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Why rapid COVID tests should be free

A woman walks past a pharmacy providing rapid antigen COVID-19 tests in Toronto, Canada, on Nov. 15, 2021. (Zou Zheng/Xinhua via Getty Images)
A woman walks past a pharmacy providing rapid antigen COVID-19 tests in Toronto, Canada, on Nov. 15, 2021. (Zou Zheng/Xinhua via Getty Images)

As if preparing for the winter holidays wasn’t stressful enough, Americans are now tasked with stalking the aisles of supermarkets for an even hotter commodity than whole turkeys or russet potatoes: COVID-19 rapid tests. The at-home tests have been flying off shelves in the U.S. as public health experts urge Americans to test themselves before gathering indoors with family and friends for some cathartic winter feasting.

COVID-19 cases are on the rise across the nation, mirroring the winter surge that Europe has been weathering. Rapid antigen tests can offer a pretty accurate and immediate answer to the question of whether or not you’re contagious with COVID-19 at the time of testing. So, it’s logical to call upon Americans to avail themselves of rapid testing kits during a time of high transmission and more indoor mingling.

But in America, there’s a problem with the test kits. They’re really expensive.

Five days out from Thanksgiving, I joined the hordes at the Walmart Supercenter in Walpole, Massachusetts casing the pharmacy aisles, on the hunt for a COVID-19 rapid test kit that was priced at “only” $15. So far, the Food and Drug Administration has approved a small handful of rapid tests for sale in the U.S. One of these test kits — Abbott’s BinaxNOW rapid test two-pack — can retail for upwards of $23 at pharmacies like CVS and Walgreens. In European countries like Germany, where regulatory procedures were relaxed to allow more rapid tests to come to market faster (without compromising the accuracy of the tests), you can pick up a pack of tests for the price of a small coffee. In the United Kingdom, rapid tests are free. You can order them from your home.

The steep price tag for Americans isn’t a new problem. Rapid tests have been selling at double-digit prices in the U.S. for several months. In September, the Biden administration invested $2 billion toward offering rapid testing at venues such as schools and health centers. The administration also reached an agreement with Amazon, Kroger and Walmart to sell rapid test kits at-cost for three months, which amounts to a 35% discount from the steeper test prices. It was a badly needed step toward making rapid tests affordable enough to become ubiquitous to mid-pandemic life in America. But the federal intervention was too anemic to make a tangible difference in time for early winter. Three months later, rapid tests are still hard to find, hard to schedule, and even harder to afford on a regular basis, let alone for a one-off family gathering.

Americans still need to think about how they can protect each other from the coronavirus, and they shouldn’t have to foot a bill for it.

When Joe Biden entered the White House, there was hope that the federal government would finally cobble together a preventative COVID-19 strategy. To be sure, the vaccines the Biden administration has thrown its weight behind are a critical tool to stopping the spread of the coronavirus and ending the pandemic. The new oral antiviral pills from Pfizer and Merck are also a potential game-changer, if given to COVID-19 patients in a finite time frame after the onset of symptoms (assuming those patients are able to navigate the Kafkaesque bureaucracy of our health insurance labyrinth and receive prompt medical care).

But what’s been lost amid this pharmaceutical-first approach to ending the pandemic is better appreciation for additional tools that can keep the virus at bay, as well as the urgency of getting these tools to Americans with minimal economic or administrative burdens.

When it comes to rapid tests, the Biden administration has been playing catch-up, streamlining the FDA approval process for rapid tests so that America may replicate the European approach. But imbuing the market with more rapid tests at the current rate won’t deliver enough relief Americans who are caught between testing as-needed and staying within their monthly budgets — especially in a country where the federal minimum wage is only $7.50, where paid sick leave isn’t guaranteed for all workers and where testing resources for schools are determined by municipal wealth.

In a way, the emphasis on vaccines and pills signals a refusal to acknowledge that we’re still in a pandemic. The desire to “go back to normal” is profound, and this winter will offer freedoms that felt like distant memories on the darkest nights of 2020. But “normal” just won’t cut it for another pandemic winter. Thousands of Americans are getting sick or dying daily. Breakthrough infections can pose a risk to vulnerable populations. Americans still need to think about how they can protect each other from the coronavirus, and they shouldn’t have to foot a bill for it.

In a way, the emphasis on vaccines and pills signals a refusal to acknowledge that we’re still in a pandemic.

In February, a survey conducted by Harvard’s T.H. Chan School of Public Health and Hart Research found that 79% of adults would use rapid tests regularly if they were available for free or next to nothing. That number plummeted to roughly 30% when respondents were asked if they would buy $25 test kits. An unprecedented federal investment in rapid antigen test production, purchasing, and distribution to American communities — with the aim of making them free — would be a major step toward flattening transmission in the U.S.

It would also signal a crucial lesson learned by the Biden administration. The decision to take COVID-19 precautions like rapid testing or masking may come down to “personal responsibility'' on a psychological level, person to person. But that doesn’t relieve the government of making it easy and advantageous for Americans to do the right things.

Rapid tests offer the twin benefits of preventing coronavirus transmission and allowing Americans to lead active and social lives, mid-pandemic, with greater confidence that they’re not putting themselves or other folks at risk. Considering the amount of stress that Americans are under, the importance of being able to lead a mid-pandemic life that’s fulfilling, happy and manageable should not be overlooked.

The pandemic may not be done with us. But with free rapid tests, it could be a lot less taxing.

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Miles Howard Cognoscenti contributor
Miles Howard is an author, journalist, and trail builder based in Boston.

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