The Covid Testing Slump- Where Do We Go From Here?

By | March 26, 2021

A few weeks ago, Citigroup began providing at-home Covid-19 testing kits to many of its workers in Chicago and New York. Each kit includes a nasal swab, a paper strip and a liquid solution, and people get a result within minutes. “It looks a little like a pregnancy test,” Dr. Lori Zimmerman, Citigroup’s medical director, told me.

The company is distributing enough tests for employees to take them three times per week, typically on Monday, Wednesday and Friday mornings. Soon, Citigroup will expand the program to all 6,000 of its U.S. bank branches. The goal, Zimmerman said, is to help people learn that they have Covid before they can infect colleagues or customers.

This is the kind of ambitious testing program that many medical experts believe should be available across the country. Why? Even as more Americans are receiving vaccine shots, the country remains months away from vaccination being the norm. In the meantime, wide-scale testing can allow life to begin returning to normal — without setting off deadly new Covid outbreaks.

“We have to do more,” Jennifer Nuzzo, an epidemiologist at Johns Hopkins University, told me. “This pandemic is not over. We still have dangerously high levels.”

Testing has declined partly because the health care system has instead focused on giving vaccine shots. And vaccinations are indeed more important than Covid tests. But the country should not have to choose between the two, experts say. If the U.S. can accelerate both vaccinations and testing, the payoff would be huge, in terms of lives saved and schools and businesses reopened.

“It pays for itself,” Dr. Michael Mina, a Harvard University epidemiologist who has argued for more testing, said. “Tests are one of the easiest, least burdensome things we could do.”

For Monica Jurado, a Citi personal banker on the South Side of Chicago, testing has become a simple part of her morning ritual. After taking a test, she gets ready for work — and, 20 minutes later, she can see the test result. “It gives me tremendous peace of mind knowing that I am coming to work safe, and so are my co-workers,” Jurado said.

Worldwide, several countries, including Australia and South Korea, have already used mass testing to hold down Covid cases, as Vox’s Umair Irfan notes. Many colleges in the U.S., as well as pro sports leagues, have also relied on testing to continue operating. And Biden administration officials say they are committed to making tests more available, including for people who show no symptoms.

“Testing is a major pillar of the president’s strategy,” Carole Johnson, the White House’s testing coordinator, told me yesterday. “We think it’s really important.”  So what will it take for the U.S. to do more testing?

Money. The recently passed virus-relief law includes $50 billion for expanded testing, including $10 billion for schools. That will help, experts say, although it’s not yet clear how much.

The tests that Citigroup is giving cost about $5 each, when bought in large quantities. A nationwide program of universal mass testing for unvaccinated people would probably cost a few billion dollars a week — which, again, pales compared with the cost of extended shutdowns. The country’s current testing plan is much less aggressive.

Logistical help. With many hospitals and pharmacies focused on vaccinations, people need places to get tested. The Biden administration is working with state and local officials to open four regional coordinating centers in coming weeks.

Corporate America can play a role, as well. Large Canadian companies recently created a consortium to give rapid-result tests to employees, and the group’s organizers announced this week that they planned to expand into the U.S.

F.D.A. approval. Citigroup has been able to distribute its tests — which are known as rapid antigen tests — only because it is doing so as part of an academic study; the Food & Drug Administration has not approved the tests Citigroup is using. The agency has approved two other at-home antigen tests, but they are not yet widely available.

One issue is that rapid-antigen tests are slightly less accurate — missing some people who have Covid — than the other main type of test, which is known as a P.C.R. test and isn’t an option for mass home testing. But that’s OK. Think of it this way: Citigroup is detecting many more Covid cases than most employers are.