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Maine CDC director underscores importance of accessible rapid COVID testing


The omicron variant of COVID-19 has now been detected in at least a dozen American states, and officials are bracing for the new strain to spread further in the weeks ahead leading up to Christmas and to the New Year's holidays. So we want to begin today by taking a closer look at one key part of the COVID winter plan that President Biden just announced this week.

The plan continues to emphasize getting more Americans vaccinated and more Americans boosted, but it also does something new when it comes to testing. It aims to make at-home COVID test kits more easily accessible for Americans who have health insurance by requiring insurers to reimburse their cost. And the Biden administration also plans to make 50 million free tests available to uninsured Americans. That's a doubling of a previous commitment. So how important is testing at this point in the pandemic?

To learn more, we called upon Dr. Nirav Shah. He's director of Maine Center for Disease Control and Prevention, and he's also president of the Association of State and Territorial Health Officials. Dr. Shah, welcome to the show.

NIRAV SHAH: Thank you so much, David.

FOLKENFLIK: So first, I'd like to get your reaction to President Biden's plan to make COVID testing more easily accessible and more affordable for Americans.

SHAH: Well, at this point in the pandemic, as we look in the future of potentially seeing the omicron variant taking greater hold here in the United States, the focus on testing, in addition to the ongoing focus on vaccination in the Biden administration's plan, is critical. We're at an important juncture where we are right now in the pandemic. And for this next phase of managing COVID-19, rapid access to rapid testing will be important to make sure we can understand where we are in the pandemic as well as give people the tools and the wherewithal to stay safe before they, for example, go to events and such things. So the focus on testing is welcome, it's necessary and it should continue to be a cornerstone of our entire public health approach.

FOLKENFLIK: So quick clarification here, if you could - when I talk to parents of my kids' friends, I find they find the kind of testing sometimes a little bit confusing. There are PCR test. There are these rapid antigen tests. What are we talking about here?

SHAH: Well, the focus right now in the Biden administration's plan is on at-home tests, and generally speaking, those are the rapid antigen tests. As you noted, there are, in big-big-picture terms, two categories of tests that are out there. One are the PCR tests. These were the first tests that were largely on the market at the beginning of the pandemic and have been around for many years. PCR tests are renowned for their accuracy. They really are the gold standard in terms of figuring out what's going on. However, as folks may have known, they maybe take a day or two to come back and get a result. And in the midst of a pandemic, that may be a day or two too late. Antigen tests differ. They are smaller. They are quicker. You can keep them at home in a drawer or in your medicine cabinet. And what you gain in convenience, you sacrifice a bit in terms of the accuracy.

But that's OK because the concept of operations in using these rapid tests is a little bit different. They're meant to be used, ideally, in a serial manner. So if you're not feeling well, you can take them multiple times over the course of the week. And by having a rapid result, again, what you lose a bit in terms of accuracy, you actually gain much more because of the repeated, serial nature of using those tests. Again, for where we are in the pandemic, the central question that folks need to answer is, hey, is it safe for me to go to this birthday party? Is it safe for me to go to this event this weekend? And these rapid at-home tests afford you that.

FOLKENFLIK: We've heard that the Biden administration intends to distribute 50 million tests, at-home tests, for the uninsured to get. At the same time, there are 20 some million uninsured. It's just there's only, you know, two tests per person, give or take, who doesn't have health care insurance. Do these plans go far enough?

SHAH: I think I view them as a good start - plus, that approach coupled with the approach to make the tests more easily accessible for insured Americans. I view both of these as the first start in the broader process of blanketing the United States with tests in the same way that other countries have done. If we see the uptake being strong, then I would hope that the administration - and we would advocate on behalf of states - that the administration expand the purview of this approach to make sure that more lower-income or underinsured Americans can have steady, consistent access to these tests.

FOLKENFLIK: Do you see regional differences in how you expect this to be embraced, or do you think that this is something that Americans are hungry for more broadly?

SHAH: My view in talking to my counterparts across the different states has been that testing has been, first of all, a challenge uniformly but also that demand for testing has been strong. Testing never really took on the same talismanic or politically divisive nature that other types of mitigation steps in the pandemic did, be it masking or, more recently, vaccines. Testing was generally something that was thought to be important and usually embraced, and so as a result of that, across the country, between all the states and territories, we've heard that both that there are challenges in accessing tests - by states, for example - as well as uniform demand for them. We think that these moves to secure more tests as well as to make them easily accessible at the point of care where they're needed - we think that's a great step forward.

FOLKENFLIK: We've been listening to Dr. Nirav Shah. He's director of Maine Center for Disease Control and Prevention. He's also president of the Association of State and Territorial Health Officials. Dr. Shah, thank you for taking the time today to speak with us. We appreciate it.

SHAH: Thank you, David. Transcript provided by NPR, Copyright NPR.