Finding a COVID test in December 2021, when New Jersey detected its first case of the omicron variant, was like hitting the jackpot.
The virus was then spreading quickly, just in time for the holidays. At the time, the state’s monthly average for new positive tests exploded by 196% over the month before and statewide hospitalizations soared by 140%.
Amid widespread demand, stores couldn’t keep rapid COVID tests on their shelves. Appointments for PCR tests were booked solid.
The shortage of tests was, in part, because testing wasn’t a priority through most of 2021 as the government focused on increasing vaccination and booster rates.
To answer the demand at a critical time, Gov. Phil Murphy announced a plan to provide free at-home PCR saliva tests for anyone who wanted one. The state expanded an already-existing contract with Vault Health to fill a critical void at a time of dire need.
The program, which supplied tests that were distributed to both individual homes and clinics run by municipalities, delivered more than 1 million tests at a cost of nearly $110 million, paid from federal COVID funding, according to data provided to NJ Advance Media as part of an Open Public Records Act (OPRA). Nearly $75 million of those funds were for tests sent to residents’ homes, records show.
But of the more than 675,000 tests ordered by individual residents — at a cost of $111 a pop — only 113,000, or 16.8%, were taken and returned to the lab for results. That left more than $62 million spent on more than 557,000 tests that were never taken.
The $111 per test cost included the test kit, mailing costs and lab processing. The price was based on how many tests were ordered, whether they were ultimately taken or not.
The Health Department said it did not negotiate a two-tiered contract with a separate price for the tests themselves and an additional fee to process them because speed was of the essence. Instead, it extended an already-existing contract with Vault Health, “in order to quickly stand up an at-home PCR testing program at a time of urgent need when the state was facing the highly infectious and rapidly expanding omicron variant and overall testing resources were limited,” spokeswoman Nancy Kearney said.
“Increasing the accessibility and availability of COVID-19 PCR testing helped meet the increased demand for tests, and also provided another outlet for people to obtain tests quickly in their own home, including if they were feeling ill or had symptoms,” she said.
MORE THAN JUST MONEY?
When the program first launched, Nalin Johri, acting program director at the Seton Hall Master of Healthcare Administration program, predicted many of the tests would go unused.
Now, Johri says that while the headline of the per test cost is “attention grabbing,” the number needs to be “peeled back” to understand the program.
He called the cost of the program “astronomical,” but, he said, it only shows one side of the story.
Johri cited the escalating positive tests, hospitalizations and deaths at the time, saying “with cases starting to rise and the holidays just around the corner, something had to be done about testing.”
He said the federal government had strongly supported the development of vaccines with upfront money, but testing did not receive the same level of financial support. As a result, testing was left to “private players who had to bear the economic risk of bringing tests to market and being uncertain of the demand for tests,” he said.
“Unlike the U.K and Germany, which had a double-pronged free vaccine and testing strategy, we had more of a singular focus on vaccines and an incoherent national strategy on testing, resulting in a patchwork of state and local government efforts to fill this glaring omission in free and easy access to testing,” he said, calling New Jersey’s at-home test program “a bold and decisive step” and a “public good.”
Stephanie Silvera, an epidemiologist and public health professor at Montclair State University, said her concerns with the Vault testing program were because “they required a lot of work on the part of the individual — scheduling an online appointment and mailing in your sample — and the results weren’t immediate.”
“In the midst of the chaos of omicron, I understand trying to get tests to everyone,” she said. “I believe the governor was trying his best to provide solutions while cases were surging. Unfortunately, this test was not particularly user-friendly and I think that created a barrier to use.”
Silvera said her family still has unused tests from the state program.
When the program was new, Kearney said even if people didn’t use the tests right away, there was value in having tests on hand because we didn’t know what direction the pandemic would take.
Given the large number of at-home tests that were not used, there’s a good chance many households still have the tests, which are probably past their expiration dates.
When the program ended in December 2022, “people with unused tests were notified they would receive a rapid test as a replacement. 4,199 Lucira NAAT COVID-19 test kits were sent out to replace unexpired Vault-at-home saliva test kits,” Kearney said. Only the unexpired tests were replaced, she said.
That leaves some 557,000 tests that expired before they could be used and were not replaced by newer tests.
In addition to the at-home tests, the program provided more than 375,000 tests at a cost of $35 million to county and local municipal programs, including those run by Vault and the Health Department. All of New Jersey’s counties except Bergen, Cape May, Cumberland, Morris and Ocean participated in the programs, the agency said.
Asked if the Health Department considered the program successful, Kearney said the program allowed the state to offer testing “during a time when testing was in high demand and low supply.”
In addition, she said, it provided the tests “at no cost to the consumer.”
Separate from the Vault program, the state provided more than 8.1 million tests to schools, local health departments and congregate facilities such as jails, long-term care facilities and psychiatric hospitals over that time, the Health Department said.
“This is in line with the Department’s mission to serve the most vulnerable,” Kearney said.
Today, it’s easy to find a rapid shelf at your local pharmacy or supermarket, and there’s not much of a wait, if at all, to get a PCR test at a doctor’s office or other provider.
Please subscribe now and support the local journalism YOU rely on and trust.
Karin Price Mueller may be reached at KPriceMueller@NJAdvanceMedia.com. Follow her on Twitter at @KPMueller.
