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Vaccines can protect people from infection, but they are only one tool to help stop the spread of Covid-19.
The Biden administration has made testing a priority. Its billion-dollar purchase contract was signed to encourage manufacturers to increase production. This follows the $ 2 billion the administration pledged in September that it said would ensure testing is available to those who need it.
The supply will continue to grow with the addition of the ACON Labs home test that the U.S. Food and Drug Administration cleared on Monday. ACON’s home test will join that of Abbott and a handful of others. The administration said on Wednesday it had also secured a commitment from two other companies to speed up production.
“We will continue to pull all the levers, as we have done throughout the pandemic response on testing, to expand test manufacturing production to make testing more widely available and to reduce costs. by test, ”said Jeff, White House COVID-19 coordinator. Zients said during Wednesday’s briefing.
Testing is also expected to become more affordable with more competition, Zients said. He added that the ACON self-test should cost less than $ 10. The Abbott two-pack costs around $ 23. In September, the administration also asked Amazon, Walmart and Kroger to promise to sell rapid home test kits at cost for the next three months.
Ultimately, the number of home tests is expected to quadruple, the Biden administration said, providing the United States with about 200 million home tests per month by December, with tens of millions more available in weeks to come. to come.
Experts say it’s a good start, but it’s not enough, and they wonder where the national testing strategy is.
Even 200 million is not enough
While 200 million tests might seem like a lot a month, it’s probably not enough, said testing expert Mara Aspinall.
Home testing can help prevent the spread of the disease and also tell someone if they are sick with Covid-19 – even if they are not showing symptoms, so that they can go for treatment and also stay at home so as not to spread this to others.
The tests are not as sensitive as a PCR test which requires a lab to process, but the advantage is that they can provide results in less than an hour, unlike lab tests, which can take days. .
The Biden administration said these home tests will be distributed to pantries, community health centers and will also be made available to businesses and individuals.
Even though cases are slowing down in some areas, with the flu season, the country will need more testing to determine if a cough is due to the flu or Covid-19. There will also be an increase in demand as more and more people return to the office. The Biden administration is still working on the details of a new workplace rule that will require companies with 100 or more employees to require employees to be vaccinated or tested regularly.
With more than 81 million people in this part of the workforce, even though 25% of employees refuse the vaccine, that means the United States would need around 4 million rapid tests for these workers alone.
“We can’t use the tests just as a punishment for the unvaccinated,” Aspinal said. “Vaccines, as good as they are – and they are 98% and more effective against hospitalizations and deaths – there are revolutionary cases. We need random testing of the vaccinated to protect the unvaccinated.”
“What is the purpose of the tests? It is not to punish. It is to stop the spread of the disease.”
We need more testing today
Dr Michael Mina, professor of epidemiology at Harvard TH Chan School of Public Health, looked longingly at countries in Europe that have widely used cheap rapid tests. In the UK, he said, you can get seven for free every day. They are available in other countries pretty much everywhere and cost around $ 1.
“To really make testing effective as a public health tool, we have to use it frequently, and that’s the power of rapid tests. Ideally, you could have 20 in your cabinet and use them whenever you have. family to make sure you are not at risk of infecting or using them before you go to work or school, ”Mina said.
The Biden administration’s announcement does not allow this level of testing.
“Unless we see a real change from the White House that will truly allow widespread access to rapid tests – in the form of better market access and competition from many top companies.” quality – I will remain skeptical as to whether this ad or similar ads will make a big difference for most Americans, ”Mina said in an email. “It’s a start, for sure and if we can really quadruple the tests, that’s fine. But doing it by December probably means by February. We need the world’s tests available in the United States. United today. We needed it a year ago. We don’t have a moment to waste. “
“Dumping tools on the market without a strategy”
When asked if 200 million tests per month would be enough, Jennifer Nuzzo, a testing expert at the Johns Hopkins Bloomberg School of Public Health and a senior researcher at the Johns Hopkins Center for Health Security, said she didn’t think so. .
“If you’re hoping most Americans will use tests every other day or so to determine if they’re contagious, then the answer to that question is a categorical no,” Nuzzo said in an email. “But if they are to be used in schools to support testing policies to stay, these tools could have a huge impact as long as they are accompanied by staff to help administer them. ‘purchase, they will become a luxury that only a few can afford. “
Nuzzo’s biggest concern is that she doesn’t think there is a national testing strategy – even more than a year after the start of the pandemic.
“It’s not enough to just increase the number of tests available,” Nuzzo said. “We urgently need a testing strategy that determines what the overall testing needs are, optimizes the use of the tests available to us, and identifies steps to fill in the gaps.”
And even with faster testing, the country will still need additional PCR testing, she said. People who test positive on a home test are encouraged to take a more sensitive PCR test to confirm it. While PCR test turnaround times are much better than at the start of the pandemic, it can still take more than a few days to get a result and it’s not as useful.
“Having more tools is good. But throwing tools into the market without a strategy to optimally guide their use weakens our ability to make sure we’re getting all we can from the tests to control the spread of this. virus, ”Nuzzo said.
“A little late in the game”
Lori Tremmel Freeman, CEO of the National Association of City and County Health Officials, is also frustrated by what she sees as a lack of a national testing strategy. This is something that should have been handled months ago, she said.
“It’s a bit late in the game to talk about our lack of a national testing strategy again,” said Freeman.
While more home testing can play an important role in disease surveillance, test results are not necessarily reported to health services like lab tests are.
“I think it’s a good thing to put it in people’s hands more easily. I don’t want to be negative about it,” Freeman said. “It’s useful for people on an individual basis, but it doesn’t help us in large-scale disease investigations.”
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