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March 18, 2021

Biden has a $12B+ plan to expand coronavirus testing. But will it 'move the needle'?

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    HHS on Wednesday announced new steps it is taking to bolster Covid-19 testing nationwide, including investing more than $12 billion to expand screenings in schools and underserved communities.

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    HHS to spend more than $12B to boost testing in schools and underserved communities

    HHS said it is providing new funding and guidance as part of President Biden's Covid-19 response plan to scale up testing throughout the United States.

    HHS said that beginning in early April, CDC will distribute $10 billion to states to expand Covid-19 screening testing for teachers, staff, and students—with the goal of reopening schools for in-person instruction by the end of the school year. Congress approved the new funds for schools under Biden's $1.9 trillion stimulus package, which Biden signed into law last week, the New York Times reports.

    The new funds are intended to help schools consistently screen students, staff, and teachers for Covid-19 to identify asymptomatic cases of Covid-19 and prevent the novel coronavirus's transmission, HHS said. States and schools will receive technical assistance from CDC and state and local health departments to help launch and implement the testing programs in schools, according to HHS.

    CDC on Wednesday released updated guidance on which types of Covid-19 tests should be used in schools and other settings, including nursing homes and prisons. CDC in the guidance also provides information on how to choose among the available tests and how to interpret test results.

    According to HHS, CDC will also spend $2.25 billion to ramp up testing, contact tracing, and other measures aimed at addressing health disparities related to Covid-19 in high-risk and underserved communities, including rural regions and areas with a large population of racial and ethnic minority groups.

    In addition, HHS said FDA has released new recommendations and information aimed at streamlining the path to emergency use authorizations for screening tests

    Experts say more will need to be done to expand testing in schools and underserved communities

    Although experts believe increasing testing remains critical to ending America's coronavirus epidemic, many raised concerned about the administration's plan.

    "This isn't going to move the needle," said Michael Mina, an immunologist and epidemiologist at Harvard University. "The states don't just need money. The states don't just need advice from the CDC. The states need the test to be available."

    Mina said FDA's burdensome regulations have made it difficult for test developers to get new types of rapid antigen tests approved. He said FDA's new guidance does not address what he considers to be the primary reason the agency is slowing down the approval of rapid tests: FDA is incorrectly measuring rapid tests against more sensitive polymerase chain reaction (PCR) tests, although the tests are not comparable.

    "The requirements of the FDA have not kept up with the science," Mina said. "They are living in this archaic world where PCR is the only test and the only metric, and literally requiring antigen test after antigen test to be buried in purgatory."

    Mina also noted that the new guidelines do not address the fact that schools are required to obtain certification under the Clinical Laboratory Improvement Amendments to administer laboratory tests.

    CDC Director Rochelle Walensky said that although some schools have found ways to get around that requirement, "there continues to be more work to do" to address the problem.

    Where America's coronavirus epidemic stands

    Recent data indicates America's coronavirus epidemic has improved since January's peak, with reported numbers of cases, hospitalizations, and deaths all declining—although they remain high.

    According to data compiled by the New York Times, U.S. officials on Wednesday reported about 58,856 new cases of the novel coronavirus. As of Thursday morning, officials had reported about 29.6 million cases since the United States' epidemic began.

    According to the Times, the United States' average daily number of newly reported coronavirus cases over the past week was 55,001—down by 15% compared with the average from two weeks ago.

    However, the Times' data showed that, as of Thursday morning, the rates of newly reported coronavirus cases were "staying high" in Washington, D.C., and 16 states that have reported a daily average of at least 15 newly reported cases per 100,000 people over the past week. Those states are Alaska, Connecticut, Delaware, Idaho, Massachusetts, Michigan, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, South Dakota, Tennessee, Vermont, and West Virginia.

    In addition, the rate of newly reported coronavirus cases was "going up" as of Thursday morning in Hawaii and Missouri, which have had comparatively lower case rates, the Times reports.

    According to the data, rates of newly reported coronavirus cases were "staying low" or declining from previously higher rates in the remaining U.S. states and territories.

    Meanwhile, data from the Times shows there were 40,143 Americans with Covid-19 hospitalized for treatment on Wednesday—down by 23% compared with the average from two weeks ago.

    Further, data from the Times shows that U.S. officials reported about 1,177 new deaths linked to the coronavirus on Wednesday. As of Thursday morning, officials had reported about 537,649 U.S. deaths linked to the virus since the country's epidemic began.

    (Anderson, Becker's Hospital Review, 3/17; Hackett, Healthcare Finance News, 3/17; Stolberg, New York Times, 3/17; Lim, Politico, 3/17; HHS release, 3/17; New York Times, 3/15; CDC vaccination data, updated 3/14).

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