The Biden administration’s program to make 1 billion COVID-19 rapid tests available to Americans across the country appears to be exacerbating pharmacy supply shortages and making it more difficult for Americans to find tests on short notice after a virus exposure, say some pharmacists and state officials.

“It’s just a matter of numbers. I mean, there’s just no question that you take a billion tests out of the supply chain, and it’s going to have an impact,” said Kurt Proctor, senior vice president of strategic initiatives at the National Community Pharmacists Association.

The White House pushed back against this characterization and said neither states nor pharmacies should be experiencing any supply problems now.

On Jan. 18, the White House launched its program to allow Americans to order rapid tests for free with delivery from the U.S. Postal Service. The Biden administration purchased and reserved 1 billion tests for the program.

The administration’s program also has its limits. Each residential address can only order four tests, and it will take seven to 12 days just to ship the tests.

Another administration policy to make rapid tests more accessible requires private insurers to cover up to eight rapid tests per month when customers buy them at pharmacies or other retailers. But pharmacy officials say they do not have enough, due to supply chain backlogs, when customers come in searching for a rapid test.

Meanwhile, hospitals across the country are filling up with omicron patients, and public health officials encourage Americans to take a rapid test at the first sign of COVID-19 symptoms.

“People are not getting [tests] when they need them. You’re acquiring them ahead of needing them,” Proctor said, adding that customers who need them immediately often have trouble finding them on shelves.

The community pharmacists association surveyed 8,000 small pharmacy owners from Jan. 11 to Jan. 17 and found 92.7 percent of pharmacists said they are having a difficult time sourcing enough at-home COVID-19 tests to meet demand.

States’ concerns

Some states also are complaining about delays in test orders. For example, Maryland ordered millions of COVID-19 rapid tests but the orders were canceled by vendors due to their obligations to the Biden administration, Maryland GOP Gov. Larry Hogan said during his weekly news conference on Jan. 19.

Hogan said the White House told him that eventually state officials would receive their full order of roughly 4.8 million rapid tests as supply is expected to ramp up in February and March. But Hogan said Maryland needed these tests “yesterday.”

Last week, a bipartisan group of governors complained to the White House in a meeting that Biden’s program was diverting their testing supply.

“Basically, the new programs did not produce any new tests. They just took all the tests off the shelves,” Hogan said.

Newly sworn-in Virginia Gov. Glenn Youngkin’s COVID-19 action plan, released Jan. 20, discourages the use of rapid COVID-19 tests for asymptomatic people due to “shortages.”

Youngkin, a Republican, is directing the Virginia secretary of health and human resources to expedite pending orders of rapid tests and working with the White House to speed up the delivery of rapid tests designated for Virginia. He also plans on sending unused tests at state agencies to hospitals, nursing homes and schools.

The Virginia Department of Health ordered 1,747,353 COVID-19 rapid tests from different suppliers and was waiting on approximately 1,003,799 tests to come in, according to a department staffer. The state placed rapid test orders with multiple manufacturers several months ago, but a combination of manufacturing and supply chain issues are making it difficult to keep pace with the surge in demand.

“The availability of rapid antigen testing may be strained for some time,” a Virginia Department of Health staffer said. But he noted that, in the meantime, the state has an adequate supply of PCR tests, and that residents should plan ahead for travel or an event by making an appointment for a PCR test rather than relying on a rapid test.

It wasn’t supposed to be this way. Dawn O’Connell, the federal assistant secretary for preparedness and response, promised senators that the administration’s plans to procure rapid tests would not diminish supply on pharmacy shelves.

“As a requirement in this procurement, none of these tests can interfere with what is available in the current commercial market, so as not to diminish what consumers are able to access now,” O’Connell told Senate Health, Education, Labor and Pensions Committee ranking member Richard M. Burr, R-N.C., at a Jan. 11 hearing on the omicron variant.

A Department of Health and Human Services official told CQ Roll Call that the administration is working with states experiencing supply issues.

But pharmacists and health plans say that these efforts are not moving fast enough and more should be done to ensure patients can easily access COVID-19 tests when symptoms first emerge.

The Group Health Cooperative of South Central Wisconsin, a nonprofit managed health care system, has had issues acquiring rapid COVID-19 tests. In mid-December, the plan put in an order for at-home tests kits with one of the prescription wholesalers it typically uses. After weeks of waiting, the plan placed an order directly with a test manufacturer.

“Realistically, we’re looking at at least another three to four weeks before we can get the over-the-counter tests in our own pharmacies,” explained Shara Bacher, the system’s director of ancillary services.

In the interim, the managed health care plan is also advising its members to go to a primary care physician or a community testing site for a PCR test if they feel COVID-19 symptoms, rather than look for a rapid test. But these sites can take several days to turn around results because demand is so high. The turnaround time for COVID-19 tests run through Quest diagnostics was two to three days, as of Jan. 9, its most recent update.

Physicians recommend Americans take rapid tests after a close COVID-19 exposure, as soon as symptoms arise or when deciding whether to leave COVID-19 isolation, even though the rapid tests are difficult to find in many parts of the country.

“Those tests don’t exist. It feels like we’re almost back to where we were, you know, in the first year of the pandemic when we were all searching for masks or searching for PPE. Now we’re searching for tests,” said Michael Bagel, public policy director at the Alliance of Community Health Plans.