Many families will be ringing in the holidays this year with a new tradition: before the eggnog and presents, they’ll be putting a nice swab up the nose. Rapid antigen COVID-19 tests — the ones you can buy at a drugstore and take at home — are less sensitive than diagnostic polymerase chain reaction, or PCR, tests you get at a clinic.
But they’re faster, more convenient and they turn positive when people are most likely to be infectious, all important factors for families gathering as the immune-evasive omicron variant begins to spread. However, tight supply and the relatively high cost could limit the utility of such tests this holiday season.
Justin Noggle in Kansas City has added rapid tests to his Christmas shopping list. Because he and his girlfriend will be seeing older relatives and unvaccinated kids, they want the extra assurance of a negative test.
“We’re nervous, but we are not willing to sacrifice yet another holiday,” Noggle said. “Our plan is to — after learning that there might be run on tests — is to go out early Saturday morning, go look around online and all the different pharmacies.”
Rapid tests were regularly sold out in stores and online a couple of months ago, but supplies have improved recently, said Lindsey Dawson with the Kaiser Family Foundation. Still, rapid tests can still be tricky to track down when demand surges, as it has now.
“It’s not a great indicator when a store says a test is available in a particular ZIP code, at a particular store, for that test actually being there,” she said.
And then there’s the cost. Dawson said prices range from about $7 to $30 per test. A Biden administration plan to make insurance companies reimburse consumers won’t kick in until next year and will only help about half of Americans who have private insurance.
“We continue to neglect testing as a public health tool that is essential, to just leave testing up to the whim of free markets,” said Michael Mina, a former Harvard epidemiologist now with digital health platform eMed.
He said a slow regulatory process has resulted in a limited number of companies approved to make the tests, and without federal investment, they can’t produce at the scale needed to bring down prices and make them readily available.
In fact, early in the summer, one manufacturer actually destroyed millions of tests and laid off workers when demand dropped, only to see it explode again with the spread of the delta variant.
“If we’re going to put public health into for-profit industry or not-for-profit industry, we have to bolster that industry,” Mina said.
Some local governments are filling the gap. In Colorado, residents can order up to eight free tests a week, said Sarah Hamma with the state Department of Public Health and Environment.
“It’s super quick and easy. You fill out a quick form, and then our distributing partner will distribute that product directly to people’s homes,” she said.
The state has spent about $10 million to send 1.2 million tests since September.
Research co-authored by Michael Mina for the National Bureau of Economic Research suggested spending on rapid testing would save many times more than the original investment by reducing disease burden and economic harm.
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