Free At-Home Tests Are a Start, But Biden Must Move Faster and Go Bigger to End Pandemic

President Joe Biden marched triumphantly into the Oval Office almost a year ago promising to strike a mortal blow to the Covid-19 pandemic. Eleven months later, the Omicron variant is forcing many communities back into partial lockdown at Christmastime, and America faces the prospect of a bruising fourth wave of the pandemic. And yet, the White House still refuses to utilize the full extent of its powers to fully fight Covid and save American lives. This is dangerous and concerning.

What went wrong? Covid czar Jeffrey Zients has prioritized cooperation with corporations rather than exercising a democratic government's rights to protect the people. Globally, Zients has emphasized vaccine charity over equity, all but ensuring that there will never be enough jabs in arms worldwide to prevent ever more mutations of the fast-changing virus. Domestically, Zients is failing to fully employ tools such as the Defense Production Act (DPA) to compel the transfer of vaccine technologies and increase provisions of free and readily available testing kits and KF94/N95 masks. This must change, immediately.

This past week, President Biden seemed to remember that he wields the Defense Production Act, whose use he must continue to exercise. Established in the wake of the onset of the Korean War and based on lessons from World War II, the act authorizes the president to influence domestic industry in the interest of national defense. As defined by Congress, national defense in this scenario includes critical infrastructure for domestic use as well as assistance to foreign nations.

It's only thanks to the DPA that Biden will be able to compel production of enough Covid-19 tests to meet his 500 million-test goal by January--a woefully insufficient number which only came after the White House was publicly humiliated after callous remarks by press secretary Jen Psaki.

It's only thanks to the DPA that Biden will be able to compel production of enough Covid-19 tests to meet his 500 million-test goal by January--a woefully insufficient number which only came after the White House was publicly humiliated after callous remarks by press secretary Jen Psaki. Researchers from the Kaiser Family Foundation have noted that if everyone over 11 tested twice a week, as is likely necessary to safely maintain an open economy during a surge, the country would need 2.3 billion monthly tests. What's more, these newly promised kits won't be available until the new year, meaning that consumers will be forced to manage a busy travel period amid a testing shortage. Still, even if Biden is tiptoeing into more muscular DPA usage instead of diving headfirst, that's better than staying out of the pool entirely.

There are multiple DPA authorities available to Biden. Under Title I of the Act, the president is authorized to require priority performance of contracts or orders deemed necessary or appropriate to promote the national defense. Title I also authorizes the president to allocate materials, services, and facilities necessary to promote the national defense. While Title I of the Act focuses on priorities and allocations, Title III caters to the expansion of productive capacity and supply. With Title III authorities, the president is free to provide financial incentives to develop and expand the production capacity of domestic sources of critical components, technology items, and materials essential to national security. Title III authorities also direct the president to ensure these critical components, technology items and materials are available from reliable sources during peacetime, mobilization, and national emergency.

Immediately after entering office, Biden effectively put Zients in charge of figuring out how best to use all of these powers. Biden signed an executive order establishing Zients' position of Covid-19 response coordinator which made him responsible for the administration's efforts to produce, supply and distribute masks, vaccines, tests, and other materials necessary for management of the pandemic. The order also delegates the use of the Defense Production Act for the nation's pandemic response to Zients.

At the time, my organization and others voiced disappointment in Biden's decision to appoint Zients considering his lack of public health experience and the fact that he became wealthy advising pharmaceutical firms on how to boost profits, while also purchasing a firm that engaged in surprise medical billing. This notably triggered direct pushback from the Washington Post editorial board. We leave it to the Post editors to decide who they think has been vindicated.

To be fair, the Biden administration has, as appropriate, used the DPA to boost production of Pfizer's coronavirus vaccine and availability of tests nationwide. However, the administration's efforts have been insufficient in handling the scale of tests truly needed to appropriately manage the pandemic.

The underutilization of testing in the United States' pandemic response toolbox is a grave disappointment. Testing helps contain spread by identifying infected people, protects health workers and allows public health officials to track the progression of the disease regionally and nationally. Yet tests in the United States range from $7 to $38.99 per test, which is cost-prohibitive for most consumers. In the United Kingdom, Germany and France, tests are free and widely available.

Right now, the administration needs to guarantee tests in schools, libraries, and pharmacies across the country. But there's another roadblock to reaching the necessary testing capacity, which is again of the administration's own making.

For much of the pandemic, the only two rapid tests approved by the Food and Drug Administration (FDA) were made by former employers of Tim Stenzel, the FDA official responsible for approvals. There is simply no excuse for this--to give a sense of the absurdity, scientist Irene Bosch developed a 15-minute inexpensive home Covid-19 test only a few weeks into the pandemic, but it still has not received approval. Stenzel should be removed from authority and investigated, and new tests should be streamlined for approval.

To get the world back to normalcy... Biden must step up and fully utilize the authorities of the federal government to guarantee widespread availability of all the tools needed to manage the pandemic.

Another use of the DPA would be to compel Moderna to share its mRNA vaccine technology. While the administration has been able to secure ample supply of vaccines domestically, the global story has been much less rosy. Poorer countries have been forced to rely on vaccine charity and its accompanying issues, including delivery of shots close to their expiry date. Beyond that, the continued emergence of variants and the corresponding need to administer more shots signal an urgent need to significantly increase production and supply of vaccines.

With DPA authorities, the government can set up multiple domestic production hubs to manufacture vaccines using the mRNA technology in Moderna's coronavirus vaccine. After all, the technology was jointly developed by three National Institutes of Health scientists, despite Moderna's ridiculous claims to the contrary (which, tellingly, they're backing off of as press attention heats up.) mRNA vaccine technology should also be shared with the World Health Organization's technology transfer hubs to facilitate global production. There are currently hubs in South Africa, Brazil and Argentina established to foster vaccine production by lower- and middle-income countries. Even without drawing on the DPA, the federal government's contract with Moderna grants the Biomedical Advanced Research and Development Authority (BARDA) the right to share information used in the vaccine recipe.

With recent reports showing the weakened efficacy of monoclonal antibody therapies in treating the Omicron variant, the arrival of anti-covid pills is good news. Clinical trials show that Pfizer's Paxlovid effectively reduces the chance of hospitalization or death of patients with severe cases by 89 percent. Widespread supply of the pill could have a major impact on preventing illnesses and strain on hospitals. However, the company is on course to produce only 80 million treatments by the end of next year. This area is another opportunity for the administration to utilize its DPA authorities to facilitate mass production of a highly effective treatment. It would be an unnecessary risk to wholly rely on one company to produce enough pills to satisfy global need in a timely manner.

Clearly, the Biden administration is keen to move on from the pandemic and tackle other pressing issues. But this crisis will not simply go away, especially when addressed with half measures. New variants should not have caught Zients by surprise, nor should Omicron be presumed the last one--and the need for vast mRNA production capacity will eventually go beyond Covid to a vast array of existing diseases. To get the world back to normalcy, and potentially even better, President Biden must step up and fully utilize the authorities of the federal government to guarantee widespread availability of all the tools needed to manage the pandemic--tests, masks, vaccines, and pills.