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Where vaccination rates are low, experts look to at-home tests to help prevent COVID spread

Francesca Chambers, McClatchy Washington Bureau on

Published in News & Features

WASHINGTON — A steep drop off in coronavirus testing nationally has the Biden administration worried that the spread of COVID-19 may be worse in some areas than it appears.

As the population of vaccinated Americans has grown, COVID-19 testing has declined. Experts are concerned the reduced testing may be masking pockets of infection that, if left unchecked, could result in greater coronavirus spread.

“One of my worries is that we are not testing enough in areas where vaccination rates are low,” Surgeon General Vivek Murthy told McClatchy. “So we may even have a larger number of cases than what we’re actually seeing recorded. And so we’ve got to test more aggressively so we can understand where the infection is.”

Health officials maintain that vaccines are the best line of defense against the virus. But with infections creeping up in some parts of the country, medical professionals are also emphasizing the continued need for COVID-19 testing.

With the closing of mass testing sites set up earlier in the pandemic, experts say state and federal officials must think creatively about ways to make it easier for individuals to test themselves.

They are especially concerned about unvaccinated individuals who have the disease but are not showing symptoms of the illness and unknowingly spread it to others. Vaccinated individuals, who are less likely to contract COVID-19, are also not being tested enough, they say.

“You get some benefit from getting a vaccination that you don’t have to test as often. I think what the challenge is, it doesn’t mean never testing. And a lot of people have taken that to an extreme and are not testing at all,” said Mara Aspinall, a professor at Arizona State University and an adviser to the Rockefeller Foundation.

Distribution of at-home tests, which some states have already opted to provide to their residents at no cost, could help, experts say.

“Big testing sites are OK, but I think if you give home tests to people who are in areas of outbreaks, I think that would be a significant benefit. Not equal to vaccination, but you know it’s a significant component,” said Brett Giroir, who was the Trump administration’s testing czar.

National Institutes of Health Director Francis Collins also pointed to over-the-counter tests as a useful tool for helping to diagnose coronavirus cases in the unvaccinated.

“That’s one of the weapons we’ve got here in this war against this virus to try and keep it from getting worse,” he said in a McClatchy interview.

The U.S. government has experimented with self-testing as a way to reduce COVID-19 spread, including a program the Centers for Disease Control and Prevention launched with the NIH in March that provided residents of two counties, one in North Carolina and one in Tennessee, free access to rapid antigen tests for a month.

Although the government typically has less visibility into the results of at-home tests, and the responsibility largely rests with individuals with positive results to make the decision to quarantine, health experts say they are important to preventing the spread of COVID-19.

“I think it’s a very good investment … to get tests in people’s hands, so there are no impediments to getting that information,” Aspinall said.

A Health and Human Services Department spokesperson emphasized the importance of vaccines and testing for the unvaccinated in a statement. “That is why the Administration has invested in expanding access to testing and taken policy actions to make it easier to access testing including through at-home testing.”



Testing nationwide sharply decreased in June, falling by 29.4% from the prior month, according to data compiled by the Deloitte COVID Testing Coordination Center, which tracks PCR tests and was provided to McClatchy by the Rockefeller Foundation. The company’s data and CDC reporting showed that testing continued to decline nationwide in July, though it has recently increased in certain states.

Coronavirus cases are climbing in some parts of the country, despite widespread availability of COVID-19 vaccines. According to the latest federal data, Arkansas, Florida and Missouri have the highest rate of COVID-19 infections nationally as a percentage of population.

At least a dozen states are finding that tests are coming back positive 10% of the time or more, state and federal data show, putting them in a range that medical experts said is concerning.

Former Surgeon General Jerome Adams, who served in the Trump administration, said more testing is urgently needed to find out if the number of positive individuals is actually higher.

Adams said screenings could be conducted at doctors offices, hospitals, community and health clinics, in addition to schools.

“It can’t be wait for people to self prevent, it has got to be, hey we’re going to test one out of every 1,000 people who walk through this door, or who come into this institution,” he said, “and that will give us a good idea as to what percentage of them are testing positive for COVID and what percentage of those who test positive are carrying which variant.”

Multiple companies are now producing FDA-approved, self-administered tests that can be purchased commercially for about $20 for a two-test package and can produce results within minutes.

Some states are also providing at-home tests to their residents free of cost.

The Iowa Department of Health announced plans this month to close its drive-through testing centers in favor of free access for the state’s residents to self-administered tests. Iowans can either pick up a test at an authorized location or have one sent to them, submit the test through UPS and receive their results by email.

Missouri residents can also have tests sent to them for free. Those tests must be submitted through a FedEx site, and the state promises results within two days by email.

County public health departments, Federally Qualified Health Centers and schools could also play a pivotal role in dispensing self-administered tests to families who can’t afford to buy the tests, experts said.

Giroir said the Biden administration should “flood the zone with home tests” to areas where COVID-19 cases are increasing and hand out tests while encouraging people to get vaccinated.

“If they’re going door-to-door about vaccination, they should be dropping off tests to all the places that they’re going,” Giroir said.


(McClatchy White House correspondent Bryan Lowry contributed reporting.)

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