In the past few weeks, the state has dramatically increased testing with drive-thru events and partnerships with retail chains.
Castlight, the company partnering with North Carolina to track testing locations, found on May 14 only 21% of counties in North Carolina had testing sites. Of the counties that did have access to testing, only 1 out of 5 was meeting the recommended testing minimums.
"I think those kinds of insights are really helping health officials sort of say, 'Ok, we really need to get a pop up here or a retail chain there in order to increase test capacity,'" said Dr. Dena Bravata, Castlight's Chief Medical Officer.
RELATED: Coronavirus Testing: What is a COVID-19 genetic, antigen and antibody test?
A week after the study, North Carolina flipped its status from reporting some of the fewest counties in the nation with access to testing to some of the most. Castlight found 90% of counties now have testing sites, and a majority are able to meet recommended testing minimums.
The increase is felt on the local level.
Chatham County now has six testing sites with most of their county covered, according to its health department.
"The closer the options are, the more accessible they are they better," said Chatham County interim health director Mike Zelek. "Not having to drive a county over to get the needed services are great, so we're certainly are excited that more options are becoming available and hopefully over time those will continue to expand."
He said increasing testing allows the health department to focus on other efforts like contact tracing and education.
Chatham is one of the counties reporting some of the highest cases per population and while the county was able to increase testing, that's not the case for others.
Around 40% of the state's counties report having fewer than two test sites, according to the NCHHS website. Some of the counties reporting fewer test sites are the same ones experiencing higher cases per population.
Dr. Bravata said lack of nearby testing sites have both individual and community-wide impacts.
"Testing is the underpinning of our understanding of what the true prevalence and true incident of disease is because if people aren't getting tested, we don't really know what the denominator is." Bravata said.
FIND A SITE NEAR YOU: North Carolina Testing Locations
One Harvard University study found an area should be conducting 152 tests a day for every 100,000 residents in order to safely reopen.
For North Carolina, that would mean around 16,000 tests a day. While COVID-19 testing has tripled in the last month, the state's average is still around 4,000 tests shy of that goal.
Currently, county-by-county testing data is not made available, which means there's no way to see where testing is increasing and where it's lacking, other than looking at the number of testing sites.
North Carolina health officials have not responded to the ABC11 I-Team's request for testing numbers by county, and many counties are not independently reporting this data.
Castlight reports around half of North Carolina counties are not meeting maximum testing capacity.
State health officials recognize the need for more testing and the importance of removing barriers to access.
"We know there is implicit bias, we know there is a lack of trust in health care systems and really making sure that when we see populations that are most infected in people of color, we can make sure that the individuals testing are representative of the community," said Dr. Cardra Burns, NCDHHS senior deputy director of the Division of Public Health.
Leaders with the state health department attribute the rapid increase in testing to partnering with community organizations, increased PPE and the creation of a test-surge work group.
"Folks in the community know transportation barriers, they know other access areas and we really want to listen and respond to their needs and get their health in this," said NCDHHS deputy secretary for Health Services Benjamin Money.
In the last week, the state announced it is looking to expanding testing further by working with qualified companies who can help increase mobile testing and working with minority owned businesses.
Both Burns and Money said the state is trying to use this time to connect residents with necessary health resources beyond the pandemic and not just temporarily close gaps to healthcare access.
"What COVID has really exposed has been historic inequities that have existed not just in North Carolina but around the country in populations that for a long time have not had equal access to care and have had longstanding health conditions and health disparities," Money said. "Now is the time as we consider how to respond to COVID, it's an opportunity for us to think, how do we rebuild and reimagine a health care delivery system that creates equitable and equal access to care for all."