Central and western Maine residents have yet to see expanded options for public, no-cost COVID-19 testing, which the state’s top public health official has called “critical” for the state heading into the winter months, as the delta variant-driven surge shows no signs of abating.

“Testing and testing access remains a challenge nationwide, as well as here in Maine,” Maine Center for Disease Control and Prevention Director Dr. Nirav Shah said at a media briefing Wednesday.

“But we’re working tirelessly to try to increase that,” he said.

The Maine Department of Health and Human Services said Nov. 1 that it opened a new testing location in partnership with the city of Calais and that Westbrook Public Safety had reopened its high-volume testing site.

In late September, Walgreens began offering PCR tests at all of its Maine locations through a federal partnership. PCR tests detect the presence of a virus if a person has the virus at the time of the test. The test could also detect fragments of the virus even after the person is no longer infected.

Some locations, as well as CVS pharmacy locations, were already providing testing.

But even with all of the options in play, residents in rural tri-county towns have few locations within a reasonable distance, which is nothing to say of finding an available appointment.

Androscoggin County has the most testing locations compared to Franklin and Oxford: three pharmacies in Auburn, two pharmacies and one health center in Lewiston and a pharmacy each in Lisbon Falls and Livermore Falls.

Oxford County has three pharmacy testing locations in Bethel, Norway and Rumford.

Franklin County residents have one option: A Walgreens in Farmington.

And because the demand for tests remains high, many of these locations do not offer testing for travel purposes. Complicating some Mainers’ holiday travels is the fact that some countries, such as Canada, require that travelers test negative within 48 to 72 hours prior to entry, regardless of vaccination status.

With options so limited in areas like Androscoggin, Franklin and Oxford counties, finding an available test could be a day trip in and of itself.

“We concur that access has been a challenge,” Shah said. He cited the Calais and Westbrook locations as one of the ways the Maine CDC and DHHS are working to address what he called “testing deserts.”

DHHS has not yet made it clear if additional sites are coming soon.

This has been the situation since at least late summer of this year. A mobile testing unit run by Promerica Health in collaboration with the Maine Department of Health and Human Services that opened in November 2020, closed permanently in May. Central Maine Medical Center and St. Mary’s Regional Medical Center, both in Lewiston, also closed their large-scale testing sites.

There are some options to get tested at urgent cares or through a private provider. That, however, typically requires a doctor’s note, insurance coverage or a waiver from the state, or both.

Some urgent care sites do not bill insurance providers directly, meaning that getting a test could cost upward of $160, out-of-pocket.

Still, many of those options are in urban centers – whether in Androscoggin County or in surrounding counties – leaving people living outside of the Lewiston-Auburn area without ready access to testing.

At-home tests are an option, though can be tough to find in-stock and can get pricey, depending on the type of test needed.

The price range for a rapid antigen test, which the U.S. CDC recommends mostly for those showing symptoms, is between $10 and $30. Those tests return results in about 15 minutes.

A PCR test, which is more accurate than an antigen test and requires sending a sample to a lab, costs upward of $100. Results are returned in one to three days. These tests are most often required for travel clearance.

“So much of the next phase of COVID depends on easy, rapid access to testing,” Shah told The Washington Post on Thursday ahead of President Joe Biden’s speech addressing the omicron variant and steps the administration is taking heading into the winter.

Before scientists in South Africa identified the omicron variant late last month, Shah said that in addition to getting vaccinated, wearing a mask and socially distancing, the best way to ensure safe and healthy holidays was to get tested before gathering.

“Ask folks to test before they come over. The rapid antigen tests can deliver results within 15 minutes and are quite reliable for this purpose, so long as they’re done right before folks get in the car,” he said at a Nov. 17 briefing.

“Now, rapid antigen tests can be a bit tough to find, but they are definitely out there. And the supply is increasing right now,” he said.