At-Home COVID-19 Test
A resident displays an at-home rapid COVID-19 test kit in Philadelphia, Monday, Dec. 20, 2021. (AP Photo/Matt Rourke)

At a White House press briefing on December 11, a reporter asked President Joe Biden’s press secretary, Jen Psaki, why the U.S. has failed to provide free COVID-19 tests to the public. Evidently irritated, Psaki shot back, “Should we just send one to every American?” Well, yes, as a matter of fact, they should.

Psaki’s comment was widely critiqued as glib and out of touch; in the week and a half since, the White House has pivoted its emphasis—first, to offer 50 million free teststo uninsured Americans, and now, as of Tuesday, to make 500 million free tests availableto all Americans beginning in January. As Biden acknowledged in his Tuesday press conference, we are not where we need to be with national capacity for testing; this policy will be a step in the right direction. But it’s not the same as ensuring that every American has access to free COVID tests.

While Americans will be able to request a free rapid test from a website to be unveiled in the New Year, this will still delay access to a primary tool for preventing transmission—as individuals are likely to request tests when they are already experiencing symptoms. Though it’s admirable to commit federal resources to providing such a large number of free tests, pinning this policy on consumer desire is risky. Instead of building a loophole into our national program for expanded testing, the administration should follow through by mailing tests to all Americans.

The plan to commit private insurance companies to reimburse test purchases is also a consumer-oriented program that falls short of the kind of universal provision that would ensure better protection against the new Omicron variant. Five hundred million tests will provide fewer than two free tests per American; for further testing, individuals with private insurance will have to pay for tests out of pocket and request reimbursement when the new policy goes into effect next year. Here, cost and inconvenience make this policy effectively a half measure. It’s an idea that seems dreamed up by policy makers who have never spent time on the phone with an insurance company.

Rather, the Biden administration should adopt a new policy: It should supply at-home COVID tests to all U.S. households, as well as providing high-quality masks at no cost. The logistics and execution of a program to test at mass scale might seem daunting, but something similar has already been achieved in the national plan to develop and distribute COVID vaccines, which benefited from significant investments of federal funds under Operation Warp Speed. By comparison, the development, approval, and production of rapid tests have been neglected.

If the administration will rely on the business community to provide the hundreds of millions of tests necessary to control the pandemic, a piecemeal approach to testing production and distribution is insufficient. As we ratchet up our capacity for rapid at-home testing, we need to think big. We need an Operation Warp Speed for testing, as Michael Mina and Steven Phillips wrote in Time—well before the appearance of the Omicron variant. Meanwhile, individual American families should not be asked to assume the costs of tests and masks up front or have to hunt for scarce tests—now in short supply in many parts of the U.S.

Another problem with the Biden administration’s pandemic response is its overreliance on vaccination. While it’s imperative to get everyone eligible vaccinated, vaccine acceptance rates have barely increased over recent weeks. The administration has rightly continued to promote vaccination—but it could amplify the benefits of vaccines by also pressing for paid sick leave, improved ventilation, and expanded masking mandates.

Other nations have established programs to make tests inexpensive and widely available. After cases dropped in Germany, the country halted its free testing programs, but during its latest surge in cases, it has resumed its free testing programs and reinstated policies mandating either vaccination or negative test results to participate in public activities. The United Kingdom provides free rapid tests to citizens through the mail.

Some states in America have implemented similar programs. Colorado, for instance, established a program in September to provide free COVID tests upon request. As Erica Wilkinson recently argued in Slate, the federal government could—and should—follow suit. Since the emergence of Omicron, it would be even better to send tests without waiting for the public to request them.

These recommendations are not radical. Biden entered office this year with promises to develop a comprehensive federal public health strategy. His administration’s own policy regarding future pandemic preparedness emphasizes the importance of having “simple, inexpensive, high-performance diagnostic tests available at large scale.”

The administration needs to send test kits and masks to every American household. While some state officials have resisted this approach with weak excuses— “It’s not like delivering pizza,” one governor claimed—mailing masks and test kits is not rocket science. It will save lives. And compared to the costs of an ongoing pandemic, it will cost pennies on the dollar.

Martha Lincoln

Follow Martha @heavyredaction

Martha Lincoln is assistant professor of anthropology at San Francisco State University.

Harris Solomon

Follow Harris on Twitter: @harrissolomon. Harris Solomon is the Fred W. Shaffer Associate Professor of Cultural Anthropology and Global Health at Duke University.