diagnosis of the bridge's collapse.工程师对桥的倒塌做一次彻底的调查分析。

6 stigma   

n.耻辱，污名；(花的)柱头

参考例句：

• Being an unmarried mother used to carry a social stigma.做未婚母亲在社会上曾是不光彩的事。
• The stigma of losing weighed heavily on the team.失败的耻辱让整个队伍压力沉重。

7 isolation   

n.隔离，孤立，分解，分离

参考例句：

• The millionaire lived in complete isolation from the outside world.这位富翁过着与世隔绝的生活。
• He retired and lived in relative isolation.他退休后，生活比较孤寂。

8 fully   

adv.完全地，全部地，彻底地；充分地

参考例句：

• The doctor asked me to breathe in,then to breathe out fully.医生让我先吸气，然后全部呼出。
• They soon became fully integrated into the local community.他们很快就完全融入了当地人的圈子。

9 vaccinated   

[医]已接种的，种痘的，接种过疫菌的

参考例句：

• I was vaccinated against tetanus. 我接种了破伤风疫苗。
• Were you vaccinated against smallpox as a child? 你小时候打过天花疫苗吗？

10 radar   

n.雷达，无线电探测器

参考例句：

• They are following the flight of an aircraft by radar.他们正在用雷达追踪一架飞机的飞行。
• Enemy ships were detected on the radar.敌舰的影像已显现在雷达上。

11 administrators   

n.管理者( administrator的名词复数 )；有管理（或行政）才能的人；（由遗嘱检验法庭指定的）遗产管理人；奉派暂管主教教区的牧师

参考例句：

• He had administrators under him but took the crucial decisions himself. 他手下有管理人员，但重要的决策仍由他自己来做。 来自辞典例句
• Administrators have their own methods of social intercourse. 办行政的人有他们的社交方式。 来自汉英文学 - 围城

12 livelihoods   

生计，谋生之道( livelihood的名词复数 )

参考例句：

• First came the earliest individualistic pioneers who depended on hunting and fishing for their livelihoods. 走在最前面的是早期的个人主义先驱者，他们靠狩猎捕鱼为生。 来自英汉非文学 - 政府文件
• With little influence over policies, their traditional livelihoods are threatened. 因为马赛族人对政策的影响力太小，他们的传统生计受到了威胁。

13 economist   

n.经济学家，经济专家，节俭的人

参考例句：

• He cast a professional economist's eyes on the problem.他以经济学行家的眼光审视这个问题。
• He's an economist who thinks he knows all the answers.他是个经济学家，自以为什么都懂。

14 altruism   

n.利他主义，不自私

参考例句：

• An important feature of moral behaviour is altruism.道德行为一个重要特点就是利他主义。
• Altruism is crucial for social cohesion.利他主义对社会的凝聚是至关重要的。

15 dilemma   

n.困境，进退两难的局面

参考例句：

• I am on the horns of a dilemma about the matter.这件事使我进退两难。
• He was thrown into a dilemma.他陷入困境。

16 shameful   

adj.可耻的，不道德的

参考例句：

• It is very shameful of him to show off.他向人炫耀自己，真不害臊。
• We must expose this shameful activity to the newspapers.我们一定要向报社揭露这一无耻行径。

17 reluctance   

n.厌恶，讨厌，勉强，不情愿

参考例句：

• The police released Andrew with reluctance.警方勉强把安德鲁放走了。
• He showed the greatest reluctance to make a reply.他表示很不愿意答复。

18 labor   

n.劳动，努力，工作，劳工；分娩；vi.劳动，努力，苦干；vt.详细分析；麻烦

参考例句：

• We are never late in satisfying him for his labor.我们从不延误付给他劳动报酬。
• He was completely spent after two weeks of hard labor.艰苦劳动两周后，他已经疲惫不堪了。

19 fatigue   

n.疲劳，劳累

参考例句：

• The old lady can't bear the fatigue of a long journey.这位老妇人不能忍受长途旅行的疲劳。
• I have got over my weakness and fatigue.我已从虚弱和疲劳中恢复过来了。

20 relatively   

adv.比较...地，相对地

参考例句：

• The rabbit is a relatively recent introduction in Australia.兔子是相对较新引入澳大利亚的物种。
• The operation was relatively painless.手术相对来说不痛。

21 anthropologist   

n.人类学家，人类学者

参考例句：

• The lecturer is an anthropologist.这位讲师是人类学家。
• The anthropologist unearthed the skull of an ancient human at the site.人类学家在这个遗址挖掘出那块古人类的颅骨。

22 judgments   

判断( judgment的名词复数 )； 鉴定； 评价； 审判

参考例句：

• A peculiar austerity marked his judgments of modern life. 他对现代生活的批评带着一种特殊的苛刻。
• He is swift with his judgments. 他判断迅速。

23 withhold   

v.拒绝，不给；使停止，阻挡

参考例句：

• It was unscrupulous of their lawyer to withhold evidence.他们的律师隐瞒证据是不道德的。
• I couldn't withhold giving some loose to my indignation.我忍不住要发泄一点我的愤怒。

24 prospect   

n.前景，前途；景色，视野

参考例句：

• This state of things holds out a cheerful prospect.事态呈现出可喜的前景。
• The prospect became more evident.前景变得更加明朗了。

25 chronic   

adj.(疾病)长期未愈的，慢性的；极坏的

参考例句：

• Famine differs from chronic malnutrition.饥荒不同于慢性营养不良。
• Chronic poisoning may lead to death from inanition.慢性中毒也可能由虚弱导致死亡。