COVID Test/Testing & Vaccine Availability

[AG_PhamD]

With the current omicron surge and the holidays, there have been serious issues with availability of testing and vaccines/boosters.

Here in Mass, getting a vaccination or booster was extremely difficult since thanksgiving. For the past week or two scheduling an appointment has been nearly impossible.

As for testing, at home-tests in Boston/Eastern Mass have essentially been sold out since Friday/Saturday. Testing appointments are pretty much booked and walk in appointments have people waiting hours.

Not to get too political, but one again our country has been caught with its pants down around its ankles. The actions of the federal government expanding testing and vax sites, as well as at home testing, frankly is probably too little, too late. With the speed the virus is and will spread, by the time a lot of these initiatives are put in place this wave have might already passed for the most part. And we can’t keep disassembling surge resources if we can’t put them back into place fast enough. We’ve known about omicron for a month and it seems only within the past few days has the alarm been sounded. It’s amazing how lessons have not been learned.

Hopefully omicron is significantly less dangerous than delta, though there is still debate as to how less dangerous. There is still a significant risk our hospitals will be overrun with the vast number of people infected. And with so many people infected, the greater the risk of mutation resistant against vaccination.

 

[Eric]

With the current omicron surge and the holidays, there have been serious issues with availability of testing and vaccines/boosters.

Here in Mass, getting a vaccination or booster was extremely difficult since thanksgiving. For the past week or two scheduling an appointment has been nearly impossible.

As for testing, at home-tests in Boston/Eastern Mass have essentially been sold out since Friday/Saturday. Testing appointments are pretty much booked and walk in appointments have people waiting hours.

Not to get too political, but one again our country has been caught with its pants down around its ankles. The actions of the federal government expanding testing and vax sites, as well as at home testing, frankly is probably too little, too late. With the speed the virus is and will spread, by the time a lot of these initiatives are put in place this wave have might already passed for the most part. And we can’t keep disassembling surge resources if we can’t put them back into place fast enough. We’ve known about omicron for a month and it seems only within the past few days has the alarm been sounded. It’s amazing how lessons have not been learned.

Hopefully omicron is significantly less dangerous than delta, though there is still debate as to how less dangerous. There is still a significant risk our hospitals will be overrun with the vast number of people infected. And with so many people infected, the greater the risk of mutation resistant against vaccination.

Couldn't agree more, at this point you would think vaccines and boosters would be available by walk-n for anyone who wants them. Same goes for tests. It seems like we have the supply but lack the ability to deal with the logistics of it all. Until there is a real end in sight we should be going all in with every resource available.

 

[SuperMatt]

A lot of people could have gotten the booster sooner but didn’t. Now that Omicron hit, they are all rushing to get it.

Resources are not infinite. This is similar to the outages of toilet paper. Everybody tried to buy a lot of it all at once.

A lot of Americans are like Homer Simpson:

 

[AG_PhamD]

A lot of people could have gotten the booster sooner but didn’t. Now that Omicron hit, they are all rushing to get it.

Resources are not infinite. This is similar to the outages of toilet paper. Everybody tried to buy a lot of it all at once.

A lot of Americans are like Homer Simpson:

To some degree that’s true, however even if everyone got their vaccine as soon as possible, I suspect we’d very much still be in the same boat. Remember that boosters were not authorized until November 19th or 20th. Omicron hit the news November 24th. While having a bunch of eligible people still un-boosted at this time (seniors, immuncompromised, healthcare providers) definitely adds to the demand unnecessarily, the overwhelming bulk of the population eligible were not beforehand.

A lot more could have been done to inform people of boosters and eligibility times. I came across countless seniors who got the J&J and had no idea they were due for a booster after just 2 months. Plus there is a complete lack of knowledge around the acceptability of mixing and matching vaccines. Tons of resources went into pushing vaccines, by comparison very little went into pushing boosters. At least around here.

Sure, resources are limited, but it depends what we’re talking about. In terms of vaccines, we have so many stockpiled that millions are at risk of expiring and being dumped. The problem there is vaccination sites. My state and many others took down temporary mass vax sites long ago. Thats fine considering they were no longer really needed, but they should have the ability to go back into place within a couple weeks.

I think most would agree testing has never got quite to where it needs to be and is certainly lacking compared the countries doing it best. At the point, the issue is less about the lack of physical infrastructure (machines, processing labs) and more about the collection infrastructure. Not to mention now on-site, rapid PCR is far more common.

As for rapid tests, this goes hand in hand with the lack of testing in this country. The cost issue should have been addressed long ago. Insurance reimbursement is the right thing to do, but not via manual claims reimbursement. That’s too time energy/consuming for what it is, too much opportunity for claims not to be paid, and doesn’t sold the cost issue if it takes 2 months to get reimbursed. More tests would be demanded if the price was there. Companies are reluctant to make more despite having the capacity over fear they won’t be purchased (like with H1N1). And by the time the govt sets up their mail order test program, this wave will probably be over with.

Both test sample collection and vaccination are not rocket science and do not require medical degrees. Many of the people giving vaccines at mass vaccination sites were nursing students and EMTs. The government could spend 2hrs training natural guardsmem/women and deploy them as needed with a medical practitioner supervising each site. Sites could then easily be scaled up and down as needed.

My question is in that month of travel bans to create time to respond, other than sitting around for more data to come in what was the government doing to prepare? It’s much like what happened prior to the first wave. It wasn’t until the virus hit hard everyone started scrambling to source more ventilators and more PPE.

Sure, we cannot predict the future. New strains were likely to occur. A Christmas wave was inevitable. We need to learn how to be flexible and adaptive as the threat evolves and fluctuates.

 

[Alli]

My question is in that month of travel bans to create time to respond, other than sitting around for more data to come in what was the government doing to prepare? It’s much like what happened prior to the first wave. It wasn’t until the virus hit hard everyone started scrambling to source more ventilators and more PPE.

Why are we blaming the government, when “we the people” have had what we needed for a year? I’m all for blaming government when it fails us, but we have to do our part, and that includes masking and getting vaccinated.

 

[rdrr]

Why are we blaming the government, when “we the people” have had what we needed for a year? I’m all for blaming government when it fails us, but we have to do our part, and that includes masking and getting vaccinated.

I only blame the government for allowing profiteering off of this. A few days ago I went on amazon (I Know) to look for home rapid tests. A shop there was selling ten tests for $950.00 and one for $99.00! I reported them to amazon and stated that the tests should only cost $12 a piece at the most. When I checked back yesterday they were still selling them.

 

[Eric]

Why are we blaming the government, when “we the people” have had what we needed for a year? I’m all for blaming government when it fails us, but we have to do our part, and that includes masking and getting vaccinated.

IMO it's the government's job to serve the people in a crisis, they really should be more organized for this rollout but I also get the hurdles. Most of us, including the government, thought the worst was behind us and started letting our guard down.

We all have a role to play but they should be leading the charge, if necessary have the NG setup more outposts for vaccines, testing, etc. having to wait two weeks and struggling for appointments is ridiculous at this point, especially with the amount of vaccine available.

 

[Alli]

I only blame the government for allowing profiteering off of this. A few days ago I went on amazon (I Know) to look for home rapid tests. A shop there was selling ten tests for $950.00 and one for $99.00! I reported them to amazon and stated that the tests should only cost $12 a piece at the most. When I checked back yesterday they were still selling them.

I ordered two tests for our cruise. They were about $30 each. That’s still high, but $99???? Outrageous!

 

[AG_PhamD]

Why are we blaming the government, when “we the people” have had what we needed for a year? I’m all for blaming government when it fails us, but we have to do our part, and that includes masking and getting vaccinated.

I absolutely agree there is a large sense of personal responsibility that falls upon the greater public here. But when it comes to things like testing availability (at home or testing sites) that is beyond an individuals control. When it comes to boosters, particularly for those who were not eligible before late November, it’s the same deal.

Vaccinated individuals can still catch and transmit the virus. I personally know 5 vaccinated people (3 of whom were boosted) in the past 3 days who have caught the virus and displayed pretty significant symptoms (ie temp of 103), thankfully no hospitalizations. Masking is also far from being a sure way of preventing spread or catching it in the first place, especially if we’re talking about cloth or surgical masks.

I am by no means a “prepper” but I happened to stock up on at-home tests prior to Thanksgiving/Hanukkah to ensure my vulnerable family members are protected (and have since also given away some to friends with high risk family members). I had other friends scrambling to drive to New Hampshire to buy tests. But not everyone has the foresight to do so or has the money to buy test kits they may or may not use. I also made sure my company had dozens of rapid tests and N95s on hand.

When the CDC and public health officials recommend to get tested before holiday parties (include those vaccinated with no signs of illness), you can bet there’s going to be a massive influx of people for testing.

Personal responsibility is a big part of this, but when it comes to public healthcare (or any type of healthcare) consideration of the human factor is important. That includes people waiting until the 11th hour to take action.

 

[AG_PhamD]

I only blame the government for allowing profiteering off of this. A few days ago I went on amazon (I Know) to look for home rapid tests. A shop there was selling ten tests for $950.00 and one for $99.00! I reported them to amazon and stated that the tests should only cost $12 a piece at the most. When I checked back yesterday they were still selling them.

I ordered two tests for our cruise. They were about $30 each. That’s still high, but $99???? Outrageous!

The fact these at-home rapid-tests generally cost $12-15 a ($25-30 per 2-pack) test is absurd. You’re starting to see some sold in single packs for $10/test. The government, one of the good things they’ve done recently, is get some of the prices down to $7 per test ($14 per kit) at some retailers. This hasn’t really come to fruition yet for the most part though.

Even $7, while far more reasonable is more than it should be. This is not revolutionary technology and I would assume costs them a most a couple dollars per test, probably less. Since the beginning of their availability, long ago, my company has been buying Abbott BinaxNOW rapid-antigen tests for far less than what the usual retail price, despite being the exact same test, just in different packing (I’m not allowed to say what we pay). And instead of getting 2 per pack you get 40.

I can say I did get offered On/Go test kits (2 tests per kit), normally cost $30 retail, for as little as $16 per kit by one of our vendors. I was also offered the CareStart test (exact same test in every way, except the medical version, meaning it comes in bulk packaging and you need a special license to buy) for as little as $5.75 per test.

These retail tests should cost everyone no more than $4-5 per test. And that’s being generous. For one thing, cut down on the ridiculous amount of packaging. All the extra packaging is wasteful, economically and environmentally, and all the extra bulk just makes shipping them less efficient.

 

[Edd]

We were luckily able to get state provided tests last night. No charge. Not sure how long they’ll take to arrive.

 

[AG_PhamD]

We were luckily able to get state provided tests last night. No charge. Not sure how long they’ll take to arrive.

How does you states system work? I know my state (Mass) was setting up some sites in low income areas to give out tests. Additionally, school children were being given 1 tests to take home… no exactly the best population to distribute to IMO but better than distributing no tests I suppose.

If your state is mailing tests, then I suppose it’s unlikely they’ll be delivered before the holidays. Afterwards I guess is the next best thing.

 

[Edd]

It was this link my wife used. She tried it about a week ago when NH announced they were available but supply ran out immediately. Then yesterday the governor Tweeted they were available again so we jumped on it.

Home - Say Yes! To Covid Test

Join the Free At-Home Testing Challenge, in partnership with CDC and NIH, is facilitating access to receive free, rapid, at-home COVID-19 test kits. Test twice a week to help protect your family and our community. Order your tests through the mail Or pick up your tests […]

sayyeshometest.org

 

[SuperMatt]

They were selling tons of tests at the grocery store yesterday. I think they were $9.99.

 

[Alli]

Sounds like the difference between the $10 tests and the $30 that I purchased is that with the more expensive test (from Abbott), you get someone online walking you through the test and then an app that has the date/time and result of your test sent to an app that can be scanned/viewed when you reach the facility requiring the test.

 

[AG_PhamD]

They were selling tons of tests at the grocery store yesterday. I think they were $9.99.

I’ve seen $10 single tests, but not for 2 packs. Unless maybe the state is subsidizing them, which is a possibility.

Sounds like the difference between the $10 tests and the $30 that I purchased is that with the more expensive test (from Abbott), you get someone online walking you through the test and then an app that has the date/time and result of your test sent to an app that can be scanned/viewed when you reach the facility requiring the test.

I’m definitely partial to the Abbott tests. There haven’t been independent studies on all the tests, but of the ones that have occurred Abbott comes out on top. Being the first rapid test to get approval, I think they probably fell under the most scrutiny and had the most investment. They’re also the easiest for people to use. The other tests generally are not great with people with poor dexterity. And for an institution administering rapid tests to many people, they are far more efficient. Having to deal with little vials is tiring and some requiring setting multiple timers to process correctly per test which gets quickly overwhelming.

 

[Roller]

There is a pre-print paper published a couple days ago that suggests lower sensitivity to Omicron for several Ag tests. As always, the study has not been peer reviewed and the results have yet to be confirmed, but definitely interesting.

 

[AG_PhamD]

There is a pre-print paper published a couple days ago that suggests lower sensitivity to Omicron for several Ag tests. As always, the study has not been peer reviewed and the results have yet to be confirmed, but definitely interesting.

Interesting. That’s a dense read to review on my vacation and I am by no means an expert in molecular biology, but it would potentially make sense newer tests (ie FlexFlow) have better sensitivity as they were developed later and may have been designed to target newer variants, more similar to omicron. It’s worth noting however that these tests only looked at sensitivity, not specificity. They were ex vivo which doesn’t necessarily correlate to in vivo conditions. It’s also not clear how many times these tests were repeated and what sort of variation occurred within tests of the same manufacturer. Clearly these tests work against omicron, but it would be nice to have more studies looking into this.

 

[Roller]

Interesting. That’s a dense read to review on my vacation and I am by no means an expert in molecular biology, but it would potentially make sense newer tests (ie FlexFlow) have better sensitivity as they were developed later and may have been designed to target newer variants, more similar to omicron. It’s worth noting however that these tests only looked at sensitivity, not specificity. They were ex vivo which doesn’t necessarily correlate to in vivo conditions. It’s also not clear how many times these tests were repeated and what sort of variation occurred within tests of the same manufacturer. Clearly these tests work against omicron, but it would be nice to have more studies looking into this.

The FDA requires Ag test developers to have a plan for assessing the impact of viral mutations using clinical or contrived samples. I agree that third-party data (i.e., not from test manufacturers) is also appropriate to assess real-world performance.

 

[AG_PhamD]

In other news:

The Biden Administration Rejected an October Proposal for “Free Rapid Tests for the Holidays”

With omicron cases spreading like wildfire, the White House is finally taking steps to make free antigen tests available to all. But this fall, Vanity Fair has learned, it dismissed a bold plan to ramp up rapid testing ahead of the holidays. Frustrated experts explain how confusion, distrust...

www.vanityfair.com

…that too many rapid tests might somehow signal to wary Americans that they could test their way through the pandemic and skip vaccinations altogether. “It’s undeniable that [the administration] took a vaccine-only approach,” said Dr. Michael Mina, a vocal advocate for rapid testing who attended the October White House meeting.

Ugh… seriously?!

Evidently in late October the federal government turned down a plan to acquire roughly three-quarters of a million tests per month because they didn’t want people to think testing is a substitute for vaccinations. Right, but I’m pretty sure the people unwilling to vaccinate are also unlikely to test at home and test proactively. This is bad policy with no foresight. The lack of preparedness is bad enough on the part of the government. Willful unpreparedness is even worse.