Dec 21, 2021 - Health

America once again faces COVID test shortages

Illustration of a test tube surrounded by metal barriers.
Illustration: Aïda Amer/Axios

Americans are encountering a familiar problem as they scramble to safely gather for the holidays despite the spread of Omicron: They're struggling to find coronavirus tests.

Why it matters: Testing has always been key to slowing the spread of the virus. Given Omicron's transmissibility, accessible testing is more important than ever for life to go on without massive disruption.

Driving the news: President Biden will announce today that his administration is purchasing half a billion rapid tests this winter, the first shipment of which will arrive in January. Americans will be able to get tests delivered by mail to them for free via a federal website, also beginning in January.

  • The president will also announce that the federal government is setting up additional testing sites.
  • Some cities and states have also announced efforts to make tests more available.
  • New York Gov. Kathy Hochul said yesterday that the state had secured 10 million more tests, half of which will arrive before the new year. The District of Columbia is making free self-testing kits available for pickup.

State of play: Less than a week before Christmas, walk-up testing lines are hours long in cities across the country, pharmacies are running out of testing appointments and rapid at-home tests are frequently nowhere to be found.

  • The situation is exponentially better than it was in the spring of 2020, before rapid tests existed and when testing was generally limited to the sickest patients. There are currently well more than a million tests being reported to the CDC every day.
  • But our reliance on testing has grown dramatically as life has returned to some semblance of normal, with many workplaces and schools using them to stay open. Demand will only grow as more people are exposed to Omicron.

Between the lines: Omicron is expected to have a lower fatality rate than previous waves, thanks to the immunity provided by vaccines and prior infections that blunt Omicron infections' severity.

  • However, if left to rip through the U.S., it could still overwhelm hospitals due to how transmissible it is and how many people are still vulnerable to severe cases.

Yes, but: Exhausted Americans are desperate to avoid the costly measures they took in 2020 to avoid the virus, like foregoing family gatherings and remote learning. Experts say one way to avoid that problem is to test frequently, especially after potential exposure and ahead of gatherings.

  • This approach, by definition, does not work if tests aren't readily available or if results aren't reported in a timely manner.

What we're watching: The Omicron surge in the U.S. is just beginning, and outgoing NIH director Francis Collins warned that we could hit a million cases a day without appropriate mitigation strategies.

  • Frequent testing will be a crucial tool for preventing this kind of caseload.
  • But if we do hit a million cases a day, some experts are skeptical that we'll see that reflected in the data — because our testing system probably can't keep up with that many cases, and rapid test results often aren't reported.
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