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President Joe Biden responds to a reporter's question after signing executive orders in the State Dining Room of the White House, Jan. 21, 2021, in Washington. © Alex Brandon / AP Photo

Strong Bipartisan Support for Biden Administration’s Deployment of Rapid Tests

Nationwide survey by COVID Collaborative, Harvard T.H. Chan School of Public Health and Hart Research shows overwhelming bipartisan support for at-home or venue-based low-cost rapid antigen tests

Published on February 24, 2021

COVID Collaborative and Harvard T.H. Chan School of Public Health, today released a first-of-its-kind national poll announcing that 86% of Americans say they would test themselves using at-home rapid antigen tests to stop the spread of COVID-19.

According to the poll conducted by Hart Research, an equal percentage of Americans support the use of rapid tests as part of a national strategy to reopen the economy, demonstrating that rapid testing is a public health tool that can play a major role in the country’s economic recovery before widespread vaccination takes effect. An overwhelming majority of Americans (85%) support the federal government paying for and deploying rapid antigen tests as a way to reopen the economy, including 94% of Democrats and 74% of Republicans.

“As the Biden Administration and Congress consider scaling up rapid testing through the proposed $1.9 trillion American Rescue Plan, we thought it was important to understand the consumer demand among the American public,” says Steven Phillips, MD, MPH, Vice President of Science and Strategy at the COVID Collaborative. “We learned that people are willing and eager to test themselves regularly at-home or upon entrance to public venues to keep their loved ones safe, stop the spread of COVID-19, and reopen America safely.”

The nationwide survey of 1,569 adults found that across gender, age, race and ethnicity, education, and political and employment categories, cost plays a key role in Americans’ willingness to get frequent rapid tests. If the test costs $1, 79% of Americans would test themselves regularly at home. This drops to only 33% if the cost was $25—the current cost of the only FDA-approved at-home rapid test.

If the testing is free—as it could be in a government program—most Americans approve of requiring antigen tests in a variety of out-of-home situations to reopen the economy, schools, and our society safely, including at U.S. borders (92%), in schools (83%), at sports venues (81%), at workplaces (79%), at entertainment venues (79%) and for public transportation (74%).

“Testing needs to be frequent, fast, and accessible in order to help end the pandemic and get the economy back on track,” explains Dr. Michael Mina, assistant professor of epidemiology at Harvard Chan School. “Rapid antigen tests detect individuals when they are most contagious. We can dramatically reduce the number of cases in the U.S. if there is a strategic deployment of rapid antigen tests so that infectious individuals know their status and can isolate or take behavioral precautions before spreading to others.”

The Biden Administration is prioritizing at-home rapid antigen tests as a major policy pillar demonstrated by the recent procurement contracts with several manufacturers. In order for rapid testing to serve as an effective public health intervention to curb the pandemic, experts believe that upwards of 30 million tests per day need to be distributed to homes and venues strategically and effectively.

Despite some price sensitivity, the survey found that rapid antigen tests are highly appealing for their low cost, quick results, and convenience. Strong majorities see getting results in 15 minutes (87%), low cost (87%), not having to wait in line (86%), or risk exposure at testing sites (85%) as important reasons to use rapid antigen tests at home. Privacy is also an important factor as 82% support rapid testing because it can be done in the privacy of their own home.

The survey also found that at-home rapid testing is popular among groups who are generally less supportive of traditional public health interventions promoted to curb the COVID-19 pandemic. For example, 45% of people who live in small towns/rural areas claimed to oppose regular COVID-19 testing. Yet when asked about testing themselves using rapid antigen tests, 81% would test themselves at home using at-home rapid antigen tests. Similarly, 49% of Republicans claim to oppose regular COVID-19 testing, but when asked, 79% of this group would test themselves using at-home rapid antigen tests.

Individuals who test positive on a rapid test said they would take precautions to keep their loved ones safe. The survey found that 78% of Americans would report a positive test result to local public health authorities, 86% would consult a medical professional and 87% would get a PCR confirmation test. Individuals would also stay home (94%), isolate from family members (93%), wear a mask (90%), and make sure household members/close contacts get tested (90%).

“We need to start putting the public back in public health,” argues former Governor Dirk Kempthorne, CO-Chair of the COVID Collaborative. “The traditional public health methods of test, trace and isolate only work if testing is done frequently and results are known quickly. If we can make rapid testing available for use at home and in other venues, we know that infected individuals are willing to make safe and healthy choices. We will identify more infectious individuals before they spread to others and ultimately see a dramatic reduction in cases.”

When pressed about obstacles to widespread adoption of rapid tests, Americans’ greatest concern is accuracy. In the survey, 36% of adults characterized accuracy as a big concern and 44% called it somewhat of a concern. This demonstrates the opportunity to educate the public on the usefulness of rapid antigen tests for public health screening purposes. Rapid antigen tests are extremely effective in detecting COVID-19 when individuals are transmitting live virus, regardless of symptoms, which is all that matters to stop community transmission. It is frequency and speed of results—not absolute sensitivity of the test—that is most important for population screening.

Frequent, rapid testing is one of the most underutilized public health interventions available to us today. One year into the pandemic, 9 in 10 think that COVID-19 is still a serious problem in the U.S. and 44% of those think that the worst is still ahead. Specifically, 77% of Americans worry about themselves or a family member getting COVID-19. In addition to masks, social distancing, and vaccination, 80% of Americans believe testing is an important tool in tackling COVID-19 and getting the economy and American life to a new state of normalcy.

“The pandemic has inflicted the worst economic crisis on the United States since the Great Depression, but we can’t get the economy back on track without first controlling the virus,” said James Stock, professor of economics at Harvard University and former member of President Obama’s Council of Economic Advisers from 2013-2014. “Frequent, rapid testing through at-home tests and entrance screening will make schools, workplaces and travel safer, bring back jobs and revenue and jump-start the economic recovery.”

Deputy Editor