It was the press briefing heard ’round the internet. A reporter asked Jen Psaki, the White House press secretary, if the United States would make rapid tests widely available for free or at reduced cost, as other countries have done. “Should we just send one to every American?” Psaki joked, smiling. “How much does that cost, and then what happens after that?” With cases rising and the new omicron variant cropping up in the U.S. ahead of the holidays, Psaki ridiculing the notion of free tests landed poorly.
She was right about one thing only: We shouldn’t send one free rapid test to every American. We should send dozens of free rapid tests to every American, and free, high-quality masks, too. Testing and masking are among the most important measures for blunting surges of the coronavirus; they should be so easy and accessible that people would feel weird not using them. The costs of continuing in this pandemic far outweigh the price of federally funded tests and masks (which, incidentally, will also be cheaper procured in bulk by the government than if purchased individually).
“The implications of the uncontrolled pandemic are bad for our entire society,” Dr. Julia Raifman, an assistant professor at the Boston University School of Public Health, told me. “Other countries are sending people free rapid tests and high-quality masks, and we should be doing that and then some.” Tests and masks are especially important for those with the highest risk of exposure, such as workers and schoolchildren in crowded indoor spaces. Tests can tell you when to stay away, and good masks help protect you and everyone around you.
Instead, the Biden administration’s new plan for rapid testing is allowing the 150 million people who have private insurance to submit claims to be reimbursed for buying tests, a cumbersome process that may never actually pay out. The U.S. government will also distribute 50 million free tests for everyone else at community centers with equally cumbersome processes. And understanding which masks are most effective, where to buy legitimate ones, and how to afford them remains a mystery for many of us.
“We’re not weighing the true costs and benefits,” Corinne Low, an assistant professor specializing in labor and development economics at the University of Pennsylvania’s Wharton School and a self-described “tired mom,” told me. The actual cost of producing the tests is low, she said. “What we’re paying in the drugstore is so disconnected from the true cost of production.” And more importantly: What are the costs of not doing it?
Beyond the moral costs—the loss of life, the searing inequities at home and abroad—there are immense and quantifiable economic costs to prolonging the pandemic. For children, there’s learning loss, potential mental health issues, and negative effects on their future careers. For adults, there’s lost productivity, stultified careers, medical bills, unsteady childcare, and the stress of rearranging everything constantly. Politicians might put all of this in terms of cost to gross domestic product—which the pandemic certainly hurts as well. But that undersells the true devastation of prolonging the pandemic.
“What would you pay as a 17-year-old to get to go live your life?” Low asked. “How much would we pay to not have the stress and anxiety and terror that we as parents have faced over the past couple of years?” What about time spent with grandparents and cousins and friends? What about caregivers—what would you pay not to lose a parent in childhood? “That’s not even a question that’s just completely abstract,” Low said. “We actually have papers in the literature that quantify the cost to families of losing parents and how disruptive that is, and how kids never recover on the same economic and educational paths that they were on before. The costs of being out of school, of losing parents, of family illness, are enormous.”
That is exactly what we have governments for—to prevent vast and wide-ranging losses like these. That’s especially true in a public health crisis, when someone else’s actions (or inaction) can have deadly consequences for friends and strangers. “Everybody who gets sick affects several other people—not just in terms of the spread of Covid, but also in terms of childcare needs and worker shortages and all kinds of societal disruption,” Raifman said. “And we have to come together to defeat it, and we need leadership on coming together with the most effective actions.”
Under the current system, we’re paying for all of this anyway—both the long-term costs and, if you’re privileged enough to be able to afford it, the more immediate expenses of drugstore testing kits and masks sourced from online retailers you’d never heard of before the pandemic. If you test your kid at home every week, for instance, that’s about $50 a month; if you buy high-quality masks, that’s another $30 or so each month per person.
“You say, ‘Oh, you should do rapid tests before you gather for Thanksgiving.’ Well, that’s not possible for everybody,” Low said. “We sometimes scoff at $15 minimum wage, and then we say, ‘Well, just go get the $20 rapid test.’”
It’s not just the monetary price of tests and masks. It’s also the difficulty finding them and the time spent looking. “You shouldn’t have to go to three CVSes to track it down. It should just be there,” Low said. She was careful to note she’s not a public health expert, but this is all Econ 101, she said. “When something has an enormous positive externality, a public health benefit, you should pay people to do it, or you should make it as easy for them as possible. And right now, we’re making it hard for people to do the right thing.”
Biden had a plan to make tests and masks cheaper and more accessible, including invoking the Defense Production Act. But so far, those plans have stalled in favor of working with the free market and private insurers.
“They could be preventing millions of people from getting sick and tens of thousands of people, if not more, from dying, and they’re not taking the actions that they need to do this,” Raifman said. Recent investments like billions of dollars pledged for monoclonal antibody treatments and antiviral medication can help those who get sick. “Yet they could prevent it in the first place,” Raifman said. Other measures are also critical for ending the pandemic: better vaccine delivery and outreach, workplace safety standards, paid leave, isolation support.
The Covid response team should be led by a public health expert, rather than a multimillionaire, and it needs to include those who represent the hardest-hit communities, Raifman said. “People are realizing that we really need to do a lot better on controlling the pandemic and that the current Covid response team is not doing enough.”
Biden’s plan from January would still work well, Raifman said. “It has everything we should have done, but starting tomorrow is much better than never doing it.”
The
pandemic will be with us for a long time to come, particularly since wealthy
countries have hoarded the resources—such as vaccines, effective treatments, and scientific
support—needed to stop the virus globally. Taking action now could make an
enormous difference in the next months and years. We can’t afford not to.
