Early this month, Stephen Buckle, 38, visited New York with his wife and two others.

When the group returned to Austin, two of them developed flu-like symptoms. But Buckle, a musician who lives in the Rosedale neighborhood, only had a minor cough, which he attributed to an oak allergy that "obliterates" his health each spring.

Nearly three weeks later, Buckle learned that Baylor Scott & White was offering drive-thru testing for COVID-19. He completed the online screening—which included listing his one symptom and noting that he had recently traveled to New York—and was approved for a test on March 20. "There was literally no one there," he said.

Two days later, Buckle learned that his test was a presumptive positive—the next week, a state lab confirmed the results. When his wife and the others in his group tried to get tested themselves, however, they were denied. "In a matter of days, it just completely changed," he said. "Which is frustrating."

Since March 22, the number of COVID-19 tests conducted in the state of Texas has more than tripled, according to the Department of State Health Services. Yet many people continue to be denied testing, even when exhibiting symptoms.

"We know that we're challenged by testing," Austin-Travis County Interim Health Authority Dr. Mark Escott said at a March 24 press conference. "We know that we're challenged by getting folks through and getting results in a timely fashion."

Neither the city of Austin nor specific hospital systems—including Ascension Seton, Baylor Scott & White or St. David's HealthCare—are providing local testing numbers or explanations for the shortage.

Nationally, lack of testing is due to a number of reasons, leading back to early January: faulty test kits distributed by the Centers for Disease Control and Prevention, initial restriction on which labs could make the test and who would qualify to take them, and required FDA approval to perform testing up until March, according to the Washington Post.

City and state health officials recommend doctors follow the CDC guidelines for determining which patients qualify for testing, with top priority going to those who are exhibiting symptoms and require hospitalization, are a healthcare worker or have recently traveled to certain affected countries. Individuals without symptoms, such as Buckle, are "non-priority," according to the CDC.

Lack of testing makes it difficult to understand the scope of the pandemic in Austin. As of Monday evening, Travis County confirmed 206 COVID-19 cases. But Dr. Escott said at the March 24 press conference that the number of local cases is likely seven times that of those confirmed.

Claus Wilke, chair of the Department of Integrative Biology at the University of Texas at Austin, said, "If you're testing at the levels at which we're currently testing, the only thing that you know is that the disease is here."

As of Monday evening, DSHS reported 35,880 tests conducted across the state. This amounts to around one in every 800 Texans being tested, using 2018 population data from the U.S. Census Bureau.

This ratio pales in comparison to some other countries, such as South Korea, which have tested at a much higher rate. According to the Korea Centers for Disease and Prevention, the county has tested 395,194 people, or around 1 in every 130 people.

In the absence of proof otherwise, Wilke said we have to behave as if everyone has the disease.

"There's a tradeoff: The less you test, the more strict you have to be with social distancing," he said.

Although Buckle self-isolated after he returned from New York, he said his positive test result led him to stop going to the grocery store—and even to his mailbox.

"I think I would be lying if I said [the test] doesn't change things," he said. "It makes you take it more seriously."