Nearly half of 500m free Covid-19 tests the Biden administration made available to the US public have not been claimed, as cases plummet.
Wild demand swings have been a subplot in the pandemic, from vaccines to hand sanitizer and tests. On the first day of the White House test giveaway in January, the covidtests.gov website received more than 45m orders. Now officials say fewer than 100,000 orders a day are coming in for packages of four free rapid tests per household, delivered by the US Postal Service.
Still, the White House sees the program as a step toward a more elastic testing infrastructure that will accommodate surges and remain on standby.
“We totally intend to sustain this market,” said Dr Tom Inglesby, testing adviser to the Covid-19 response team. “We know the market is volatile and will come up and down with surges in variants.”
The White House says Americans have placed 68m orders for tests, which leaves about 46% of stock still available. Testing will become more important with mask requirements easing, some experts say.
“If infection control is still our priority, testing is central,” said Dr Leana Wen, a former Baltimore health commissioner. “Four tests per household for one family will only last you one time. There should be enough tests for families to test twice a week.”
Private insurers are required to cover eight free rapid tests per person, per month. Medicare coverage will start in the spring. The administration has also been making free at-home tests available through libraries, clinics and other community venues.
Capacity for more accurate PCR tests performed by labs has been built. The White House recently put out a request to industry for ideas on how to sustain and expand domestic testing this year.
Wen said people still need a guide for when to test and how often.
Joe Biden’s pivot to testing came under duress as the Omicron variant gained force before Christmas. Tests were hard to come by and expensive. The White House is sensitive to criticism that help may have come too late.
“There is no question some people found out they were positive from taking one of these tests and were able to keep other people from getting infected,” said Tim Manning, supply coordinator for the Covid-19 response team.
Around mid-December, White House officials began discussing how to make free tests available.
“A critical thing to us was that anything we did had to be done in a way did not create a shortage at retail to the general public,” Manning said.
The White House enlisted the Pentagon and parts of the health department that worked on the Trump administration effort to distribute vaccines. Logistics experts scoured the globe for tests. The postal service was designated to take and deliver orders.
That proved to be a good call, said Hana Schank, an expert on government technology projects with the New America thinktank. The postal service had a database of every address in the land and the means to deliver.
The project took less than a month to get ready, Manning said. “We said this is not online retail. This is emergency response, so we have go to as fast as possible.”
The administration targeted deliveries to low-income areas.
“We prioritized the processing of orders to the highest social vulnerability zip codes in the country,” Inglesby said.
Denise Smith, executive director of the National Association of Community Health Workers, said the group was able to use its website to link more than 630,000 people to covidtests.gov.
Overall about 20% to 25% of the tests have gone to distressed areas, officials said. Now demand is way down, it is unclear what will happen to the White House giveaway. Allowing repeat orders is one possibility.
Smith says groups like hers should get any surplus.
“We know where the people are,” she said.
Lindsey Dawson of the Kaiser Family Foundation said the program’s legacy may lie in familiarizing people with testing.
“It may get someone comfortable with utilizing the tests, thinking about how they might use testing in their lives,” she said.