PHILADELPHIA (KYW Newsradio) — Nearly two years into the coronavirus pandemic, testing is still a problem in the United States. It can be difficult to find at-home test kits and frustrating to find an appointment at a testing site.
Jennifer Kolker, from the Dornsife School of Public Health at Drexel University has some insight into why COVID-19 testing, as a matter of public health, has been so difficult to master in this country. She says the fault lies in the way the United States approaches health care generally, and she says there are some lessons to be learned.
"I think we never did really get it right," Kolker said. "You can argue we were taken by surprise at the beginning. And then there were a lot of missteps. … But the fact that we didn't learn from that and got ourselves so caught unaware this time is pretty embarrassing and pretty awful."
The gold standard is still the lab-based PCR test, she says. They are the most accurate, even in the early days of an infection, but patients must go somewhere to get them done, and they must wait for results. And what once took 24 to 48 hours has now slowed down considerably because of lab capacity.
Rapid tests, while imperfect, are still a very accurate indication if a patient is currently infected with COVID-19, but they are hard to find and they can be expensive.
Kolker says a focus on developing and distributing vaccines distracted public health officials from development a well-oiled, nationwide testing apparatus. Guidance from the Biden administration issued this week says that health insurance companies must cover the costs of at-home tests starting Saturday, but so far they have not figured out how to make that happen.
And besides that, she says, the American health care system is not designed in a way that would have allowed testing to become a regular "equitably based, egalitarian, open-access" part of everyday life.
"What we're seeing now, in many respects, is simply an extension of our existing health care system and our existing starving of our public health infrastructure," she said.
"We're doing everything the way we've always done it, which is really bad."
She says she remains hopeful, however, that the “gross inequities” of American health care, which have been revealed by the response to the coronavirus pandemic, are providing lessons that could lead to a more equitable system in the future.
It is also essential to close the gap between testing and treatment, she says.
"If we're going to develop these great treatments, which is sort of the next great thing – well, how do you get that?" she said. "If you find out that ... you've got COVID, what's the mechanism [for] saying to your doctor, 'I just tested positive. How do I get this new pill that can help keep me from getting very sick?'"