The nation’s response to the pandemic has taken on a new phase, as mask mandates and social distancing give way to home-based testing and outpatient treatments. That’s why it’s essential the Biden administration get its new “test-to-treat” program up to speed. With new infections rising in Florida and nationally, the program is vital for helping a fatigued nation manage this ongoing outbreak.
The program, announced in March, is meant to control COVID-19 hospitalizations and deaths by providing antiviral pills on the spot to people who test positive for the virus. It’s another step in the government’s evolution of making individuals more involved in the nation’s response. As a recent report by Kaiser Health News explains, Pfizer’s Paxlovid and Merck’s Lagevrio are both designed to be started within five days of symptoms appearing. Millions of chronically ill and older Americans are eligible, and more people may qualify soon, but many Americans don’t have access to the program. It’s ridiculous that cost and bureaucratic hurdles are still undermining this public health effort more than two years after COVID-19 exploded on the scene.
As envisioned, the program allows people with COVID-19 symptoms to get tested, be prescribed antiviral pills and fill the prescription in a single visit. The federal government and many state and local health departments direct residents to an online national map of test-to-treat sites. But as of two weeks ago, large swaths of the country had no test-to-treat pharmacies or health centers listed, according to a Kaiser survey. The program’s largest participant, CVS, had technical issues that made booking an appointment difficult. The roll out has exposed America’s fragmented public health system, where the federal, state and local governments all play a role. And it shows how high, upfront costs are barriers to keeping people healthy and hospitals operating as normal.
The federal government has set aside nearly 400,000 courses of the antivirals for its federal pharmacy partners — about a quarter of the total supply since the program began, according to Kaiser. Although the cost of the pills is covered by the federal government, obtaining a prescription at participating pharmacies can be expensive, upwards of $100 for exam appointments. Kaiser also found that finding treatment might be impossible. While CVS said it is working to fix a software glitch affecting in-person appointments, some Americans, especially seniors, may lack the equipment or skills for telehealth visits. And many rural communities that lack doctors, clinics and pharmacies are underserved, forcing people to drive long distances for hours to participate.
This is unacceptable. The nation is rightly moving away from top-down restrictions on masks and movement. In-home tests and treatments are more widely available, reflecting how far America has come in its public health response. But a nimbler strategy depends on execution. With cases in Florida nearly doubling over the last two weeks, and new infections nationwide up 51%, the “test-to-treat” program is critical to curbing the spread and an unmanageable spike in hospitalizations.
The administration needs to commit enough resources to enroll more providers and to make the application process more reliable and convenient. Putting treatments directly into the hands of those infected with COVID-19 is smart strategy, and early intervention could spare some Americans from longer-term health complications. But the federal government needs to get this right, and then use the program to its full potential.
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