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You are here: Home / Anderson On Health Insurance / Over the counter testing is available now

Over the counter testing is available now

by David Anderson|  April 20, 20217:59 am| 50 Comments

This post is in: Anderson On Health Insurance, COVID-19 Coronavirus

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Very good news in addition to the very good vaccination eligibility news:

 

Consumers will be able to buy rapid coronavirus tests without a prescription this week at three national chain retailers. https://t.co/Cz6AEASsWz

— USA TODAY Health (@USATODAYhealth) April 20, 2021


 

These tests are now available over the counter (OTC) without a prescription and can be performed by any adult. OTC tests promise a rapid and actionable result within fifteen minutes.

Rapid OTC testing is going to be part of the tool kit of getting back to normal-ish in conjunction with vaccinations, improved ventilation, masking and other public health measures. These tests are sensitive enough to pick up people when they are likely infectious to other folks and they are quick enough that a positive test can put someone into isolation for ten or more days and break any subsequent counterfactual chains of transmission before they can get started. These tests are good enough to find non-symptomatic spreaders. I could see a use case where a school district issues each kid a pair of tests per week and uses that to clear the school building with testing on Monday morning and Wednesday morning before the kids arrive.

There are downsides to these tests. The first is that they are not as specific as PCR tests. This is fine. The repeated (‘serial’) nature of the test works as a guard against a false positive. The second big challenge is that these tests are not cheap. A pair of tests goes at retail for $20 to $40. As a one-off expense, this is plausible for many families but as a weekly expense for multiple people in a household, it gets expensive real fast. We’re in a different world if there are rapid, good enough tests that cost $1 per use compared to the current world of $10-20 per use tests. At $1 per use, the school screening strategy I mentioned above is readily plausible for an entire academic year.

Right now, we have a lot of things that are coming together in testing, vaccination and better weather for outdoor activity that should continue to allow us to get the pandemic outbreaks under control. Now we just need to grind forward for a few more weeks and get case counts real low.

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50Comments

  1. 1.

    rikyrah

    April 20, 2021 at 8:07 am

    Sounds good ????

  2. 2.

    John S.

    April 20, 2021 at 8:21 am

    Would it be correct to assume that these tests qualify for HSA spending?

  3. 3.

    David Anderson

    April 20, 2021 at 8:24 am

    @John S.: I don’t know enough to give you an answer to that excellent question.

  4. 4.

    Soprano2

    April 20, 2021 at 8:30 am

    That looks exactly like the one they did on us at choir about a month or so ago. It was super-easy to do and to read. Sure wish we’d had these last fall.

  5. 5.

    wvng

    April 20, 2021 at 8:32 am

    I was at the farm store yesterday, asked a worker there if she had been vaccinated. She has, she and her entire family have taken this seriously from the beginning, always masked – but most workers in the store refused to ever wear masks, and only two have been vaccinated. One tells her he is afraid the vaccine will make him sterile. Thus the great mass of younger conservatives will ensure we don’t get over this epidemic; they will keep virus in circulation, mutating.

    Regarding the woman who masks, her family just had a birthday party for her 100 year old father, with masked well wishers driving past him to give thanks and gifts then moving on.

  6. 6.

    Matt McIrvin

    April 20, 2021 at 8:41 am

    @wvng:  Depending on how long immunity from the vaccine lasts, school vaccination mandates could help a lot here, though of course there may be political barriers to that. But we have pretty good coverage for many childhood vaccinations.

  7. 7.

    What Have the Romans Ever Done for Us?

    April 20, 2021 at 8:42 am

    @wvng:  There’s some evidence that getting actual Covid causes sterility in men…they don’t know whether it’s permanent or just temporary at this point but if he’s going to go sterile either way, might as well choose the route that eliminates the risk of lung failure.

  8. 8.

    wvng

    April 20, 2021 at 8:47 am

    @What Have the Romans Ever Done for Us?: One would think, but clearly his preferred media would never tell him this.  And given that it is Democrats who are really pushing the vaccine drive, I mean what have Democrats ever done for us? :-)

  9. 9.

    Matt McIrvin

    April 20, 2021 at 8:50 am

    Remember when the stereotype was that antivax was the “liberal” type of anti-science idiocy, and it was the whataboutery that conservatives always jumped for when people complained about conservatives rejecting science?

    (The stereotype was never really true, incidentally–there were definitely liberal antivaxxers but the distribution was pretty nonpartisan.)

  10. 10.

    Fair Economist

    April 20, 2021 at 8:56 am

    Six months ago easily available rapid testing might have been a game-changer. With everybody eligible for a vaccine, though, I don’t think it makes much difference. Anybody who gets vaccinated reduces their chance of serious problems from COVID to the point that semi-regular testing isn’t really worth the cost and hassle, so it’s not going to get done.

  11. 11.

    Rocks

    April 20, 2021 at 9:05 am

    @Fair Economist:  Actually, I’m on the reopening committee for our church. We have a small contingent that has drunk the Kool Aid and adamantly refused to get vaccinated. A rapid test might help us protect the rest of the congregation from these deluded fools.

  12. 12.

    mali muso

    April 20, 2021 at 9:05 am

    @Fair Economist: This might be useful in the under age 16 space though, as the vaccines have not yet been approved for use in that population. My kiddo is 4, and while both her dad and I are vaccinated, she could still pick up COVID. I’m aware that the risks to her health are pretty low, but I’d hate for her to be a carrier that spread it if it could be avoided.

  13. 13.

    Skepticat

    April 20, 2021 at 9:05 am

    @wvng: 

    One tells her he is afraid the vaccine will make him sterile.

    @What Have the Romans Ever Done for Us?: @wvng:

    There’s some evidence that getting actual Covid causes sterility in men…

    Although I haven’t heard about the potential for sterility, I’ve read that it can cause erectile dysfunction. Given that worker’s mind-set, it would be good to see him unable to reproduce.
    As for the test, I suppose better late than never, and I fear we’ll need them for quite a while.

  14. 14.

    taumaturgo

    April 20, 2021 at 9:06 am

    From the Daily Stoic:

    The Stoic focuses on where they can make a difference, where their efforts register. Why beat your head against the wall trying to convert everybody when there is plenty of somebody—the elderly, the technologically challenged, the disabled—who wants a vaccine but need help getting one? Here’s a young woman who helped 600 people get their vaccines in Texas. Here are two other women who did the same. Less newsworthy are the countless people who drove their parents, who gave their employees paid time off, who texted a friend, who showed their neighbor.
    Did they convince the recalcitrant? Did they persuade the selfish to not be selfish? No—not yet anyway—because in the meantime there are plenty of willing people you can make a difference for. A Stoic doesn’t need to get everyone on board—with Stoicism, with the four virtues, with anything, really. We focus instead on those who want to be reached. We focus on helping as many people as we can…instead of despairing that we can’t reach everyone.
    After all, herd immunity doesn’t require 100% participation—whether it’s against a virus, a panic, or plain old ignorance. It just requires enough. And luckily, we’re almost there.

    https://www.nbcnews.com/news/latino/latina-volunteer-texas-helped-600-people-get-vaccines-rcna566

  15. 15.

    dr. bloor

    April 20, 2021 at 9:36 am

    As a one-off expense, this is plausible for many families but as a weekly expense for multiple people in a household, it gets expensive real fast.

    Yep.  The price point essentially rules out the vast majority of front-line retail employees, who are probably at greater risk than most.

  16. 16.

    Enhanced Voting Techniques

    April 20, 2021 at 9:47 am

    Well had to go threw three different orgs but finally got an appointment for the 1st shot this Thursday.

  17. 17.

    Enhanced Voting Techniques

    April 20, 2021 at 9:49 am

    @dr. bloor: In a sane world these people would be vaccinated and the employer would doing the test to keep the entire staff from getting ill at once.

    Up tell now it’s been taking your temperature when you go into work for a fever.  Turns out I am legally dead most days of the week.

  18. 18.

    The Moar You Know

    April 20, 2021 at 9:50 am

    . I could see a use case where a school district issues each kid a pair of tests per week and uses that to clear the school building with testing on Monday morning and Wednesday morning before the kids arrive.

    Our local district will not test kids even if symptomatic.   So, nice idea, not going to happen in real life.

  19. 19.

    Another Scott

    April 20, 2021 at 9:59 am

    @Fair Economist: At best it takes 3-5 weeks to go from vulnerable to fully vaccinated.  Yes, the test is too expensive for much use at home, but it’s not worthless.  Just waiting for everyone to get vaccinated will drag out the pandemic.  We need to do everything else we can while getting people vaccinated.

    Schools and businesses could use it for their employees and students.  IIRC, many residential colleges have been doing frequent testing of their students for months.

    If Target or Amazon bought a few million copies for their employees, it would help drive the price down for people who want/need home testing (e.g. home health aids).

    Work on using fitness trackers to detect disease early is also going on and should be accelerated.  There’s no continuing cost once people have them, and they can be used for more than just COVID.

    “Johnny can’t go to school today, his Fitbit says he’s caught something.”

    Cheers,
    Scott.

  20. 20.

    narya

    April 20, 2021 at 10:00 am

    FQHCs are getting FREE rapid tests from the federal government–we’re ordering them this week. Folks may be able to utilize that route by the end of April.

  21. 21.

    TheOtherHank

    April 20, 2021 at 10:21 am

    @Enhanced Voting Techniques: I swim on a masters swim team that practices at an outdoor pool. We have been swimming, with approved safety protocols, since July. One of the things we do is have our temperature taken before we can walk onto the pool deck. According to the little infrared pistol thermometer I am suffering from severe hypothermia every day.

  22. 22.

    TheOtherHank

    April 20, 2021 at 10:26 am

    @Another Scott: ​
      My son is currently living a monastic lifestyle in the dorms at CalPoly SLO. Part of that includes being tested twice a week. Failure to keep up on one’s testing causes one to be locked out of being able to attend the virtual lectures and in-person labs. They recently switched over to saliva tests, so he doesn’t have to stick q-tips up his own nose anymore.

  23. 23.

    Steeplejack (phone)

    April 20, 2021 at 10:27 am

    @TheOtherHank:

    Are you a sea lion?

  24. 24.

    Steeplejack (phone)

    April 20, 2021 at 10:30 am

    Just got my second Pfizer shot at the Inova facility in Alexandria, VA. The line was long but moved quickly. My shot-giver said they would do about 4,300 people today—”a slow day.”

  25. 25.

    Another Scott

    April 20, 2021 at 10:33 am

    @Steeplejack (phone): Excellent.  Let us know what flavor of antlers you get.

    Cheers,
    Scott.

  26. 26.

    Matt McIrvin

    April 20, 2021 at 10:36 am

    @taumaturgo: The problem I see there is that resistance isn’t uniformly geographically distributed. It’s not as if 80% of people everywhere will get vaccinated–there will be places where it’s almost nobody, and the infection is just going to have to burn through.

  27. 27.

    TheOtherHank

    April 20, 2021 at 10:36 am

    @Steeplejack (phone): My kids were. But I’m a Coastside Tigershark.

  28. 28.

    gvg

    April 20, 2021 at 10:39 am

    @Fair Economist: I think It may be useful in the after times when people sometimes forget to get a booster. I think Covid can only be reduced to something like flu where it comes around for some people every year or so but not getting massive waves and probably not killing as many. so we will need to keep testing and make it easy.

    By a test or do, stick it in a cabinet till you need it kind of thing.

    Right now my employer has free weekly testing this whole past year, but when things go back down to a new normal, I am sure that will stop. So we almost all get vaccinated and get boosters when recommended but after a few years get lazy and there is a new smaller Covid season…that is when you want home tests.

  29. 29.

    Hoodie

    April 20, 2021 at 10:39 am

    @Another Scott: This could also be a way of nudging the vaccine hesitant.  Right now, while the vaccines are still operating under an EUA, you can’t require an employee to get vaccinated.  However, you’re probably on solid ground requiring regular testing.  If you have a vaccine hesitant employee, the testing requirement may signal to them that they’re being a pain in the ass and help convince them to go ahead and get vaccinated.

  30. 30.

    Soprano2

    April 20, 2021 at 10:43 am

    @Matt McIrvin:  This is the next thing I think it will be hard for people to accept; the pandemic is going to be over in some places much faster than others due to the uneven distribution of vaccine resistance. I’m praying that we reach the 50% mark of people vaccinated in my city. We’re at 28.01% right now. I tell everyone I know that if they don’t like the mask mandate, GET VACCINATED because that’s how we get rid of it!

  31. 31.

    Roger Moore

    April 20, 2021 at 10:46 am

    @Enhanced Voting Techniques:

    Up tell now it’s been taking your temperature when you go into work for a fever.

    My employer has stopped doing the fever checks because the best evidence says they’re useless.  By the time you’re sick enough to have a fever, you’ll have other symptoms, too.

  32. 32.

    Steeplejack (phone)

    April 20, 2021 at 10:48 am

    @Another Scott:

    I told my shot-giver about my appointment problems and was referred to a “registration person.” I told her the whole story about no e-mail notice and problems with the appointment mechanism not working on the Inova website. She thanked me and said they had heard some stuff and the IT people are working on it—soothing boilerplate. I’m sure I coded as “computer-illiterate geezer.” I did restrain myself from saying “I worked in software for 25 years!,” which would have definitely pegged me as a nutter.

    General notes: My shot-giver, an R.N., said to use my arm today, keep it active, and said that I could take Tylenol, Aleve or whatever pain med I usually take. She said I might feel tired tomorrow and need a nap, which fits my current lifestyle perfectly.

  33. 33.

    Enhanced Voting Techniques

    April 20, 2021 at 10:56 am

    @Roger Moore: True, but workalcoholics won’t admit to those symptoms.

  34. 34.

    Matt McIrvin

    April 20, 2021 at 11:00 am

    @Soprano2: I do think the situation with seniors is encouraging– resistance among over-65s has melted away in most places. Of course, they’re the people most likely to interact with the conventional health-care system a lot. The hardest nuts to crack will be younger people who never go to the doctor and think they’re immortal, and have heard they won’t die from COVID in any event.

  35. 35.

    Soprano2

    April 20, 2021 at 11:06 am

    @Matt McIrvin: I know, I work with a few of those, and one of my nephew-in-laws is one. I’m hoping that in a few months they’ll just quietly get vaccinated when it’s not such a big deal. And yes, I’m hopeful that the death rate will go way down since the vast majority of the most vulnerable are protected now. We are going to have to learn to live with Covid, I hope people are prepared for that.

  36. 36.

    Matt McIrvin

    April 20, 2021 at 11:09 am

    @Soprano2: One thing we don’t know yet is how long resistance from the mRNA vaccines lasts. Doctors have been very cautious and talking about yearly boosters, but there’s an off chance that you might retain some elevated resistance for years–and if that’s so, then just requiring COVID vaccination in high schools and colleges, once there’s full FDA approval, will do a lot of the work of slowing this down among the young. There’s really no good reason to be more hesitant about this than with other vaccinations.

  37. 37.

    WaterGirl

    April 20, 2021 at 11:36 am

    @narya:

    FQHCs?

  38. 38.

    Steeplejack (phone)

    April 20, 2021 at 11:40 am

    @WaterGirl:

    “Federally qualified health center,” I believe.

  39. 39.

    Alex

    April 20, 2021 at 11:41 am

    @mali muso:  Yes, I think this would still be really helpful for kids given that Michigan has more than 300 active school outbreaks (not counting day care or sports). But does anyone know if they are approved for use for all ages?

  40. 40.

    Soprano2

    April 20, 2021 at 11:42 am

    @Matt McIrvin: I heard an interview with Dr. Hoetep a couple of weeks ago. He said he thinks that the two shot vaccines might need one more booster, and the one shot might need two, but he thinks there’s a good chance that after that we’ll be done. I sure do hope he’s right, and that it doesn’t turn into something like the yearly flu shot.

  41. 41.

    Soprano2

    April 20, 2021 at 11:44 am

    @Alex: I don’t know why they wouldn’t be approved for use by everyone; you put a solution in the little “book”, then you swab your nose and put it in the little book to get the result.

  42. 42.

    Fair Economist

    April 20, 2021 at 11:58 am

    @Skepticat: There has been work showing SARS2 can infect and damage testicular cells. So sterility is *possible* although there’s not any direct data yet. I’d guess it would happen but be very rare but who knows.

  43. 43.

    WaterGirl

    April 20, 2021 at 12:05 pm

    @Steeplejack (phone): Thank you!  I had guessed at the Health Center part, but I could not get the FQ part at all.

  44. 44.

    Another Scott

    April 20, 2021 at 12:06 pm

    @Soprano2: I can’t find a link now, but my understanding is that the J&J adenovirus-based vaccine is one shot because of the way it works.  The body will attack the incoming virus framework from second injection before it can enter cells to do its job, rendering it useless.  So, if J&J needs a booster later it’s not clear to me how it would work.  (Though presumably if the virus framework is attacked, then the immunity is still present, at least to some degree.)  I’m sure the experts understand all this stuff and know what will need to be done.

    Cheers,
    Scott.

  45. 45.

    What Have the Romans Ever Done for Us?

    April 20, 2021 at 12:28 pm

    @Fair Economist: There’s some data already that it affects sperm count and quality, whether or not it’s actually infecting testicular cells.

  46. 46.

    way2blue

    April 20, 2021 at 12:29 pm

    We have several mobile testing sites in my SF Bay Area county (run by Curative) that were set up mainly to test grade school and high school students & staff weekly.  Now that we’ve reached Orange / Level 3 and schools have moved to hybrid teaching.  RT-PCR tests with ~2 day turnaround.  Free if the person resides in the county & doesn’t have health insurance, otherwise covered by their health insurance provider.

  47. 47.

    planetjanet

    April 20, 2021 at 12:48 pm

    How soon after exposure can the tests be taken?

  48. 48.

    Another Scott

    April 20, 2021 at 1:01 pm

    @planetjanet:

    FDA instructions (15 page .pdf):

    The BinaxNOW COVID-19 Ag Card is a lateral flow immunoassay for the qualitative detection of the nucleocapsid protein antigen to SARS-CoV-2 directly from anterior nasal (nares) swab specimens collected from individuals who are suspected of COVID-19 by their healthcare provider within seven days of the onset of symptoms.

    It doesn’t seem to say about any delay from onset of exposure.

    HTH a little.

    Cheers,
    Scott.

  49. 49.

    planetjanet

    April 20, 2021 at 1:19 pm

    @Another Scott:

    My concern is that waiting until onset of symptoms already leaves a long period that the person may be infectious and spreading the virus.  That will limit its usefulness in containment.

  50. 50.

    narya

    April 20, 2021 at 1:26 pm

    @WaterGirl: Sorry about that :-)

    Basically, they (we) provide health care without regard to anyone’s ability to pay, and in return we get a higher Medicaid reimbursement rate. (There’s more to it than that.) In 2019, FQHCs served about 30 million people. We are getting vaccine, tests, and masks, now that there are competent people in charge.

    It’s a wonderful program, and I’d be happy to share info about it if people need that.

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