The Daily - A Covid Testing Crisis, Again

Episode Date: December 22, 2021

By the end of last year, if you needed a coronavirus test, you could get one. But when vaccines arrived, focus shifted.Many of the vaccinated felt like they didn’t need tests and demand took a nosedive. Testing sites were closed or converted into vaccination sites. And Abbott Laboratories, a major test manufacturer, wound up destroying millions.However, with the surge of the new Omicron variant, which is less susceptible to vaccines, demand for testing is back — and it is outstripping supply.Guest: Sheryl Gay Stolberg, a Washington correspondent, covering health policy for The New York Times.Sign up here to get The Daily in your inbox each morning. And for an exclusive look at how the biggest stories on our show come together, subscribe to our newsletter. Background reading: President Biden came into office vowing to make coronavirus testing cheap and accessible, but matching supply with demand has been a persistent problem.For more information on today’s episode, visit nytimes.com/thedaily. Transcripts of each episode will be made available by the next workday. 

From The New York Times, I'm Michael Barbaro. This is The Daily. Today, as demand for COVID testing surges and vastly outstrips the supply of available tests, we look at why shortages still remain two years into the pandemic and what President Biden can do about it. I spoke with my colleague Cheryl Gay Stolberg. It's Wednesday, December 22nd. So, the way this day really begins is with me giving Michael Simon Johnson a better mask than the light blue surgical one he had.

Ooh, that is a fine-fitting KN95. Yeah, you can tell this is the real deal. Okay. Okay, so it is around 8.40 a.m., and we are standing outside of a CareCube COVID testing clinic on Court Street and Wyckoff Street in Brooklyn. And the line is quite long. It's about 40 something people on this line. And you can tell that people know they're going to be here for a really long time

because they are prepared. They have their coffee and their snacks. There's a woman in the front doing jumping jacks, jumping up and down to stay warm. There's a mother reading a board book to a not very happy child. This is a really long line. I mean, this is a dishearteningly long line. It's going to suck. Can we talk to you guys? We're from the New York Times.

Sure. Do you have a minute? We're from the New York Times. I just want to talk to people about long lines and COVID testing. This is stupid. Okay, tell me. This is stupid. The test tell me. This is stupid. The test takes literally less than 60 seconds.

I don't understand why I've been standing on this line for two hours. I mean, look at it. The line is going to be at Starbucks in a minute. Hi, my name is Eliza Reinhart. Corey Dayani. Nadia Dayani. Sam. Sam? Yeah.

I am 26 years old. I'm a law student. Sam from the neighborhood. I'm 12, just turned 12. Sam from the neighborhood. My name is Melissa and I'm 32 and I work in the medical field. What brought you to this line? Why are you getting tested for COVID? My friend at school tested positive so I'm exposed so I'm getting tested and there's six minutes till school starts. Actually there's probably three minutes

till school starts 8 57. Can we ask you who you are? Yeah I'm Sam and I feel sick so that's why I'm here. What do you think may have been the source of your exposure? Yeah, I mean, it's like I had a really great weekend. I had a bunch of friends coming in and visiting, and we went out. It was her birthday. Yeah, it was my birthday. It was your birthday. Did you have a moment right before or during of asking yourself, like, is this a great idea?

I think there was, like, concern that, like, we could be safer, but I also think we have to live our lives to some extent. So, I don't know. I don't have any regrets. We was actually here for four hours yesterday, and I had to work yesterday and today, but I can't go back until I have a negative COVID test, so it is frustrating. What kind of line of work are you in that they require you to get tested like this every day? Retail. Retail. Yeah. So how can you work in retail if you're

standing in line for four hours twice in a week? I don't know. I know I need to make up this $500 for these two days I lost. Yeah, I mean, I just want to say $500 worth of your time and hourly wages. You're standing in this line. Exactly. So work yes yeah so yeah it's kind of tough it's kind of tough we had like a conversation the other day at my school about like when do you think or do you think this is gonna end and i And I think that it's going to get worse to get better. Like, it's going to get a little bit more challenging to eventually be over. So your attitude about the future of the pandemic is basically that the night is darkest just before the dawn. Yeah.

To quote Batman. What? That's one note. Well, I think that it's going to, we're going to all have to take many more precautions and maybe new, like, strategies of precautions before it's going to fully be over. Are you mentally ready to do that?

Yes. Okay, so any final thoughts here? If you're sick and want to spend four hours waiting in line, bring gloves. Yeah. Cheryl, I was just out in the bitter cold speaking to a lot of very frustrated New Yorkers who are in line waiting for a COVID test. And New York City is in a somewhat unique situation given its scale and demographics, but by and large, it feels like testing isn't really working right now at the peak of Omicron. So we want to talk to you about why it is that testing is still such a mess in the United

States now, two years into this pandemic. Well, Michael, the United States really bungled testing from the outset of the pandemic. really bungled testing from the outset of the pandemic. You'll probably remember that in the early days, the CDC wanted to keep tight control over testing. They felt that their test was the gold standard and they didn't want anybody else's tests to be used. And then it turned out that their test kits were botched, that they were problematic. They didn't work. So we really started out behind the curve. Right. And what I remember is in keeping such tight reins over testing and ultimately creating a botched test, like you said, the CDC kind of set back the schedule for private companies to jump in and create a lot of tests for the United States.

Right. And not only did it set back the schedule, but the virus was already kind of in full swing by the time we got tests that we could use. Right. I remember talking to governors who were begging the Trump administration, please send us tests. They were literally competing with one another for these scarce tests. And testing was a huge issue all throughout the spring of 2020. Right. So then in April of last year, President Trump invoked the Defense Production Act. That's a Korean War era law that gives the president broad powers to direct companies to prioritize shipments to the government. And after private companies started really scaling up the supply of coronavirus tests, things started to even out toward the end of last year. It was pretty much the case that if you needed a coronavirus test, you could get one.

Okay, so a year in, at that late stage, testing is finally at a somewhat okay place in the U.S. That's right. And then, Michael, the vaccines arrived. I feel hopeful today, relieved. I feel like healing is coming. The talk was all about vaccines. Once we get enough people to get this vaccinated, we can kiss COVID goodbye. Can you get vaccines? Can you get on the list? You have to check multiple times a day and you have to check multiple sites to get that appointment. People who were vaccinated felt like we don't need to test because we've got this vaccine.

And demand really took a nosedive. Both Georgia and South Carolina are not meeting testing goals. Part of the cause could be an increase in vaccinations. And testing sites started closing down, too. Mayor Lenny Curry says the plan is to convert the Legends and Regency testing centers into vaccination sites by early next year. People who were running testing sites were trying to convert those sites into vaccination sites because that's where the demand was. So much so that a major test manufacturer, Abbott Laboratories, One of the leading producers of these tests reportedly began destroying inventory with a limited shelf life.

Wound up destroying millions of tests that they had worked so hard to create. And stuffed them into garbage bags. And was anyone saying at that point to themselves, well, wait a minute, pandemics are cyclical, we're maybe going to need more testing soon enough? Testing should always have been integrated into the response, even with vaccination, that the singular focus the Biden administration had on vaccination was somewhat misguided and that we needed a layered approach that would involve testing, vaccination, masking, and other public health measures like social distancing. But instead, Americans seem to be able to do only one thing at a time. And what is the result of all of us collectively taking our eyes off testing? The result is that now we have this new variant, Omicron, and there is a huge demand for tests

because we know that people who are vaccinated can still get infected. And this is creating major strains on the United States testing system. The new rapid tests, which have come online since President Biden took office, are flying off pharmacy shelves. There are waits for PCR tests, like you yourself just saw, Michael, you were standing out in line in the cold. Three to four hours. Right. And laboratories that process those tests are overwhelmed. There are delays in processing time, just like there were at the very beginning of the pandemic. the very beginning of the pandemic. So let's dig into the data on testing right now. Just how many tests are there in this moment, and how does that align with the demand now that Omicron is here?

So the latest estimates show that right now in December of 2021, we have a total of 593 million tests in the country. And that's all kinds of tests. That is at-home tests, it's professional tests at your doctor's office, it's PCR tests. Almost 600 million tests. That sounds like a lot of tests. It does sound like a lot, Michael, but think about how many Americans there are. There are about 330 million Americans. So that's just really not quite two tests for the whole month for every American. So it might sound like a lot, but it's not. And when you think about the need for tests,

it becomes even more complicated. There are parents who have three kids, and any time there's a potential exposure in that family, I'm thinking about a colleague of mine, that's five tests. Or let's say you work at a company that requires testing. To go back to work. You might need multiple tests a month, three tests a month.

Right. Or let's say you're a school. The CDC announced this week its new strategy of what they call test to stay, which means that students who are exposed to the coronavirus can test to stay in school instead of having to quarantine at home. Well, if you've got a school and a classroom of 30 kids or two or three classrooms of 30 kids are all exposed, you know, you can do the math and see that you're going to need a lot of tests. Right. So all of a sudden, 600 million tests a month, which does sound like a lot, gets used up very quickly. And as we can see from these long lines, it's not sufficient. Right. Do we have a sense of what would be a sufficient number? of Mara Espinol. She's an expert in medical diagnostics at Arizona State University who keeps those numbers that I just gave to you. And she paused for a minute and she said, well, significantly more. Right. More than we currently have. Exactly. And so the system we have now is if you need a test, you either wait in a really long line for a laboratory test or you try to buy an at-home test from the pharmacy where they're in short supply and they're also costly, usually about $25 for a package of two.

And people are feeling a lot of frustration over that. Right. Why are the at-home tests so expensive? package of two, and people are feeling a lot of frustration over that. Right. Why are the at-home tests so expensive? I think any of us who've ever walked into a store and bought them experiences some level of sticker shock. So I think part of that has to do with the old supply and demand. Because the FDA was slow to approve these rapid tests, there are only, there are only a few companies making them. There are about a dozen on the market, so they can set their price. And the Biden administration also made a crucial decision, which is that unlike nations in Europe, where the government bought tests directly from manufacturers, creating a ready

market, the United States didn't do that. So in Europe, tests are maybe a dollar or two dollars apiece. And in the United States, they're roughly $12.50 apiece or $25 for a box of two, which is how they're sold. Right. So to sum this all up, the reason why testing remains slow and disorganized at this late stage of the pandemic is because the U.S. got off to a very late start and then everyone took their eye off the ball, focusing on vaccines instead. And now there's a real mismatch between supply and demand. And the U.S. is not subsidizing testing in the same way that countries in Europe are to make up for all that. Right. And that sets the stage for what President Biden did on Tuesday. He's recognizing that we are facing an alarming surge in coronavirus cases because of Omicron that threatened to overwhelm the hospital system. So he gave a really big speech talking about what he's going to do about that.

And a lot of that speech and Biden's new strategy has to do with testing. We'll be right back. I promised when I got elected I'd always give it to you straight from the shoulder. The good, the bad, the truth. So as we head into Christmas weekend, I want to answer your questions about the rising number of COVID cases, COVID-19 cases. So Cheryl, what did President Biden say in this speech?

So before he even got to his new plan, he really tried to console an anxious nation. We should all be concerned about Omicron, but not panicked. If you're fully vaccinated, and especially if you got your booster shot, you are highly protected. He told Americans that we should all be concerned about Omicron, but not panicked. Another question that folks are asking is, are we going back to March 2020? He tried to draw a contrast between now and March of 2020, which is when his predecessor declared a national emergency. That's what I keep getting asked. The answer is absolutely no, no. He said this is not March 2020. More than 200 million Americans have been fully vaccinated. 200 million people are vaccinated. We're prepared. We know more. In March of 2020,

we were not ready. And I know some Americans are wondering if you can safely celebrate the holidays with your family and friends. The answer is yes, you can. If you and those you celebrate with are vaccinated, particularly if you've gotten your booster shot. He told people that if they're vaccinated, they should feel comfortable going about their holiday business so long as they follow other public health protocols like masking when indoors and social distancing and washing their hands, etc. But while COVID has been a tough adversary, we've shown that we're tougher. So very much a message of calm, but stay vigilant.

Exactly. Exactly. Exactly. And when he gets to his new plans, especially for testing, what are the details? So the details on testing are that... The federal government will purchase one half billion. That's not million, billion with a B.

Additional at-home rapid tests. His administration is buying 500 million rapid COVID-19 tests to distribute free to the public beginning in January. And we'll have websites where you can get them delivered to your home. This will happen over a new website where Americans can go on this website and ask for tests to be sent to them and the tests will be sent. Although I have to add, Michael, that it was a little scant on the details. Got it. And what is the logic of sending 500 million tests to Americans at home?

I think the logic is twofold. to Americans at home? I think the logic is twofold. First, we want tests because we have new therapies, new antiviral pills coming online. And if they're going to work, they need to be administered early on. So you want tests so that people can know whether or not they're sick,

if they're experiencing symptoms. Right, because then they can actually get these pills that might, in many cases, make their experience of COVID much milder, or in some cases, save their lives. That's right. But the second reason we want tests is so that we can all go about our daily lives, so that we can continue to go to work and to school, so that people can gather and feel comfortable about gathering, especially because we know that this Omicron variant can infect people who are vaccinated, but it often causes only mild or no symptoms, which means that you could be carrying it and passing it on to other

people, vulnerable people like the elderly or the immunosuppressed without even knowing it. So if you were going to be in the company of such people, let's say you were going to go visit with a cancer patient, you would want to take a test first just to assure yourself that you weren't bringing in a deadly disease. Cheryl, you said that the details for distributing these 500 million at-home tests were scant? Yes. Are these going to come by mail? Who's going to be eligible? How many could each person, family get?

I think the answer to who's going to be eligible is everybody's eligible. Okay. But we don't know how these tests are going to be sent and whether there will be limits on how many you can order at one time. be limits on how many you can order at one time, and also whether there will be any priorities for how they're used. Right. From what you said earlier, that's basically a month's supply of testing in the U.S. Yes, and that is if these 500 million all come online in one month. And experts say that's actually unlikely. I just got off the phone with Dr. Michael Mina, who is a former professor of public health at Harvard, and he now works for an eMed, which is a company that distributes coronavirus tests. And he has been calling for two years

for the government to ramp up testing. And he said he expects that these 500 million tests will roll out over a period of months and will not be available all at once. Hmm. So does he think it will make much of a dent in the testing shortage? He and other experts I've talked to think that it's a good start, but it's inadequate.

Okay. So what else did the president say in his speech about testing? Starting this week, the federal government will set up emergency testing sites in areas that need additional testing capacity. Well, he said that he's going to open up some new testing sites. Before Christmas, the first several of these federal testing sites will be up and running in New York City, with many more to come. And that will start right away in New York City, where there will be several new federally run testing sites, and they expect to scale that up

in other places, although we don't know how many places and how many sites. This free testing is going to help reduce the waiting lines, the time you have to stand there, and sometimes it's an hour or more. So in addition to making it easier to test yourself at home, he wants to make it easier for people to go and get tested. So these would be large-scale, presumably, federally-funded testing sites? I think we can say these would be federally-funded testing sites. I don't know if they'll be large-scale or small-scale or what scale. Hmm. I'm sensing a theme here of not that many details.

Yeah, I'm feeling like there are a lot of things that I would like to know, a lot of questions that I would like answered that I don't yet have answers to. In addition, I've directed the Pentagon to mobilize an additional 1,000 troops to be deployed to help staff local hospitals and expand capacity. I think the speech on Tuesday was a recognition that the administration needed to act and act more aggressively than they have. You also saw him say that 1,000 military personnel would be at the ready to go to hospitals to keep them from getting overwhelmed. I've ordered FEMA, the Federal Emergency Management Agency, to stand up new pop-up vaccination clinics.

There would be vaccinators sent out. They are going to send ventilators across the country to states. They're going to open up new pop-up vaccine clinics and take other steps to make sure that the nation can withstand this surge. Does this plan, Cheryl, feel up to the task, given especially where COVID testing is in the U.S. right now? So that's a good question, but I think we need to talk about what the task is. And this plan and no plan can stop the spread of this virus. So the task is really to slow the spread and to use testing to prevent the most vulnerable people from getting sick and to prevent hospitals from getting overwhelmed. May God bless you all and may God protect our troops and happy holidays. God love you all. Thank you. And after the speech, the president faced some pretty tough questions

from reporters who asked, is this a failure of your administration? Should you have acted sooner? Mr. President, what's your message to Americans who are trying to get tested now and who are not Is this a failure of your administration? Should you have acted sooner? What's your message to Americans who are trying to get tested now and who are not able to get tested and who are wondering what took so long to ramp up testing? Come on, what took so long? I'm hearing that from people who are. And he got a little testy about it. What happened was the Omicron virus spread even more rapidly than anybody thought. If I had told you... And said, no, it wasn't a failure, that they couldn't have seen Omicron coming. What did you make of that exchange? Well, it echoed what his vice president, Kamala Harris, said recently.

But his answer flies in the face of what experts say, which is that we could have and should have seen it coming. Thank you. I'm shocked, Cheryl, that the Biden plan here definitely feels like it's borrowing from what Europe has been doing, especially in subsidizing home testing for COVID. But when we think about what's going on in Europe, they're doing lots of testing. And that doesn't seem to be altering the course of the pandemic all that much or improving it. And I know you said that at this point, really trying to contain the virus might not be a reasonable ambition. But that does raise the question of whether improving testing really does improve much of anything when it comes to this pandemic.

Well, to that, I would say we don't know what we don't know. In other words, we don't know how much worse it would be if we had no testing at all. This is a very, very infectious variant. So I suppose you could say Europe is overrun. It's giving us a lesson that the tests don't work at curbing the spread. But I don't think that's a reason not to try. Right. And I think I can speak for many of the 65 or so people in line in Brooklyn this morning in 31 degree weather and say that they would have loved to have had an at-home COVID test, a reliable COVID test, rather than waiting three, four, maybe five hours in that freezing cold for a test.

Right. I think part of this is about the nation's psyche and enabling people to go about living their daily lives. You know, the pandemic has taken away a lot of agency, especially now. It's left people feeling like things are out of control. And these tests can give people some peace of mind. And they also might save some lives. Well, Cheryl, thank you very much. We appreciate it. Thank you, Michael, as always.

On Tuesday, just as President Biden was announcing plans for a federal testing center in New York City, New York City officials said that they would open 23 new testing sites of their own by the end of the week to meet the surging demand. But there were new signs that the United States was still struggling to produce and conduct enough tests. Walgreens, the country's second largest pharmacy chain, said that due to unprecedented sales, it was imposing a limit on the purchase of at-home tests of four per customer. We'll be right back. We'll be right back. Here's what else you need to know today. On Tuesday, health officials said that an unvaccinated man in Texas who died this week of COVID-19 had the Omicron strain of the virus,

making him the first person in the country whose death has been publicly attributed to the variant. Local officials blamed the man's death on underlying health conditions and his decision not to be vaccinated. The county where he lived, Harris County, is now averaging more than 2,000 new infections a day, five times the average from two weeks ago. And in response to the Omicron variant, day, five times the average from two weeks ago. And in response to the Omicron variant, several European countries, including Germany, Portugal, Scotland and Sweden, are ordering tighter restrictions on gatherings.

Sweden's new rules include a cap of 50 people for private gatherings and instructions that most people should work from home. Meanwhile, Portugal said it would shut down all nightclubs and make a negative test result required to enter establishments like theaters and sports venues. Today's episode was produced by Michael Simon Johnson, Robert Jimison, Daniel Guimet, and Austin Mitchell, with help from Paige Cowett, Sydney Harper, and Alexandra Lee Young.

It was edited by Dave Shaw, contains original music by Dan Powell, and was engineered by Chris Wood. Our theme music is by Jim Brunberg and Ben Landsberg of Wonderly. That's it for The Daily. I'm Michael Barbaro. See you tomorrow.