Short Wave - The Hodgepodge Of COVID Testing In The U.S.

Episode Date: January 20, 2022

The U.S. government has launched a website where people can request up to four free coronavirus tests per household--shipping is scheduled to begin in late January. They're responding to the fact that many Americans are really struggling to find tests as omicron surges across the country. (https://special.usps.com/testkits) Today on the show, our colleagues at Planet Money try to get tested — and they run into problems. From scammy testing sites to no tests at all, they explain what's behind the nation's COVID testing mess.See pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences.NPR Privacy Policy

You're listening to Shortwave from NPR. Hey, shortwavers, today we are tagging along with Planet Money on a quest for a test, a COVID test. The show had staff members around the country tried to get one in 24 hours. Now, they did this before the Biden administration put up its website where folks can sign up for delivery of free tests. We'll have a link to that site in our episode notes. So you can sign up for a free test too. But those ship in late January. There's still a huge need to figure out where COVID is spreading.

So officials can make decisions about things like mask guidelines, school openings, and vaccination requirements. Planet Money follows their staff in this mission to get a test with armchair thoughts from a public health pandemic response expert. They talk about the implications of a patchwork of testing and how the U.S. ended up in this situation. in the first place. So, buckle in. It is a ride. Stay tuned. This is Planet Money from NPR. Team Planet Money, hello. Hello. Hello. Thank you for joining me today and thank you for agreeing to this mission. Over the next 24 hours, you will travel to strange locations. You will wait in the cold or the

sleet, maybe worse. Today, my friends, I want you to go get a COVID test. All right. Are you willing and able? Oh, yeah. Yeah. Yes. I'm a little scared, but I'll do it. Okay, good enough.

You guys, tell our listeners where you are. I'm in Santa Fe, New Mexico. I'm in Portland, Oregon. I'm in Chapel Hill, North Carolina. Los Angeles, California. Richmond, Virginia. I'm in New Paltz, New York. And I'm in New York City.

All right, so are there any questions? Is there a preference for a test? No, that is a very good question. You can go get an antigen test. You can go get a PCR test. whatever test you can find. Is it a race? It is not a race, but you have 24 hours to accomplish this goal.

And then at the end, I will check back in with you guys. Is there a way to win? I was just going to ask that. Is there a way to win? Let me think about it, and I will get back to you. Okay, team Planet Money, the 24-hour clock starts in three, two, one. Go, go, go, go, go. Good luck, team.

out there. Woo, woo, woo, woo, go get COVID tests. Get tested to the testing hunt. Hello and welcome to Planet Money. I'm Amanda Aroncic. If you've tried to get a COVID test lately, you might have noticed it is a journey, or at least it can be. Depending on where you are, tests might be really easy to get, or they might be ungetable. What is behind this mess? Right now, the government's trying to fix it, but it's not clear if their plans are going to do the trick. Today on the show, we race around the country looking for tests and see what kinds of problems we run into. We have a guest commentator along for the ride to explain what is behind the wild ups and downs of trying to get a COVID test. All right, got to put in my shoes.

Walking to my car. I left my house about 15 minutes ago. I stopped and I got a delicious burrito. I don't know if we're going to factor that into our time here. I can't find my car keys. Not a good start, not a good start. All right, we're getting closer. We got some construction on the side, so forgive me for that.

This place appears to be next to a pretty sizable chicken coop. Oh, there in my pocket. Okay. Oh my God, there it is. There's a tent. I think it says free COVID testing on it. So here is what we are going to do today. The Planet Money team is outdoing the not-so-amazing race to try to get COVID.

tests, not just for an economic experiment, but also because everyone had reasons to get tested. And with a team so spread out and different cities and states handling testing so differently, we wanted to see it for ourselves. I told everyone to check back with me and with my expert, who will help explain any strange things we find. Can you introduce yourself? Sure. My name is Dr. J. Varma, and I am the director of the Cornell Center for Pandemic Prevention prevention and response in New York City. Over the past 20 years, Jay has mostly worked for the government trying to stop outbreaks of Ebola or Legionnaire's disease or SARS.

And most recently, he helped New York City set up its COVID testing program. He says if you are fighting a pandemic, it all starts with testing. People like myself who spent my career trying to promote the early detection and response to epidemics have spent most of our careers not working on drugs to. treat infections or even necessarily vaccines, but trying to figure out who is sick and who is not, because that is the first step to everything. Every decision follows testing, big ones like when can we open up the economy again, and individual ones like, can I send my kid to school tomorrow?

Testing leads to more informed decisions around whether the vaccines are working, what kinds of medicines we need, should we be in lockdown, can we reopen the border, etc., etc. You get it. And right now in the U.S., testing is not working, which starts to become clear with the first callback from the team. Caller number one, Nick. Amanda! Hello, Nick Fountain. Oh, my God. It is so sketchy where I am right now. Nick was in Los Angeles trying to figure out if the test he just got was legit.

Where are you? So I left my house. I walked three and a half blocks, and I ran across here. I'm going to turn my camera round. Okay. This tent. Okay. Yeah, yeah. It's a tiny little tent with a sign up.

Right. It says COVID-19, Delta variant. And underneath the tent is just one woman who has a hat that says, Mom's Off Day and a wine glass. She's right outside an AutoZone parking lot. I got swabbed pretty quickly. And then afterwards, she, like, Took my little swab and put it in a little vial and put that in a little Ziploc bag

and then put that Ziploc bag into a Marshall's reusable shopping bag. Wait a minute, Nick. You actually did your test at this tent. Oh, yeah. So Nick's test seems shady, but then again, he didn't give them any money. Nick, did you give this random person under a tent your credit card number or your bank or key to your crypto? No, it was free.

And interestingly, I was like, hey, I don't have insurance today. Whatever. I didn't have my insurance number. And she's like, oh, that's fine. Don't worry about it. All right. So I brought Nick's case to Dr. J. Varma and asked him, did Nick just take a legitimate COVID test?

Or was he somehow scammed? Well, it's a really interesting question. And I think this is probably one of the challenges that everybody's facing, right? you'll see a sign set up. It says COVID testing, and you don't really know whether it's legitimate or not. It's possibly legitimate. Possibly legitimate. All right. Without having seen it, I can't know for sure. I mean, so here's the thing about testing that people may not understand, and it relates to the kind of economics and business operations, is that there are really two main components of testing.

One is, who collects your specimen? And the second is, what lab actually tests the specimen itself. Jay says here is how to look at Nick's test. Nick got a PCR test, the kind that has to be processed in a heavily regulated and specialized lab. But it doesn't have to be collected at a lab. And if you're in the middle of, you know, a global pandemic, you want to bring the tests to the people. Hence, tense. That's why you can get these operations, you know, where Joe's rapid testing site gets set up, where they put up a tent somewhere and they form a contractual relationship with the lab and are collecting specimens of doing it. Jay says that the fact that it is a tent with a sign printed at, I don't know, Kinko's,

doesn't mean that it's not legit. When Hugh is helping set up New York City's testing program, they set up hundreds of tents. The tents are really helpful. They make testing convenient. It's easier to set up than a building. And you can put tents in neighborhoods that need better access to testing. But how do we tell if Nick's tent is for real? The one thing that would lead me to believe that this is a government site is the fact that they didn't ask for any insurance information.

They also didn't ask for any money. So that seemed like a good sign. The other thing Jay suggested we looked for was the name of a lab and the name of a doctor. Now, the people doing the collection don't have to be physicians themselves, but there generally has to be some type of what we call authorizing physician. So, you know, one of the questions to ask is, well, who is the physician overseeing this? who is the medical provider that actually requested the test? And that'll give you some idea about who set this up and who's running it. Okay, so now I know what to look for, an authorizing physician and the name of a lab.

I am going to look into both of these things for Nick, and we'll see what kind of follow-up he gets on the test. Caller number two. Dave. Hello. Dave Blanchard. How's it going? Good. Though I'm not feeling very confident.

I was sort of thinking that this would be an easy task, but it's a total shutout for me so far. Huh. Remind people where you are? So I'm in Portland. Okay. And I've tried going through the Oregon Health Authority's website, and they're all booked out like a week ahead of time. So I've turned to secondary markets. And this sounds questionable when I say it out loud. But I think I'm going to try to get a COVID test off of Craigslist.

But there was one that was posted about three hours ago. It's COVID-19 home test. Brand new on open, result in 10 minutes, two tests in one box, prices firm, text for fastest response. It's listed for $50, which is definitely an upcharge from like the pharmacy price, which I think usually around like 20, 25. So I guess I'm going to go do this. All right. Good luck. Dave, uh, text me the word mango if you're worried about anything.

Okay, that sounds good. Mango. And I guess I would just say meet the person outside. Yeah, they've been very responsive. I'm sure they have. They're about to make some money off you, Dave. Don't worry. I did hear from Dave shortly after this call.

There were no panicky mango texts. He venmoed the stranger 50 bucks. She gave him a legitimate FDA-approved rapid test. I explained Dave's case to Dr. J. Varma. They don't have it. So we ended up buying a test for 50 bucks on Craigslist, one of these rapid tests. Yeah, it sounds to me kind of like a Beanie Babies or Xbox-type situation around Christmas, right? I guess if I was really in a crunch for cash, I would sell the five boxes of tests that we keep sashed in our house at all times.

Now, while Nick got a PCR test, Dave bought a rapid test. These are very different kinds of tests. But no matter what kind of test you get, the prices you can pay are all over the place. You can get them for free or you can pay $489, which is an actual price I saw for a quick turnaround PCR test in Manhattan. I know of laboratories that have, you know, essentially a VIP lane, right? If you have a private laboratory and a private medical provider, as long as you disclose all of the information about the costs up front, I'm not aware that there's any restriction on doing that. Jay, why is this the system that it's such a hodgepodge? Hodgepodge is probably the polite word to use that doesn't rhyme with, you know, pit go for how you might describe our, you know, U.S. health care system.

Why is testing such a pit go with tests costing such a wide range of. prices. Well, first of all, it took a while for some of the rapid tests to get approved. So there were very many companies making them. Abbott, the company that makes Bynax now, said they didn't need to lower their prices. There just wasn't enough competition to bother. Jay says that the second reason testing is such a pick-go can be traced back to a decision that both the Trump and Biden administrations made. They could have been a major, consistent buyer of tests. That's what the government did with the COVID vaccines with Operation Warp Speed. The government promised to buy vaccines and removed a lot of the risk for companies.

Well, we had an Operation Warp Speed. That's kind of the analog that we need really for testing if we want to avoid these types of bottlenecks that we're running into right now. Without consistent demand, like from the government, testing companies are just following the ebbs and flows of the pandemic. When Delta or Omicron comes on the scene, they scramble to make. more. When cases fall, they make less. But they don't time it perfectly. And that leads to shortages. And like Dave, buying a test for 50 bucks, which is better than not finding a test at all, which brings us to our last caller, caller number three. Molly. Hello, Molly. Hi. So, remind our listeners, where are you? Right now I'm in New Pulse, New York. So about an hour

and a half outside of New York City. Molly started her search by making some phone calls. So I called like an urgent care. I called a pediatrician's office. Welcome to Benbeni Pediatrics. There was just like no one even answering the phone. There are 14. Colors in the queue. And then I got some really fun hold music. Okay. On brand hold music. Okay, so then what did you do? So I went to Walgreens. Oh, here's a sign. We are out of COVID rapid tests. Sorry for any inconvenience. And then I went to Tops. I've got my fingers crossed, but this will be the solution again. And then finally I went to shop right. This is where you all usually have COVID tests. Is that right? Yeah. And you don't

you don't know. No, we were supposed to get a Tuesday. We never received it. At that point, I'd spent two and a half hours trying to get tested. And I just kind of gave up. Molly did not find a COVID test. I laid out what happened to Dr. J. Varma. We're at this moment where people are supposed to get tested to sometimes go to their jobs, get tested to go to school, get tested to travel. What are you supposed to do if you just can't find it? Oh, I wish I had a good answer for that. This is, I just have to say, it is just absolutely shocking to me that the U.S. ended up in this situation. So for people like Molly, unfortunately, all I have are thoughts and prayers at this time.

So that's what the doctor's got. Jay says this is the worst outcome of a system that cannot keep up. Well, what you're seeing is a stress test on one aspect of our health care system, which is the diagnostic process. Diagnostics usually work through a bunch of public and private labs. And that patchwork, it's been struggling with the huge demand for tests. On any given day, let's say 10% of the U.S. population is trying to get this one specific laboratory test. performed. And it's, you know, the economic equivalent of a run on the bank, right? Everybody's like, okay, well, today's the day I need to get my money out. Well, the bank isn't set up for that.

So you'd get long lines. So all of these problems that those of us who work on public health have known about are just being put up front in the extreme and visualizable to everybody. Thoughts and prayers, Molly. Thoughts and prayers. Up next, we gather the team together again and find out who managed to get a test within 24 hours. and who got their results back. Okay, we only doing the PCI today. We have no rapid in the state, so this is for you. Oh, do I do myself?

Yeah, just swore. Okay, here's the fun part. I've never stuck anything into my nose like this before, so this is going to be an interesting thing. Swab out. How far? All the way? Pulling down the mask.

Oh, boy. All right. Ow. Went a little deep there. Nasty. So testing in many places in the U.S., it is broken. Scam tests, secondary markets, no tests, but the U.S. is trying. The details are still being worked out as we are recording this episode,

but the government says it is buying a billion tests to give to Americans for free ASAP. Also, people with insurance can now, in theory, get reimbursed for buying those rapid tests. But Dr. J. Varma doesn't think these measures will be quite enough. In theory, you could and probably should, you know, in an ideal world, test yourself multiple times a week to make sure you're not asymptomatically spreading this infection to other people, especially if, as is likely to happen, we're going to continue to see waves of this infection and we're continuing to need to have testing be one of the many tools that we have. President Biden's announcement was a little too little and a little too late for our test-taking team. and possibly also for this latest COVID wave. So here is what happened to us. I sent six people out on this mission.

For three people, it was actually pretty easy to get a test and to get a result. For the other half, the ones that you heard from, Nick, Dave, and Molly, not so much. Test one, two. We all got back together on a Zoom call. Rolling. Rolling. Rolling. Rolling.

I'm rolling. Ah, la, la, la. There were a few loose ends to tie up. So, Nick, you gave me the name of the lab and the name of the physician, and I did look into it. They both check out. And the California Department of Public Health said, yes, that test that you took was free. There is no secret bill coming later. But what I was wondering was, did you ever get a result?

No. Oh. Nick. Sorry, buddy. You didn't get a result from your PCR test? No, and I keep, like, texting them. Like, the last text message I sent to them was like, question mark, question mark, question mark. And they have not responded.

Well, I guess the turnaround time for lab test has gotten very long. It's also possible that my handwriting is terrible and that they just couldn't read my phone number and tell me my test results. So many things could have happened. Yeah, that's true. Okay, so the good news is that everyone who did get a result back was COVID-negative. Yay. Yay us. We are bucking the national trend.

So, as you know, the system is about to change and you should be able to get reimbursed by your insurance for a rapid test. and in theory, the government is supposed to be mailing you some tests soon. Will the government reimburse me for my Craigslist secondhand test? I think you're on your own there with that one, Dave. Thank you, everybody, for participating. Wait, who won? Yeah, wait, I know. It's true. Who did win? I decided that there were no losers.

You were all winners for trying to get tested. I feel like I was the loser. I feel like that's pretty clear. Yeah, maybe Molly. Maybe that's fair. Maybe Molly was the loser. If you are running into new and unusual situations as the pandemic enters its third year, wow, I hate saying that, we want to hear about it. Email us at planetmoney at npr.org.

We're also on Instagram, Twitter, Facebook, and TikTok at Planet Money. Today's show was produced by Emma Peasley with help from Dave Blanchard. It was mastered by Isaac Rodriguez and edited by Jess Jang and Molly Messick. Planet Money's executive producer is Alex Goldmark. I'm Amanda Oranjic. This is NPR. Thanks for listening.