In December 2021, the highly infectious Omicron variant of the SARS-CoV-2 virus spread through the United States, proving to be highly transmissible even among vaccinated, boostered, mask-wearing people. With negative test results required for overseas travelers, students, and those who had recently tested positive who wished to return their regular activities, as well as for those who chose not to get vaccinated—and recommended for people making plans to travel and gather over the holidays—the demand for quick-result rapid antigen and PCR tests was overwhelming. Drugstores ran out as soon as they were restocked, and kits sold through drugstores, Walmart, and Amazon were expensive for many, averaging $18–$24 for a pack of two—when available. Despite the Biden administration’s allocation of federal funding for every household to receive a maximum of four test kits in January and an increasingly improved supply chain, home COVID-19 test kits remain in high demand. Now, with spring break approaching for students, home tests may see a similar run.

Libraries have been distributing masks throughout the pandemic. In 2021, they began partnering with local health departments to distribute test kits as well—at curbside, in parking lots, or in the building—with varying results. Particularly in late 2021 and January of this year, kits ran out almost immediately even as takers lined up for blocks. Communication from city and county health agencies was not always timely or accurate. And library workers once again found themselves on the front lines managing patron reactions and their own safety concerns.

TESTING FOR THE HOLIDAYS

Large cities were hit especially hard by a shortage of kits, and library systems were unable to keep up with the demand. In December 2021, the city of New Orleans Health Department provided what stock it had remaining at the time—nearly 6,000 kits—to more than a dozen branches of the New Orleans Public Library. The giveaway was supposed to last from Wednesday, December 22, and continue into Thursday. Instead, supplies were exhausted within 90 minutes.

This scenario played out repeatedly across the country in December and early January: After announcing that they had kits to give out, libraries were immediately swamped with takers and available supplies were gone within hours, leaving residents frustrated and often angry.

Lines stretched for blocks outside eight branches of the DC Public Library (DCPL) as soon as home test kits became available on December 22, and supplies quickly ran out. But DCPL was able to restock the second day, easing up the demand and resulting in shorter wait times. DC Mayor Muriel Bowser ordered another 6 million tests to meet post-holiday demands, and stated that the city would establish stand-alone vaccine and testing sites to take the burden off of libraries.

Ohio libraries, among the first in the country to distribute home tests, have handed out more home test kits than local health departments—more than 2.3 million, by the Ohio Library Council’s (OLC) count. With the surge of the Delta variant in summer 2021 and Omicron in December and January, libraries across the state distributed a steady supply of kits. After the beginning of this year, however, the Ohio ran low on test kits, and what little stock it had went to schools rather than libraries.

In late January the Ohio Department of Health revised its COVID policies for schools, dropping recommendations for universal contact tracing, case investigation and exposure notification in favor of cluster- and outbreak-based models, and once more began distributing test kits to libraries. Supplies are still low, OLC Executive Director Michelle Francis told LJ, but demand eased up somewhat with the rollout of the federal program. Many libraries have pivoted to providing assistance to residents who need help requesting their free kits online and via the federal hotline. As the state gets more kits, she noted, “whatever they get in they are shipping out to local partners for distribution. But right now libraries are not distributing what they were distributing in December.”

NEW YEAR, MORE KITS

Omicron continued to spread in January, and with the post-holiday spike in infection concerns, libraries giving them out found their supplies exhausted almost immediately.

At the beginning of the year COVID seven-day case rate in California’s Sacramento County nearly tripled in one week, to 72 per 100,000 residents—passing December 2020’s record of 64. Selected locations of California’s Sacramento Public Library (SPL) system and nearby Folsom Public Library gave out 91,000 at-home rapid COVID testing kits during the first week of the new year. The iHealth COVID-19 Antigen Rapid Test kits, which each contained two at-home tests, were made available through a partnership with the Sacramento County health department.

The kits became available on Tuesday, January 4, and on the first day the libraries distributed tens of thousands during regular hours of operation at curbside pickup parking lot locations; residents texted their phone number to the library, and were texted back when it was their turn for pickup. Kits ran out by mid-afternoon at SPL. While the library acquired more the following day, they were gone by noon, and SPL posted on its Facebook page that it did not expect to receive more from the county. Folsom distributed its entire stock the first day and did not get more.

The same story played out in libraries across the country. Libraries in Florida’s Broward and Manatee Counties distributed tests provided by the Florida Department of Health, giving away thousands on a first-come, first served basis—a maximum of four kits per person. All were given out within hours.

REPORTING OPTIONS

Many of the at-home kits provided to libraries return results only to the test takers. These have the advantage of being convenient, immediate, and private. However, some local health departments are concerned that users don’t always report positive results, resulting in an undercount of cases that can skew statewide and national data. Only two of the approved home tests include an app to report results, and it’s unclear how many users are doing so. In November 2021 the Centers for Disease Control dropped its messaging encouraging test takers to report their results to health agencies.

Some libraries, however, are making a point to distribute kits that offer reporting mechanisms. Pima County Public Library, AZ, distributed 50,000 tests in November and December 2021, each of which came with a QR code printed label. The Health Department asked test-takers to report their results, even if they were negative. As of January, however, PCPL announced that it would no longer be giving away tests.

Libraries in 43 systems across Virginia, including Gloucester County, Hampton, and Portsmouth, gave out free kits supplied by the Virginia Department of Health (VDH) with the goal of reaching under-resourced communities, and as of the first week of January they were “flying off their shelves,” according to 13 News Now. Test takers needed Wi-Fi, a microphone, and camera access to use the kits—either at home or at the library—as an online proctor walked them through the process. Results were then electronically recorded. VDH plans to expand the program to all libraries in Virginia next year.

Although most kits test for antigens only, and can be completed fully at home, some libraries provide PCR kits that are sent to labs for analysis. As of January, Everlywell PCR test kits were available at curbside pickup areas at all libraries in Spokane County, WA. These contain instructions for collecting the samples and a UPS label to ship the test to a lab; results are expected within 72 hours, not including shipping time. Tests can be used by anyone 16 years or older, and a library card is not required to pick up a free kit.

ON THE FRONT LINES

Several library workers took to social media to voice their concerns about potential compromises to their safety, whether that meant handing out masks to possibly infected individuals or coping with residents who were frustrated and discouraged when supplies ran out—and often wet and cold as well.

“Some people would get angry and yell at us,” said a librarian in Virginia who wished to remain anonymous. “Most people were understanding, but a lot of people were upset that our dictate from the county was to give out as many as you had members in the family. They thought that we should be limiting them. But that wasn't what the Department of Health told us to do.” Handling phone inquiries wasn’t much easier, she added; when kits came in, the library would field 25 to 30 calls an hour for three or four days in a row. “It was sort of like when we gave out eclipse glasses,” she said. “The mania around it was a little intense.”

The Hoyt Library in Saginaw, MI, piloted a partnership with the Michigan Department of Health and Human Services (MDHHS) in which the library gathered information for the agency on how many tests people took home; with that information, MDHHS can be better prepared to gauge local supply needs in the future. Stephanie Reinhardt, branch manager at the Hoyt Library, discussed the logistics of test kit distribution with her director—who then chose to hand them out herself in January rather than ask staff to take on the work.

Similarly, Gavin Woltjer, director of the Billings Public Library (BPL), MT, elected to hand out test kits with his assistant director. “There are going to be people that come in sick, and I am not going to assign a staff member to do this,” he told LJ (although some staff volunteered to help). From the pandemic’s earliest days “I made it very overt to them that their safety was my number one priority, then the public’s safety, and then the mission of our organization, in that order.”

COMMUNICATION BREAKDOWNS

Library officials reported being given short notice of the kits’ availability by their city or county health departments. They often had only a day or two to let the public know, decide on a method for distribution, and allocate staff for the process.

Most reported relatively smooth operations on the library’s side, but there were glitches. The Virginia librarian told LJ that her branch manager didn’t receive information about distributing kits until they showed up, starting in early December 2021. “We never knew when the boxes were coming, or how many there would be, and neither would the public,” she said. “So people would be lining up all the way around the block at 10 in the morning.” Staff would distribute the library’s daily supply within the first 10 minutes, “and then we'd be all out and there would still be a long line.”

In Saginaw, said Reinhardt, MDHHS initially confused the Hoyt Library’s registration to distribute tests with another library that had opted out. “But it was 15 minutes down the road,” she said, “so we just went and picked them up.” Although MDHHS’s press release had listed the wrong library, a local news channel helped get the word out that Hoyt had then available. Reinhardt announced the giveaway on TV and on social media.

The library gave out about half of its supply in one day on a mid-January weekend. “We've had no rush,” Reinhardt told LJ. “Everybody was really respectful and kind. We’re just offering them to people as they come in the library.” (Other libraries in the state, she noted, have had a higher demand.)

A librarian in Western New York, who asked that her name not be used, told LJ that her library found out they would be distributing kits in January when the county did a press briefing at the end of December. “They announced that they were going to start pushing home test kits, and recommended everyone stop wearing cloth masks and wear better masks. At that time they [said], ‘You’ll be able to walk into any library in the county and pick up an N95 mask and home test kits.’”

The announcement took library staff and leadership by surprise. Although the library had been giving away masks from a table just inside the front doors, “the idea of people who could potentially be positive with COVID coming to the library to pick up a COVID test really ruffled some feathers,” she said.

By mid-January the question was still up in the air; the director felt that since the library wasn’t set up to hand out kits—people would need to come to the front desk and ask a staff member—it shouldn’t be required to do so. “And then the COVID test kits showed up at our library, and that's how we discovered we were handing out test kits,” the librarian said. Staff began distributing them at the end of January.

At press time, the supply hadn’t run out—largely, she thinks, because the county never publicized their availability at the library. Ironically, more responsibility has fallen on the smaller branch because the main central library has had to cut hours due to staff COVID absences.

“A lot of the time, people only know because I say something as they’re done checking out their books—‘Oh, we're handing out COVID kits, do you want any?’” she said. The exchange is done quickly, and she continues to wear an N95 mask at all times. “No one’s come in appearing to be visibly ill—mentally, that helps,” she added. “I don’t really think about it. I just try to stay behind my desk.”

In Billings, Woltjer has been on numerous COVID task forces during the past two years, and had initiated conversations about distributing home tests with RiverStone Health, the county public health officer, in fall 2021. Both sides agreed that it would be better to wait until they were more widely available. “If you just give me 30, that’s not really going to be impactful—it’s probably going to be more problematic than anything else,” Woltjer recalls saying; the library serves about 184,000 people in a county the size of Connecticut. Ultimately he was able to get 2,300 tests in early February and began giving them out at the library—one per family member, throwing in an extra test for those with small children. “You know a child’s going to squirm, and you’re not going to get a good sample,” he noted.

He feels that the current surge will probably soon peak in Montana, as infection rates there are six to eight weeks behind the East Coast and spiked at the end of January. Some have told him that distributing tests is a waste of library resources—despite the fact that the library doesn’t pay for them—but Woltjer feels strongly that giving out kits is in line with BPL’s mission, and will continue to distribute them alongside the federal government’s supplies, as a “just-in-case measure” for residents. “It comes down to the common goal of bridging the gap,” he says. “We are public servants. How can we best serve the public?”