The cost of masks and tests for COVID-19 exacerbates the gap of the pandemic among those most in need

By Phil McCauslandNBC

In recent weeks, as the omicron variant spread rapidly across the United States, Americans have found the financial costs of the pandemic falling increasingly on their shoulders.

As cases of COVID-19 have risen, public health experts have urged people to ditch their cloth face coverings for higher-quality options and get tested more often to curb the virus.

The Centers for Disease Control and Prevention (CDC) updated its mask guidelines on Friday to note that disposable N95 or KN95 masks offer the "highest level of protection" against the virus.

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For some, the added financial burden is a bummer, but it's still affordable.

For others, the prospect of paying $1 for a single disposable mask or $24 for a test kit is an economic pain, raising fears that the pandemic will further exacerbate inequalities.

During the pandemic, three-quarters of workers said they found it somewhat or very difficult to make ends meet, 40% said they couldn't scrape together $400 in an emergency, and about 20% said they were hungry because they couldn't afford to eat enough, according to Project Shift, an ongoing survey of American hourly wage workers led by Harvard University sociologist Daniel Schneider.

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Most also don't get paid sick leave and have continued to work when sick because they can't afford to miss a paycheck. 

“These are the workers facing the virus, and we ask them to buy high-quality masks and pay for rapid tests?”

Schneider noted.

“For a lot of these workers, it's just not a possibility — it's about putting food on the table.

And when you're faced with that impossible choice, pandemic prevention for impoverished workers is unrealistic." 

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The White House also announced that private health insurance companies must reimburse up to eight COVID-19 tests at home per month, and this week the Biden administration will make up to four tests available to residents of the United States through a portal. online.

President Biden also announced Thursday that his administration planned to make “high-quality” masks available at no cost, but declined to provide details, including when they would be available.

Still, workers and experts have expressed frustration that state and federal governments are not moving more quickly and transparently to provide rapid testing and high-quality filtering masks, such as the N95 and KN95. to residents at little or no cost, especially in recent months, when the number of cases and hospitalizations soared due to the omicron variant.

Many cannot afford to wait to be reimbursed or do not have health coverage. 

In some cities, local mutual aid groups - many created amid protests over the death of George Floyd during the summer of 2020 - have worked to fill the void.

Organizers in Portland, Oregon, and Seattle have invested their own money in the effort and have launched appeals for cash and test kits to distribute to those in need.

Boyer cashier Kathryn Laudermilch scans a customer's purchases at Boyer's Food Markets grocery store in Womelsdorf, Pennsylvania, on Thursday, April 8, 2021. Ben Hasty / MediaNews Group/Reading Eagle via Getty Images

The founders of these organizations hope to raise enough money to offset their expenses, but they are ultimately aware that testing has become inaccessible to those without financial means. 

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The founder of the Seattle Rapid Test Bloc, who asked to remain anonymous for fear of personal publicity, said people in the community had donated tests and cash.

The group also charged $2,000 for 100 tests to a credit card and hoped to recoup the cost through fundraising.

As of the weekend, he had raised $1,200.

"We know that we are all we have and all we can trust, so we have to be a community and take care of each other because nobody else does," said the group's founder, noting that the cost of 100 tests had increased by $500 since his order.

"It's annoying to be at this point and know that by the time the government or someone does something, it will be too late," he lamented.

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Sam Stettiner, who is disabled and lives in Brooklyn, said fear of the disease and anger and sadness over the government's response, especially toward the disabled, have almost defined his time during the pandemic.

It has been difficult for Stettiner to acquire evidence, and the cost is difficult to digest because his chronic illnesses prevent him from working. 

Having enough supplies for yourself is a challenge, but you would also like to have rapid tests for the various home health aides that come to your apartment, especially after one came in despite being sick. 

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"Cost is a big issue for me, and I think for a lot of other people who have low fixed incomes," Stettiner said.

"We can't necessarily spend hundreds of dollars to get supplies, and at the same time we go to high-risk settings more often than non-disabled people for medical appointments and procedures that we can't skip."

Some members of Congress are putting more pressure on the Biden administration to take more action in response to the continued spread of the virus. 

Congressman Ro Khanna, D-Calif., joined Sen. Bernie Sanders of Vermont and other Democrats last week in pushing a bill that would provide three N95 masks to every person living in the United States.

They have also pushed to expand access to rapid tests. 

The hope, Khanna said, was that the federal government would use the Defense Production Act to expand the number of rapid tests and face masks available, then provide them for free to every person in the US who needed them.

Even allowing people to be reimbursed for tests they bought through their health insurance companies doesn't go far enough, he said, noting that there are many here who have neither health coverage nor the time to mess with their companies. insurance.

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"A lot of people don't have the money to pay up front and wait for reimbursement," Khanna said, adding that even he had waited months to get reimbursed for tests that were covered by his insurance.

“That's why I think it's so important for the government to buy them, mail them to people and let people order them online or by calling a hotline and then provide them in grocery stores, health centers, in post offices…they should just be ubiquitous.” 

In a message sent Friday, Khanna sounded more optimistic after a meeting with White House officials about the need for a more aggressive and equitable response, particularly in his effort to provide high-quality masks to Americans. 

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“I had a good call with the White House.

They get it," he said in a text.

“They are doing everything they can to quickly get high-quality masks to Americans and I look forward to a big announcement soon,” he said.

The details of that announcement remain unclear, but it will likely come shortly after the Biden administration begins distributing free home tests, up to four per household.

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But the 500 million tests the Administration is distributing isn't enough, many experts say, especially for families with children in school and parents returning to work. 

"It's good, but it's really just a drop of water," said Dr. Eric Feigl-Ding, an epidemiologist and senior fellow at the Federation of American Scientists.

“Considering that we need to test millions and millions of people regularly, 500 million tests is about one and a half per person.

It's really insignificant," he said.

It is a particular challenge for students and workers, as some schools and employers require that those who test positive or have been in contact with an infected person must present a negative test to return to the classroom or their workplace.

For low-income workers, the inability to pay for or find tests can exacerbate the cycle of poverty, as many do not have paid sick leave or the ability to afford childcare. 

Consumers in other countries seem to have much less expensive or even free options.

.

Rapid tests are mailed out in the UK to residents who request them, or they can be collected from a number of pharmacies or distribution centres.  

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Demand in the United States is too high compared to available supply, according to Feigl-Ding, who said he knew people who had bought huge quantities of tests because they wanted to use them for parties.  

"We have to invoke the Defense Production Law to make them cheaper and ensure that there is no excess price," he said.

“We have to make them available to the most disadvantaged.

Pandemic speculation is simply unacceptable, and actively harms economic progress because it punishes our recovery."

But it doesn't look like COVID-19 tests are going to get any cheaper. 

Walmart and Kroger said they were raising prices for rapid tests after an agreement they had with the Biden administration to sell the tests at cost expired. 

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Tricia Moriarty, a Walmart spokeswoman, noted that the company has been one of the few retailers to participate in the White House program to sell Abbott BinaxNow tests at cost for three months.

Although he said there was continued demand and that the company had placed purchase limits, he acknowledged that Walmart had raised its prices.  

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"When the 90 days expired in mid-December, we still kept the product at cost over the holidays," he recalled by email.

“Now that we are back to our original price point of $19.98, we believe we are still the lowest priced compared to other retailers.” 

At Kroger, another company that had agreed to keep its prices low, spokeswoman Kristal Howard also noted that the supermarket chain was one of three companies that had reduced the cost of rapid tests.

He said they were adding tests from other manufacturers to store shelves to increase product availability. 

“It is important to note that we fulfilled our commitment to the Biden Administration to sell at cost for 100 days, and that price program has been phased out and the pre-commitment retail price ($23.99) has been restored,” he said. Howard in an email.

However, according to critics, Walmart and Kroger workers themselves would have to work long hours to afford a single test kit at those prices. 

Increasingly, pandemic prevention strategies -- face masks, rapid testing, working from home and paid sick leave -- have become a luxury, according to Schneider. 

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“It's a world turned upside down, because frontline workers who are out there facing risk and facing the public can't afford testing, they're not rigorously tested by their employers, they don't have the resources and the time. necessary to go after these pandemic prevention strategies and are the least likely to have paid sick leave and must work in person.

It's exactly the other way around," he said.