As LNP | LancasterOnline’s Nicole C. Brambila reported Friday, “COVID-19 testing is a critical tool for controlling the spread of the novel coronavirus, but nearly two years into the pandemic the United States has struggled to keep a sufficient supply. At-home, rapid-test kits are difficult to find, and most health care providers require a known exposure or symptoms because of the national shortage. Local hospitals have reported a run on emergency departments for routine COVID-19 testing.”
Here’s “a hot tip,” read an email circulated Monday among LNP | LancasterOnline staff members.
The tip: A local branch of a chain pharmacy just had received a shipment of COVID-19 rapid antigen tests.
We’re not naming the pharmacy and location because it’s likely the shipment will have been depleted by the time you read this. That is the nature of the scramble these days for COVID-19 tests that can be performed at home.
People are tipping off friends, relatives and co-workers when they stumble upon a stash of the test kits on local store shelves. Once word gets out, the test kits fly off those shelves.
This is no way to combat a pandemic.
While we may not have expected the turbocharged infectiousness of the omicron variant of COVID-19, anyone could have foreseen the likely development of yet another variant. Too many people refuse to mask up in public spaces and our COVID-19 vaccination rates remain stubbornly low and because of this, the virus has been given ample opportunities to mutate. (Only 54% of all Lancaster County residents, for instance, are fully vaccinated.)
Unfortunately, the Biden administration seems to have been caught flat-footed on testing.
President Joe Biden announced last month that the federal government was setting up emergency testing sites “in areas that need additional testing capacity.”
He also announced that his administration would purchase 500 million COVID-19 rapid antigen tests to be distributed to Americans for free.
But omicron isn’t waiting for the distribution of those tests.
So more than 40 U.S. House and Senate Democrats sent a letter to Biden on Monday, asking him to “utilize the full scope” of his executive power under the Defense Production Act “to manufacture enough rapid tests to ensure that each American can take at least one rapid test per week.” They also urged Biden “to integrate access to free rapid tests in public locations that are already frequented by people in their day-to-day lives.”
Encouragingly, the White House announced Monday that beginning Saturday, people with health insurance plans will be able to get over-the-counter COVID-19 tests covered by insurance (insurers will be required to provide reimbursement for eight tests per month for each individual on a plan). The tests must be authorized by the U.S. Food and Drug Administration.
If your health plan provides for direct coverage, the test will be free at the point of sale; if not, you’ll need to keep your receipt to be reimbursed by your insurer.
Which is fine. If you have health insurance. And if tests are available to purchase.
The congressional Democrats who wrote to Biden on Monday noted that COVID-19 rapid test kits now are priced roughly between $14 and $34. “For families who are struggling financially, the overhead cost may be enough to dissuade purchasing the tests altogether,” they pointed out, urging the administration to take “these potential hurdles into consideration.”
It must. Because testing is critical to reducing the spread of omicron.
Basics of testing
There are two types of COVID-19 tests.
As Brambila noted, “A PCR test is a molecular test analyzed in a lab and can detect fragments of the virus even after a patient is no longer contagious. Results can take up to three days, or longer when the labs are backed up. It is considered highly reliable.”
An over-the-counter rapid antigen test can deliver results in 15 minutes, but “can miss early stages of a COVID-19 infection,” Brambila wrote. “Studies suggest an antigen test is accurate nearly 80% of the time compared to 97% for a PCR test.”
The Centers for Disease Control and Prevention recommends testing five days after a COVID-19 exposure or when symptoms emerge. As Brambila noted, “Testing too soon could jeopardize the results because the body must build up enough of a viral load to be detected.”
Right now, medical facilities and pharmacies are facing a crush of people seeking PCR tests, and so may require that people be experiencing COVID-19 symptoms, or to have had a known exposure, in order to be tested.
An important note: Please don’t go to the hospital emergency room to be tested. Emergency departments now are filled to overflowing with sick people.
This is yet another instance in which we wish Lancaster County had a public health department that could help individuals — and health care facilities — navigate through this testing crunch.
No quick fix
There’s been a lot of understandable confusion and anger surrounding the CDC’s updated guidance on isolating after a COVID-19 exposure or infection.
Today, we’re focusing on the part of that guidance that recommends testing for COVID-19 “at day 5 after exposure. If symptoms occur, individuals should immediately quarantine until a negative test confirms symptoms are not attributable to COVID-19.”
This is what the CDC calls the “best practice.” But it’s easier recommended than followed, given the scarcity of COVID-19 tests (it also presumes that we know just when we were exposed).
Nearly two years into this pandemic, we should not be scrambling to find and pay for COVID-19 test kits.
At-home tests are not perfect, but they can offer some guidance about our next steps should we be exposed to COVID-19. They can help us to determine whether it’s safe to return to our normal routines.
We do urge you to stay home and away from other people if you have symptoms — cough, fever, chills, headache, etc. — of any respiratory illness, whether COVID-19 or influenza.
Again, this is easier said than done. We know that if some people don’t go to work, they won’t get paid. We also know that many employers are facing labor shortages, so some are encouraging employees to return to work even if they don’t feel 100% well.
If that’s the situation you’re facing, please wear a mask and make it a good one: a medical-grade surgical mask, or a KN95 or N95 that fits snugly to your face (see projectn95.org for mask recommendations). As we wrote last week, cloth masks don’t offer much protection against the omicron variant.
Dr. Amesh Adalja, an infectious diseases physician and senior scholar at the Johns Hopkins Center for Health Security, told Brambila that people cannot test themselves too frequently. “We want people to test as much as they need to,” he said.
“The ability to test yourself at will and cheaply is going to be very important,” Adalja said.
Alas, we lack that ability now. We hope that is remedied — and soon.