Above Photo: Martin Fisch / CC BY 2.0.
Why is the Biden administration only now making rapid antigen tests available for free when the British government has been doing so for months?
After two years without being able to travel home from London, England to Los Angeles, Cali. to see my family, I finally arrived in a chaotic U.S. in time for the holidays amid the Omicron wave of the Covid-19 pandemic. Although I’d been preparing for a difficult return thanks to the new variant, I had been eager to see my family now that I’m finally vaccinated against Covid-19 and that my partner, who holds a British passport, was able to visit alongside me after more than a year of travel restrictions barring Europeans. What I hadn’t been expecting, however, was to find family and friends desperately trying to procure rapid antigen tests as many of them developed Covid symptoms and wanted to protect their loved ones and community over the holidays.
You see, in the U.K., despite chronic mismanagement of nearly every aspect of the pandemic—thanks to Conservative Boris Johnson’s right-wing government and their interest in profiteering from the pandemic rather than saving as many lives as possible—two bright spots have been the National Health Service’s rapid vaccine rollout and its provision of at-home lateral flow (also known as rapid antigen) testing kits. While there is a vast network of tax-funded rapid antigen and RT-PCR testing sites throughout the U.K., for months, the NHS has also been mailing kits of seven at-home Covid-19 tests to anyone who requests them free of charge, once a day. These kits are also readily available without charge in pharmacies and community centers for those who could not order via mail.
It has become common in recent months before any gathering with friends or family, especially those who might be more vulnerable to severe effects when contracting Covid-19, to request that visitors take a lateral flow test. Whenever we visited my partner’s family, or attended dinners or gatherings, each of us would open the little blue and white boxes that felt like rudimentary chemistry sets to take a sample for our lateral flow tests. Although these tests are most accurate when symptomatic, they allowed Britons to catch infections safely and quickly at home before spreading Covid-19 further. Most people I know in the U.K. who have contracted Covid-19 have found out first via an at-home lateral flow test, later confirming with a RT-PCR test—although this is no longer required. It has also allowed the British government to track community spread more accurately and quickly, given that each test also has a QR code that allows you to report the results directly to the NHS.
As my partner and I packed for our trip to Los Angeles, we each placed a kit in our baggage, conscious that my mother’s health conditions meant we had to be extremely careful around her. Although we understood that the tests aren’t 100% accurate (they’re about 90% accurate) and we would still need to take other measures such as mask-wearing and distancing, we thought it would provide us with some peace of mind as we visited with her and other family members. When we arrived, several family members and friends let us know they’d been experiencing Covid-19 symptoms, but many were unable to obtain a rapid antigen test to confirm, and due to the most recent wave, community testing was slammed, with results of RT-PCR tests often taking more than a few days to arrive. Pharmacy after pharmacy I visited had signs on their doors alerting customers to the fact they had run out of rapid antigen tests, and I saw posters on lamp posts (like the one in the picture below) as well as posts on websites like Craigslist announcing second-hand sale of Covid-19 tests.
Even before the shortage, the costs of rapid antigen tests have proven prohibitive to many people. Binax, a commonly used brand of tests, runs at $23.99 + tax for a box of two rapid antigen tests. As Robert Mackey noted in The Intercept in December, the Biden administration’s reluctance to follow in the footsteps of the British government and others seems to have everything to do with our for-profit health system. Mackey writes,
“…Americans are still paying more for health care than their counterparts in countries with socialized medicine or single-payer systems.
Experts like [Michael Mina, a physician who teaches at the Harvard T.H. Chan School of Public Health] and [Jennifer Nuzzo, lead epidemiologist for the Johns Hopkins Coronavirus Resource Center] have urged the U.S. government to use its leverage to press test-makers to sell the kits for between $1 and $5 each. But because the Biden administration has tried to work within the constraints of America’s profit-driven system, commercially available rapid tests are considerably more expensive for consumers and often hard to find in stores. Abbott Laboratories’ BinaxNOW kit, for instance, can be purchased by the government for $5 each but costs consumers $11.99 a test at CVS or Walgreens.
The U.S. government’s reticence to use emergency powers to get the testing kits made for less contrasts sharply with the situation in Europe, where more efficient government-run health care systems are the norm.
In September, for instance, the Biden administration struck a deal with Walmart, Amazon and Kroger to sell Abbott’s tests at the discount price of $7 each for three months. But Reuters reports that the British government is paying about $5.80 each for similar test kits (which cost about $2 each to make) that it distributes for free.”
Mina also noted early on in the pandemic that “the spread of Covid-19 could be dramatically curtailed if just half of the U.S. population tested themselves every four days with at-home rapid kits that could cost the U.S. government as little as $5 billion.” Activists have also been calling on the Biden administration to make at-home rapid antigen tests free for months, and after a wave of anger aimed at White House Press Secretary Jen Psaki who “scoffed at the idea of sending Americans free rapid tests” in early December, the White House finally capitulated and changed its policy. President Biden has now committed to make 500 million at-home rapid antigen tests available to Americans at the start of this year. This measure, which could have been implemented months ago, comes after tens of thousands more lives have been lost in the latest wave of Covid-19 and the U.S. inches closer and closer to 1 million deaths from the coronavirus.
The U.S. government has finally chosen to use its considerable leverage to negotiate and purchase 500 million rapid antigen tests via a bidding process so that the government can mail tests directly to Americans—as the British government does—via a new government website that has yet to be unveiled. There will also be 50 million tests made available to community centers. In addition, the Biden administration is also forcing health insurance companies to cover the costs of the tests. NPR reports:
“Under the new policy announced by the White House, individuals covered by a health insurance plan who purchase an over-the-counter COVID-19 diagnostic test that has been authorized, cleared or approved by the Food and Drug Administration will be able to have those test costs covered by their insurance beginning this Saturday.
Insurance companies and health plans will be required to cover eight free over-the-counter at-home tests per covered individual per month, according to White House officials. For instance, a family of four all on the same plan would be able to get up to 32 of these tests covered by their health plan per month. […] The Biden Administration says it is “incentivizing” insurers and group health plans to set up programs that will allow Americans to get the over-the-counter tests (PCR and rapid tests) directly through preferred pharmacies, retailers or other entities with no out-of-pocket costs.”
It’s unclear then whether uninsured Americans, many of which are undocumented and low-wage essential workers, will still have to pay for tests out of pocket or if they’ll be able to receive them through the government website. It should be noted that the U.K. also experienced both rapid antigen and RT-PCR test shortages over the holiday period, but was able to make more tests available at different moments via the NHS, and at no point did I ever see signs announcing second-hand tests for sale. In fact, on the contrary, I received notifications from local text groups in my borough of people helping others procure free tests in their time of need by either giving their neighbors tests they had at home or alerting them to new supplies available locally—always free of charge.
As professor of molecular medicine at Scripps Research Dr. Eric Topol noted in December, “500 million free rapid tests by request sometime in January is totally inadequate. We need several billion of these, and have needed them for over a year to help prevent spread. It’s good that the administration has finally responded to the loud voices of frustration, but it’s [exemplar] of too little, too late.” Topol also called for KN95 masks to be distributed to all households as “the US government can purchase these for very low cost (i.e. pennies) and get them widely distributed as has been done in other countries to enhance protection.”
Needless to say, the testing fiasco I’ve witnessed while visiting my home country has only left me more disillusioned with our broken-beyond-repair for-profit health system as, yet again, universal health care models like the U.K.’s NHS have proven more effective, even under the charge of a right-wing blowhard like Johnson. It’s also left me furious at a Democratic administration that seems unable to pass public health measures that have been proven to work elsewhere in time to save its citizens lives. One of my greatest hopes for 2022 is that, as the pandemic rages on, Biden will learn from this most recent mess and act when he is urged to. What can I say, a woman can dream.