September 22, 2021

Why America has so few Covid-19 rapid tests (and how that could change)

Daily Briefing

    In contrast with many European countries, rapid testing for Covid-19 in the United States has been hindered by lack of access and supply shortages—but the Biden administration has introduced new efforts to increase test availability. 

    How Covid-19 will impact the supply chain

    The U.S. remains behind on rapid testing

    According to the New York Times, rapid testing (or antigen testing), enables people to learn within minutes if they are carrying enough of the coronavirus to be contagious. Armed with that information, people who are infectious can help contain the spread of the virus by staying at home and away from others.

    However, access to rapid testing in the United States has remained low for several reasons, including limited FDA authorization for such tests, according to the Associated Press.

    The tests primarily used in the United States at this time are PCR tests, the Times reports. While PCR tests tend to be more sensitive than antigen tests, they also take far longer to produce results. PCR tests must be processed by a laboratory, and it can sometimes take more than 24 hours for people to receive their results—during that time, a person could infect others.

    In comparison, rapid tests are easily accessible and inexpensive in many European countries, including the United Kingdom, France, and Germany, where the tests have been subsidized by the government.

    According to various health experts, that widespread availability has played a key role in managing in the pandemic in those nations. For instance, Stefanie Friedhoff, a professor at the School of Public Health at Brown University, wrote on Twitter about the benefits of rapid testing in Germany, such as how the day care center where Friedhoff's sister works has been able to stay open during the pandemic because both staff and children are tested frequently.

    "Imagine what ubiquitous cheap testing could do in the U.S.," Friedhoff wrote. "It is incomprehensible how the U.S. has failed on testing."

    Previous lack of demand exacerbates current supply shortages

    Another issue undermining antigen test availability in the United States is simply limited supply, the Times reports—a trend spurred in large part by generally improving conditions during the spring. At the time, positive factors in the pandemic, such as fewer cases, a rise in vaccination rates, and guidance from health officials that vaccinated people did not require testing, led to a shrinking demand for tests.

    "For all of us, there was a combination of optimism and hubris in the June timeframe that led us believe this was over," Mara Aspinall, a health industry researcher at Arizona State University, said.

    Amid this lack of demand, Abbott Laboratories, which manufactures one of the most popular rapid tests for Covid-19 in the United States, began discarding millions of products in its inventory, the Times reports. The company said the tests have limited shelf lives and were not eligible for overseas donation.

    However, as the delta variant spread across the United States, leading to surges in cases, Abbott could not produce enough tests to meet the rising demand. In August, the company's at-home rapid test was sold out at several retailers, including CVS and Rite Aid, and Amazon indicated shipping delays of up to three weeks for the product.

    Since then, Abbott has hired back hundreds of workers to meet the new demand and said it is producing "tens of millions" of its BinaxNOW rapid tests every month, with an aim to increase production in the next few weeks.

    "It is now very clear that testing is a necessary companion to vaccines and Abbott is ramping up again," an Abbott spokesperson said.

    New efforts to ramp up rapid testing

    In addition to increased manufacturing efforts, President Joe Biden said this month, when announcing new initiatives to combat the Covid-19 pandemic, that he would work to expand the availability of rapid testing.

    In his announcement, Biden said he would use the Defense Production Act to acquire 280 million rapid tests and work with retailers, such as Kroger, Walmart, and Amazon, to increase the availability of these tests nationwide. Through the partnership, the retailers will begin selling at-home rapid tests for Covid-19 at a 35% discount over the next three months, CBS News reports.

    "We're proud to work with the Biden administration to increase access to affordable, high-quality, FDA-authorized tests, to keep us moving toward a full recovery," Brian Huseman, Amazon's VP of public policy, said.

    According to the Times, rapid tests will be essential in allowing life to function normally going forward.

    Michael Mina, an epidemiologist at Harvard University, said while rapid tests may miss cases where a person has been infected weeks before, they can still identify around 98% of cases where a person has been newly infected and is contagious—which would help sharply reduce the spread of the virus.

    "Testing is how we end this pandemic without disrupting society," Mina said. (Leonhardt, New York Times, 9/21; Perrone, Associated Press, 9/21; Walsh, Axios, 9/11; Gibson, CBS News, 9/10; Fink, New York Times, 8/20)

    Learn more: How Covid-19 will impact the supply chain

    supply chain

    Covid-19 has revealed critical shortcomings in the health care supply chain. Shortages of personal protective equipment (PPE), ventilators, and other vital supplies have hindered the U.S. health care system‘s response to this crisis, and additional waves of shortages are likely in coming months.

    Read our take to learn three requirements for a more resilient, transparent supply chain in light of Covid-19.

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