The cars start lining up at 6:30 a.m.
Some people in them are sick, others exposed. By the time Kyla Watford's team opens the Colonial Healthcare drive-through COVID-19 testing site at 8 a.m. and closes it at 4 p.m., they'll have swabbed noses in 300-400 vehicles.
Colonial's urgent care site on Broad Street has been the visual epicenter of the pandemic since the virus arrived to Sumter just shy of two years ago, its staff springing to immediate action. They haven't stopped since.
"There was three or four months when we were only seeing about 25-30 cars a day," says Watford, a manager at Colonial, an urgent care and family practice that has locations in Sumter, Manning and Columbia. "I told my staff, 'After Christmas, we need to be ready because it's going to pick back up again.' And it did."
She said they're preparing to test 500-600 people a day around Jan. 21 before the omicron-fueled surge peaks, as it has in Europe and the UK.
Until then, their drive-through is open seven days a week. Even on Saturdays and Sundays, cars have been lining up before dawn through the parking lot, into the dermatology office's parking lot and down Morgan Avenue. One time, Watford said, they even backed up all the way to the last stop sign.
They keep people engaged in line. Staff have a well-oiled system. Once you get in line, someone gives you two packets. Every 50 feet or so, someone else is either taking them from you, getting your drivers license and insurance card - must be a physical card or copy - asking you about symptoms, swabbing your nose and then sticking the results on your windshield.
Colonial is certainly testing the most people in Sumter. They're unique, however, in how they end the drive-through. Every vehicle is seen by a doctor or nurse practitioner before leaving with their COVID-19 results. So patients aren't just getting tested and left to then see a doctor.
"If I'm going to go somewhere and I'm sick and I need antibiotics, I'm not going to go get a test then have to go to my doctor to get medicine. I'd rather do it all at one time. I know I have a sinus infection or I have COVID. It just made more sense to treat them there instead of overloading the ER at the hospital with something simple," Watford said.
Clay Lowder, Colonial's founder and a family medicine specialist, said they have rarely sent a patient to the hospital during this surge, which is revealing itself more as an upper respiratory infection than an attack on the lungs.
That's important because hospital systems across the nation are buckling under the strain of omicron.
As of Thursday, Prisma Health had 628 COVID-19 patients in its hospitals across Sumter, the Midlands and Upstate. Of them, 78% were unvaccinated.
In Manning, only 14% of patients hospitalized with COVID-19 at McLeod Health Clarendon were fully vaccinated last month.
Patients are not as gravely ill when they're hospitalized, health care leaders say, but the pure number of them in combination with staff shortages, due to infections and quarantines among hospital workers, is a burden.
Rachel Gainey, McLeod Health Clarendon CEO, said similarly to Colonial's Watford that the high transmissibility of the omicron variant means cases are "only expected to rise in the next two to three weeks following the recent holidays."
That means more long lines for tests and more people going through in-home quarantines, which has been impacting wide-ranging daily life, from classrooms and restaurants to manufacturing plants and grocery stores.
Because of the high demand for tests, South Carolina's public health department said to only get tested if you have COVID-19 symptoms, have been exposed to someone who tested positive or work in a high-risk setting for potential exposure. Don't get tested if you have tested positive in the last three months and you don't have symptoms.
President Joe Biden announced Thursday the federal government will double the amount of rapid, at-home tests to be distributed free to Americans to 1 billion, along with the most protective N95 masks, the Associated Press reported.
Watford said they are running low on their rapid tests. They only had about 900 left as of Wednesday. If they run out and can't get more, they'll start using tests that return results in 20 minutes.
Lowder said he spends much of his time now ordering more tests.
As noted on big signs at multiple points in the line, Colonial charges $120 for a rapid test and $240 for a PCR test for patients without insurance. Watford said they see "quite a bit" of self-pay patients.
Colonial is not federally funded. As a private practice, Watford said, they pay for the tests they distribute.
She said they deal with people who are angry if they have to pay. People are angry there's no porta-potty in the parking lot, angry they can't go inside.
During each surge, she's there seven days a week. She arrives at 7 a.m. and sometimes doesn't leave until 6 p.m. on the weekends. That's an hour after urgent care closes and six hours after they walk the last car through the line.
"I'm so thankful for those girls who stand in that line every day in the freezing cold temperatures and swab people all day and deal with the public," Lowder said. "With one of the most contagious diseases in the history of man. I take my hat off to them."
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