How accessible is the drive-through covid test? – Victoria Bartle

 

I’ve been tracking symptoms daily on an app[1] which is being used by researchers to try and predict covid-19 hot spots, increase the understanding of symptoms and examine the impact of vitamins and supplements, exercise, weight and other factors on coronavirus symptoms. The app has changed and developed over lockdown as they’ve learnt more about the virus and I’ve enjoyed keeping track of how I’m feeling, as well as reading the blogs, looking at the statistics and seeing how research is progressing. So, when I received an email asking me to go for a coronavirus test I found myself feeling a bit concerned about what I’d been logging, as I really didn’t think that I was sick. (I’d had a couple of days of eating very unhealthy food and was logging symptoms that I knew where they’d come from and I’d actually caused myself). However I thought that being offered a test was an opportunity and it’s always better to be safe than sorry, so I followed the instructions on the email and went for a drive-through covid test!

Having contact with people who have wide-ranging disabilities, from visual and hearing impairments, to mental illnesses and learning disabilities, has made me think about accessibility not simply in terms of the physicality of things, but also being able to access information in a format that is suitable for you. After doing a bit of research I found this blog[2] which quickly and easily explained how to use apps and devices with a visual impairment, and I found that the covid-19 symptom tracker app isn’t yet fully accessible[3] which is a shame as this means that they’re missing the data from a large group of people. The subject of information accessibility also got me thinking about people with cognitive disabilities and how accessible it could be for them (which opens a whole other, much larger, conversation which you can have a read about here[4]). 

I’m not sure how accessible this app is for people with cognitive disabilities, I can only say that I find it easy to use and only have problems with the phrasing of some of the questions in terms of existing conditions. Thinking about the broader issue of diversity in medical research, though, I’d be interested to know the demographics of the people who are using the app and providing data. 

The majority of people that I have met through patient and public involvement in research projects have overwhelmingly been white, middle class retirees which is obviously not an accurate representation of the population. To read that medical research only included women since the 1990’s shocked me and highlighted the issues that we have now when women have different symptoms to men but only those of men are publicised and widely known (watch Rosie O’Donnell explain her heart attack symptoms in her stand up show that she didn’t take seriously because they weren’t the ones that she thought to be symptoms of a heart attack, she just didn’t know at the time that women present differently to men![5]) I feel that medical research needs to find ways to diversify its participants across race, gender, disability and age and I hope that due to the current pandemic a larger proportion of society will hear about and become involved in research projects and stay involved so that we can have more diverse groups providing opinions and participating in research, an issue that is also raised on the symptom app website[6]

Early on in lockdown when the app asked for feedback, I said that some of the questions don’t take into account ongoing symptoms or separate the unusual or new from the usual or understandable because your own actions (in the case of my eating) or regular flare ups of existing conditions. For example, one of the questions is about fatigue, which I always have, so do I answer yes everyday, or just when I’m feeling worse than usual? And if I’m feeling worse than usual, this could be because of something I’ve done and am aware of...

It gets complicated to track symptoms when you already have symptoms every day. My initial thoughts about accessibility are that the app needs to adapt to be able to accurately track the virus in people with chronic health conditions who know if our symptoms are unusual, or just something that we live with through flare ups and downs. (They have recently updated the questions by using “unusual” when asking about symptoms.

So, I’ve been able to access the app, I could read and understand the email they sent me, and now I had to book my covid-19 test and go and get it done. You can book online, which I found pretty easy (I’m not sure about the overall digital accessibility of the process because I’m quite good at being online) but you have to answer some questions, find your NHS number and upload a picture of your ID (photographed in a very particular way, which was a bit of a pain to do), then I could pick a date and time to go that suited me. 

Luckily my local testing centre was only about a 20 minute drive away so I knew I could manage it easily and, as I’m only going out of the house once or twice a week at the moment, I knew I’d have enough energy to get it done pretty quickly.  I got it all booked, read the instructions, downloaded my QR code and packed my bag with tissues, hand sanitiser and wipes as I was told to do. You can go to walk through testing centres if you don’t drive and, if it’s between day 1-4 of the onset of symptoms then you can ask for a home testing kit to be sent out, so there are options.

I found the test centre area easily as it was well signposted from the motorway but I was shocked at how big it was. They’ve taken over an entire park and ride car park, which I did not expect.  I drove up and read the signs telling me to keep all of my windows closed and followed the cordons which had people in PPE at various points to help direct you. The best way I can think of to describe it was that it felt like the lines you have to follow in an airport, but on a much larger scale as I was driving around them. As I wound my way around the site I was greeted at the first stopping point by an attendant with a sign telling me to hold my QR code up to the window, (you can print it off but I just had it on my phone) so holding up my phone to the closed window they scanned it and I was sent on to the next stop. This person shouted a question to me asking if I could do the swab myself, or if I needed someone to do it for me. The instructions you get when you book say that they’d prefer that you do it yourself, but you can get it done for you if you want. I decided that I was fine doing it myself, so I was told to go to station 2. 

I drove round the snake lines being directed by staff with arrows on cards that they hold up for you so you know where to go, and pulled up at a portacabin. This time I was shouted at to ring the number on the card they were holding up. (I have no idea what they’d do if you didn’t have a phone? Probably just shout the instructions at you through the closed window - You couldn’t do this job with a quiet voice!) The person on the other end of the call was visible in the portacabin as he explained what was going to happen. I was told to roll down the window a little so they could throw in my testing kit and to sanitise my hands. He then talked me through all the bits in the kit and how I had to do the swab. I was finding the whole experience quite exciting; it was an interesting break from the norm for me, but it was very alien.  I could see someone with anxiety really struggling to cope when dealing with so many masked people in a completely strange situation...especially when you are testing yourself for a potentially fatal disease, but I wasn’t thinking about that at the time. I was just finding it all quite amusing.

Now that I’d been given all of the instructions, I was directed to a parking space and told to turn the car off whilst I completed the test. There wasn’t a time limit given, which was good, but I did feel as if I sat there for ages reading through the instructions a few times, cleaning my hands and parts of the car that I was resting the testing kit on and preparing myself. You are told that taking the swab might make you gag and the pictures of how far up your nose you have to stick it made me feel a bit sick before I even got started, but I managed ok. I wasn’t sick and I got all the bits into the right bags and sealed them up before moving on to the last stop. 

The last stop was another portacabin with another person covered in PPE shouting at me through the car window. This time I had to hold up the bag with my swab in it, to check it was all sealed up properly and that I’d put the labels in the right place. Then, I had to open the window a little bit and throw the bag into a box which was taken into the portacabin and stored. I got a bit confused here and didn’t know if I was allowed to leave yet, so I did a little sign language/shouting through the window till the person confirmed that I was finished and should follow the directions out. 

 I followed the ‘snake’ of cordons to the exit and almost drove past the final attendant, who asked me to show the card that was in the testing kit so I could get out! No one had told me I’d have to do that and I’d thrown it in into my car bin, so I spent a few minutes looking a bit daft as I scrabbled around in the car trying to find it so I could show her. Finally I was waved on and I left the site. The whole thing took about 20 minutes and the email I got said that I’d get the results by text within 48 hours. About 24 hours after I’d done the test I got the results that I was negative for covid-19. 

The whole experience was a bit surreal, a little fun, ultimately straightforward, but also quite intimidating because of how serious the situation is and how many processes there were. I was really impressed with how simple it was made, even though it seemed complicated at the time.  I think that was because I’m not used to drive through medicine and the process has been broken down into smaller components to make it simpler, making it seem longer and more involved.  I wanted to make sure I got it right so that I didn’t have to do it again and took extra time so I could be sure that I didn’t put myself at risk by handling anything or getting too close to anyone who could potentially have the virus. Now, if I have to do it again, I know I’ll be calmer. I think be able to follow the instructions easier and just enjoy the novelty of it.

Ultimately, I hope that after lockdown we’re able to keep some of the benefits of making things more accessible to people who can’t get out of their cars easily, need to keep away from viruses and infections and find travelling exhausting or challenging so that the world stays a little easier to access for people with disabilities like mine. 

 [1] https://covid.joinzoe.com/

[2] https://lifeofablindgirl.com/2019/02/03/how-do-blind-and-visually-impaired-people-use-a-mobile-phone/

[3] https://covid.joinzoe.com/faq

[4] https://www.w3.org/TR/coga-usable/

[5] https://youtu.be/QhCzSYvBMuQ

[6] https://covid.joinzoe.com/post/health-equity