Current shortfalls in Biden's "Test to Treat" initiative

Last update: Saturday 4/23/22 

This blog note calls the reader's attention to an important assessment of President Biden's new one-stop "Test to Treat"  initiative by Zeynep Tufekci that was recently published by the New York Times. Ms. Tufekci has been one of the most perceptive critics of our nation's pandemic management policies during the Trump and Biden administrations, so her warnings must be given serious consideration.

•  "Covid Drugs Save Lives, but Americans Can’t Get Them", Zeynep Tufekci, NY Times, 4/22/22 

The title of Tufekci's article takes a dead aim at the fundamental objective of Biden's one-stop "Test to Treat"  initiative, her point being that the drugs are still inaccessible to many Americans. In her own words, here are some of her most telling examples of this inaccessibility:

• "The national map of participating pharmacies in test to treat shows large parts of the country with none."
  
  
• "A Kaiser Health News reporter spent three hours driving around Washington, D.C., before finding a pharmacy where testing was available and the drug was in stock ... When trying to book appointments online in several states, the reporter was sometimes denied an in-person appointment ... Many places did not have any same-day appointments, a big obstacle for a drug that should be given as quickly as possible."
  
  
• "The greater difficulty is that the drug [Paxlovid] can be prescribed only by a medical doctor, advanced practice registered nurse or physician assistant ... It cannot be prescribed by a pharmacist. Many pharmacies aren’t participating in the national program because they don’t have a clinic on site where a health practitioner can assess a person’s eligibility. "
  
  
• "As further congressional funding has not been approved, the funds used for reimbursement for coronavirus testing have begun to be depleted, so people without insurance or whose insurance doesn’t cover such clinics have to pay for the health appointment out of pocket."
  
  
• "If many doctors are unaware of these therapeutics or unsure how patients qualify for them, where’s the effective awareness and education campaign for health care providers?"
  
  
• "However, Paxlovid received an emergency use authorization, which means that legally, Pfizer cannot directly market it yet, so physicians don’t get even this sort of outreach. This leaves individual doctors on their own for keeping up with new drugs and treatments, even in a pandemic and even when the drug is potentially lifesaving."
  
  
• "In March, The New York Times reported that a whopping 80 percent of the doses were sitting unused as the Omicron wave washed over the country. "
  
  
• " A CNN investigation found desperate patients unable to find the drug, doctors unaware that it even exists and some pharmacies with hundreds of unused doses while others had none."
  
  
• "A Kaiser Health News investigation found that government maps of supplies were missing many locations that had doses"
  
  
• etc, etc, etc.

Half-empty vs. half-full

So what should one conclude? The editor of this blog concedes that Zeynep Tufekci's anecdotes paint an accurate portrait of a policy glass that is half-empty; wheres the editor prefers to see the same glass as half-full. Professor Tuckeci is an eminent sociologist, a profession that has become highly adept at identifying systemic impediments to success; whereas this editor, being an engineer, long ago acquired a firm grasp of the psychology of success, i.e., "What else do we have to do to finish the job?" 

Regular readers of this blog understand why the editor has tweeted a blog note again and again that proclaims the "Good News" that "Test to Treat" is a component of the President's comprehensive, super convenient COVID.gov initiative to provide all Americans, including doctors and other healthcare professionals, with a single landing page from which they can get to just about all the information they need to cope with the changing challenges of the pandemic. It's good, but it's not perfect, and so what. To quote Ambassador Clinton, "We can't let the perfect stand in the way of the good". ... :-)

So what else needs to be done?

Most of the potholes and other roadblocks identified by Professor Tufekci are supply chain management issues. Months before he became president, Biden recognized that the distribution and administration of vaccines was a classic supply chain management operation. That's one of the reasons why he appointed Jeff Zients, an experienced manager of complex systems, to be his White House Coronavirus Response Coordinator to manage the nation's vaccination efforts. After a slow start, Zients was soon overseeing the delivery of millions of jabs into American arms each week.

The "Test to Treat" program is also off to a slow start. Zients has recently been replaced by Ashish Jha, who does not seem to have extensive experience managing complex systems.  If Jha doesn't whip the "Test to Treat" supply chain into much better shape within the next month or so, President Biden should consider providing him with a deputy who has the requisite hands-on skills set.

Meanwhile the rest of us can help move things forward via our own individual initiatives, such as:

• Making sure that our our personal physicians are aware of COVID.gov and its "Test to Treat" component.
  
  
• Probing the "Test to Treat" pages from time to time to be sure there are participating pharmacies or other dispensaries in our areas, how easy it is to schedule testing appointments, and whether they are currently supplied with the treatment pills. 
  
  
• Making sure that our family, friends, and associates are aware of COVID.gov and its "Test to Treat" component. Distracted by Ukraine and inflation, the Biden administration has not done a good job in spreading its "good news" ... :-)

Links to other notable pandemic critiques by Professor Tufekci:

• "Show Me the Data!", Zeynep Tufekci, NY Times, 8/27/21
• "For the Elderly, Complacency Could Be a Killer", Zeynep Tufekci, NY Times, 12/9/21
  
• "The C.D.C. Is Hoping You’ll Figure Covid Out on Your Own", Zeynep Tufekci, NY Times, 1/5/22 
• How Millions of Lives Might Have Been Saved From Covid-19", Zeynep Tufekci, NY Times, 3/11/22 

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Links to related notes on this blog:  

• "Omicron Defense", This news page is updated on Wednesdays and Thursdays.
• "U.S. Pandemic Who's Who ... and what's where", This news page is updated every Friday.