The University of Tennessee, Knoxville.

COVID-19 Testing Availability in Tennessee

A Policy Brief by the Howard H. Baker Jr. Center for Public Policy in Partnership with the Coronavirus-19 Outbreak Response Experts (CORE-19)

August 17, 2020
Tennessee State Capitol and Flag
Using publicly available data from emerging research on COVID-19, this brief was written and reviewed by the Coronavirus-19 Outbreak Response Experts (CORE-19) at the University of Tennessee, Knoxville. The brief outlines testing availailability in Tennessee county by county.

COVID-19 Testing Availability County by County

The coronavirus pandemic has created many challenges across the state of Tennessee, including the need for widely available testing for COVID-19. Widely available testing is recommended by the CDC as a way to improve case detection and contact tracing through all phases of the United States plan to Open Up America Again. In March Governor Bill Lee announced there would be free COVID-19 testing available for any Tennessean, regardless of symptom presentation; by April, more than 23,000 Tennesseans received a free COVID-19 test at one of the 67 drive-through sites across the state. The state cases now exceed 100,000, schools, universities and businesses are in various stages of reopening, the need for widespread, readily available testing is more critical than ever.
County-level availability 
Practically all health departments across the state of Tennessee are offering free COVID-19 testing, but not all are providing testing on demand, regardless of symptoms. The following, although not all inclusive, is a list of county health departments who require pre-screening for symptoms before being tested for coronavirus:
  • Haywood County Health Department
  • Mcnairy County Health Department
  • Hardin County Health Department
  • Bedford County Health Department
  • Grainger County Health Department
  • Humphreys County Health Department
  • Hardin County Health Department
  • Robertson County Health Department
Testing Hours
Additionally, many health departments are only testing within certain hours which results in many individuals having to book appointments days in advance or experience long wait times (≥1). For example, while the Carter County Health Department, the Unicoi County Health Department, and the Johnson County Health Department do not require an appointment COVID-19 testing is only done between the hours of 9:00 am and12:00 pm and 2:00 pm and 4:00 pm at the Carter County health department, and between 9:00 am and 11:00 am at the Unicoi County and  Johnson County health departments. The Washington County Health Department begins testing at 9:00 am, but individuals begin lining up at 7:00 am and experience an average wait time of 1-2 hours. Alternatively, other health departments such as the Tipton County Health Department and the Dyer County Health Department are providing COVID-19 testing from 9:00 am to 3:00 pm, Monday through Friday for as many people as needed.
Currently, COVID-19 testing remains free, with or without insurance, for all individuals being tested at a health department in Tennessee.
Turnaround Time
As Tennessee continues to see an increase in coronavirus cases, many health departments are experiencing an increase in turnaround time for COVID-19 test. Across the state, turnaround time may be anywhere from 3 to 10 days without any guarantee that an individual’s test result will be back within that 10-day time frame. Fortunately, some health departments such as the Hamblen County and Lake County Health Department, have been able to switch labs and are now reporting a 24-48 hour and 1-5-day turnaround for test results, respectively.
Turnaround time may be anywhere from 3 to 10 days without any guarantee that an individual's test result will be back within that 10-day time frame.
Non-state testing
CVS
has been another institution that has helped increase COVID-19 testing availability and accessibility; on any given day CVS can conduct approximately 39-45, 10-minute appointments. Although CVS seems to have more testing accessibility throughout the day, individuals are required to book an appointment and answer a few questions to determine if they qualify for COVID-19 testing at a designated CVS location. In regard to cost, CVS claims there should be a $0 out-of-pocket cost with most insurance or federal programs for uninsured, however, patients should check with their health plan to confirm before scheduling a test. Similar to the health departments, CVS is requesting that patients allow 6-10 days for results to come back due to high demand and, in some instances, their lab partners may take even longer to return results.
Other establishments that have aided in Tennessee’s fight for available and accessible COVID-19 testing are AFC Urgent Care and Physicians Care. The AFC Urgent Cares throughout Tennessee are offering both walk-in appointments and scheduled telehealth appointments; walk-in appointments begin at 8:00 am, Monday through Sunday. If an individual is interested in scheduling a telehealth appointment for COVID-19 testing at an AFC Urgent Care they should consider scheduling sooner rather than later. For example, on July 6, 2020 the AFC Urgent Care in Farragut had open and available appointments beginning July 9, 2020 at 12:20 pm and on July 10 the AFC Urgent Care in Knoxville had an open appointment on July 14 at 1:45 pm. Similarly, on July 9, 2020 the AFC Urgent Care Chattanooga’s next open and available appointment was not until July 13, 2020 at 3:45 pm.
While you can schedule an appointment to get a PCR and Antibody test for COVID-19 at any AFC Urgent Care clinic, many are conserving their rapid test kits. The AFC Urgent Cares found in Ooltewah, Hixson, and Sevierville are only providing rapid testing for high risk or symptomatic patients. In order for the test to be covered by insurance an individual must present with one of the following symptoms: chills, repeated shaking with chills, muscle pain, headache, sore throat, new loss of taste or smell, fever, dry cough, shortness of breath, or the individual is confident that they have been exposed to the virus. Many AFC Urgent Care clinics do not accept TennCare (Medicaid), but they encourage patients to use another type of insurance.
Physicians Care centers are offering PCR tests and Antibody tests; however, they are only offering PCR testing for the highest-risk and sickest patients due to a limited daily supply of COVID-19 tests at each center. Contrary to many of the other testing centers Physicians Care is reporting a 3-5-day turnaround for test results and like CVS, states that most insurance plans cover the cost of these tests, but individuals should still confirm with their insurance plan.
As coronavirus cases continue to surge, counties all over the state of Tennessee are seeking ways to compensate for the lack of sufficient available and accessible testing. In an example of local leadership and determination to provide available testing, Shelby County ramped up their testing efforts during the week of July 13-19, 2020. Turnaround times for test results at these pop-up testing sites were similar to all other testing centers; there was an estimated 3-7-day turnaround time, but with no guarantee that the test results would be back by the seventh day. In order to test as many Tennesseans as possible, Shelby County’s COVID-19 testing locations offered multiple days of testing at various sites, with flexible testing times. Of the 19 testing sites, four offered testing until 5:00 pm, one offered testing until 6:00 pm, and two offered testing until 7:00 pm.
COVID-19 cases exceed 100,000 in Tennessee with schools, businesses and universities in various stages of reopening.  Widespread available and accessible testing with improved turnaround time is more essential than ever to control the pandemic in the state of Tennessee.
Send any additional questions to the CORE-19 team. 
core19@utk.edu | 865-321-1299

Coronavirus-19 Outbreak Response Experts (CORE-19) 

Policy Brief Authors
Elizabeth Molinet

Breanne Tremblay, MPH

Tremblay is a recent graduate from the Department of Public Health at the University of Tennessee, Knoxville. She holds a Master's of Public Health with a focus in Health Policy and Management, as well as a minor of Epidemiology and minor of Intercollegiate Graduate Statistics & Data Science. 

Coronavirus Outbreak Response Experts (CORE-19)
Steering Committee
Dr. Kathleen Brown

Dr. Kathleen C. Brown, PhD, MPH

Brown is an Associate Professor of Practice in the Department of Public Health and the Program Director for the Master's in Public Health (MPH) degree. Her research focuses on the health and well-being of individuals and communities. She has experience in local public health in epidemiology, risk reduction and health promotion.
Dr. Katie Cahill

Dr. Katie A. Cahill, PhD

Cahill is the Associate Director of the Howard H. Baker Jr. Center for Public Policy. She also is the Director of the Center's Leadership & Governance program and holds a courtesy faculty position in the Department of Political Science. Her area of expertise is public health policy. She leads the Healthy Appalachia project. 
Dr. Kristina Kintziger

Dr. Kristina W. Kintziger, PhD, MPH

Kintziger is an Assistant Professor in the Department of Public Health and the co-Director of the Doctoral Program. She has worked in academia and public health practice. Prior to coming to Tennessee, she served as an epidemiologist and biostatistician at the Florida Department of Health. She is an environmental and infectious disease epidemiologist. Kintziger is a member of the CORE-19 Steering Committee
Dr. Matthew Murray

Dr. Matthew N. Murray, PhD

Murray is the Director of the Howard H. Baker Jr. Center for Public Policy. He also is the Associate Director of the Boyd Center for Business and Economic Research and is a professor in the Department of Economics in the Haslam College of Business. He has led the team producing Tennessee's annual economic report to the governor since 1995. 
Dr. Agricola Odoi

Dr. Agricola Odoi, BVM, MSc, PhD

Odoi is a professor of epidemiology at the University of Tennessee College of Veterinary Medicine. He teaches quantitative and geographical epidemiology and his research interests are in population health and impact of place on health and access to health services. He was a public health epidemiologist before joining academia. Odoi is a member of the CORE-19 Steering Committee. 
Dr. Marcy Souza

Dr. Marcy J. Souza, DVM, MPH

Souza is an associate professor and Director of Veterinary Public Health in the UT College of Veterinary Medicine.  Her teaching and research focuses on zoonotic diseases and food safety issues. 
Disclaimer: the information in this policy brief was produced by researchers, not medical or public health professionals, and is based on their best assessment of the existing knowledge and data available on the topic. It does not constitute medical advice and is subject to change as additional information becomes available. The information contained in this brief is for informational purposes only. No material in this brief is intended to be a substitute for professional medical advice, diagnosis or treatment, and the University of Tennessee makes no warranties, expressed or implied, regarding errors or omissions and assumes no legal liability or responsibility whatsoever for loss or damage resulting from the use of information provided.
Howard H. Baker Jr Center for Public Policy
1640 Cumberland Avenue
Knoxville, TN 37996
Phone: 865-974-0931
Email: bakercenter@utk.edu
Online: bakercenter.utk.edu
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