President Biden, Don’t Let a Crisis Go to Waste: Lessons in Vaccination and Testing from a COVID-19 Testing Expert
It would be a drastic understatement to say that our country fumbled COVID-19 testing last year. I know this first-hand because I’ve worked closely on this issue in a professional capacity since the beginning of the pandemic, when my company 1health brought to market the first EUA FDA approved COVID-19 saliva test. Since then, I have watched our government give money to all sort of players who could not execute on testing, while miles away plenty of effective, university labs were running COVID-19 testing but did not have budget to expand. I have seen many state governments buy faulty antigen and antibody testing kits with low test sensitivity, only to find out that these tests missed positive patients causing community spread. I have witnessed state governments literally buying space to try to erect physical labs from scratch, instead of investing in existing labs that have operational experience and far lower risk if failure. Our country has thrown so much money at the pandemic, often without clear strategy or oversight to measure results. And now, we’re stuck relying on the same system that fumbled testing for vaccination.
Luckily, our country can learn from these mistakes. The Biden administration desperately wants to do things differently, and continues working through the vaccination and post-vaccination process, which includes more COVID-19 and emerging antibody testing. Now, I am urging the Biden administration to consider a few suggestions so that our country doesn’t walk right into the pitfalls that made COVID-19 response so agonizing in 2020.
1. President Biden, please push for innovation our testing infrastructure is as old our highway system
The U.S. has spent billions on COVID testing in the past year. There are many testing technologies out there: some require the customer to drive long distances to go to a testing center, others are dropped at your home. Some require clinical personnel with PPE to take the sample from your nose, others you can simply spit into a tube. Some run in 20 minutes, some in 48 hours. When all of these are piled together in a jumbled mess, it’s clear that our policy towards funding testing today has no strategic vision. We have not clearly used our massive government funding to advance the science and technology of testing.
In fact, most government policies today favor the legacy testing infrastructure which is inefficient, inaccessible, and was never designed around the patient. If you review the regulatory infrastructure, it favors well established legacy labs networks which were designed around the 1970s. Instead of relying on these dinosaurs, we have the technology to deliver solutions to each person, wherever they are, without them driving to a lab and standing in line around other infected individuals, waiting for an exhausted nurse. We have spent billions without advancing our testing infrastructure. It’s imperative for this new administration to spend time thinking critically about the infrastructure they want to pay for going forward — and not just fall prey to monopoly lobbyists.
2. Go smaller. Massive healthcare centers are not the future of healthcare.
So much of our healthcare system is increasingly concentrated in big metropolitan hospital systems and labs. But COVID-19 testing taught us that it’s highly efficient to rely on smaller health clinics in local neighborhoods and remote solutions, to get testing directly to the people. People do better when they are receiving more personalized care, whether in clinics nearby or in the comfort of their homes. So, we have to bring healthcare to the people and stop investing in the 1950s model of healthcare, which was designed around the physician and the hospital — not the patient. It’s vital to remove restrictions around the delivery of care at home, and make sure that vaccination and testing budgets are distributed beyond major hospital systems and labs.
Nearly 20 percent of Americans live more than 10 miles away from hospitals. Most people cannot and should not travel tens of miles to get COVID-19 solutions, but our outdated regulatory framework around healthcare payments assumes that you have to be physically in a clinic or lab to get anything done. If Uber can pick you up anywhere, why can’t healthcare solutions bring vaccination and testing solutions closer to you? We have local, remote, and mobile testing options now. Let’s take advantage of this. Moving away from large, crowded hospitals provides a paradigm that is safer, more affordable, and provides mental health benefits.
3. Remove regulatory barriers to let platforms better the healthcare ecosystem.
Like many have noted, rolling out the vaccine is a huge IT challenge that the U.S. is just not equipped to handle. At the same time, so much of the innovation you see in other sectors of the economy comes from platform technologies that form efficient marketplaces through centralized software. You see this across the board in finance (Stripe, SoFi), transportation (Uber, Lyft), entertainment (Netflix, Spotify), and hospitality (Airbnb). All these companies take a complex process and simplify it for the end user, allowing for a safe yet free flow of information.
In healthcare, this is almost impossible to do this given our country’s current regulatory framework. Software can help expand how many people receive resources and where. Just like riders can order a car to a nearby town or city, we should also, for instance, be able to expand COVID-19 testing and vaccination across state lines. Much of testing was delayed because tests were stuck in big legacy labs. We must be able to send a sample from a New York patient, to a lab with higher availability in New Jersey or Connecticut. This flow of resources should be easy and seamless.
We cannot innovate fast enough in this market, and we need to move quickly if we want to get everyone from vaccination to immunity. Removing regulatory barriers can lead to more patients getting second doses, receiving antibody testing, and thus more confirmed immunizations.