Not Everyone Wants to Get Tested for COVID-19. Here's Why

at-home covid test

Verywell Health / Dennis Madamba

Key Takeaways

  • Some people may be hesitant to take a COVID-19 test for fear of having to miss work or isolate.
  • Test hesitancy could increase the risk of transmission as states begin to lift mask mandates.
  • Advocates say that workers should learn their rights and educate one another until there are substantial policy changes.

To monitor the spread of COVID-19, public health experts encourage widespread testing. But some people may be hesitant to test for COVID-19 for fear of having to isolate and miss work.

Many companies follow the guidance from the Centers for Disease Control and Prevention, which recommends people who test positive for COVID-19 isolate for five days. While some workplaces guarantee paid time off for employees who need to quarantine, some hourly workers have been forced to take off without pay. In some cases, some have been fired after testing positive.

Test hesitancy could increase the risk of COVID-19 transmission as states begin to lift mask mandates. Someone who’s test hesitant could contract COVID-19 without knowing and isolating as recommended to limit transmission. But public health advocates say this problem isn’t new—it’s an outgrowth of systemic inequities in the healthcare system and economy in the United States.

“Not everyone has the luxury to be able to stay at home if they test positive,” Kristin Urquiza, the founder of Marked By COVID, a grassroots organization that advocates for better public health policies, told Verywell.

Urquiza said test hesitancy appears more common among people who are financially insecure.

“I’ve definitely run into many folks who just refuse to get a test if they’ve had a sniffle or a cough,” Urquiza said. “When you really sit down and talk to some people, there’s an underlying worry about job security.”

Hesitancy may be especially prevalent among people who have language barriers, distrust the government, or come from native or immigrant communities, she added.

“My grandparents were immigrants, and there was always this sort of ingrained philosophy of ‘you work really hard, and you don’t take time off, you make the boss happy, so that you don’t get fired,’ because you’re expendable,” Urquiza said. “When you look at what this pandemic has exposed, it starts to connect dots where we haven’t prioritized conditions for workers, and especially low-wage, frontline, non-remote positions.”

How Insensitive Pandemic Response Contributed to Test Hesitancy

Yosef Hershkop, the regional manager at Kāmin Health Urgent Care Centers in Crown Heights, New York, works with a largely Orthodox Jewish patient base. He said that many in the community are reluctant to test for COVID-19, and government distrust is a common reason for their hesitancy or refusal.

Part of this distrust is a result of early contact tracing methods, which were insensitive to the Orthodox Jewish community, Hershkop said. From asking invasive questions to pounding on people’s doors on the Sabbath, government tactics often felt coercive and disrespectful, he added.

Further, many members of the community are descendants of Holocaust survivors or refugees from the former Soviet Union. For some of these people, invasive questions asked by strangers felt threatening, even if they had good intent, Hershkop said.

“Even if the government worker is literally just asking this from a script and they have no bad intent, people are automatically not feeling the greatest to answer such questions,” he added.

Although the city government recruited some contact tracers from the community in the fall of 2021, prior interactions continue to leave “a very bitter taste in people’s minds,” he added.

“People shouldn’t be afraid to go get a medical test if they’re not feeling well and the symptoms are potentially COVID related,” Hershkop said. “We don’t want to create this culture of fear, but the reality is that’s what was created.”

How Can We Address Test Hesitancy?

Addressing test hesitancy means instituting policy to change systemic inequity issues and recognizing that these problems didn't arise solely with the onset of COVID-19, Urquiza said.

“Because of the stress test that the pandemic has put on all these different systems, we now as a society, see clearly where our systems are not in line with our values,” Urquiza said. “What we have right now at our fingertips is a plethora of real stories of the impact of inaction."

Until policy change happens, people should educate each other on their rights and how to advocate for themselves, she added.

“It’s important to help workers understand that they should be raising these issues with their employers,” Urquiza said. “That communicates to management that people are paying attention, they have access to information, and can sometimes create a better, more equal playing field between workers and in management.”

What This Means For You

Experts recommend people test for COVID-19 if exposed or symptomatic. But some people are hesitant test due to fears of having to miss work or lose money if testing positive. Advocates say combatting testing hesitancy will take a multi pronged approach that targets systemic inequalities.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

By Claire Wolters
Claire Wolters is a staff reporter covering health news for Verywell. She is most passionate about stories that cover real issues and spark change.