I need help policy

Free and Accessible COVID-19 Testing and its Related Benefits

Abstract

Free, fast, and accessible COVID-19 testing has been difficult to acquire for many United States

inhabitants since the start of the pandemic. The lack of testing has in turn worsened the rate of

spread and seemingly indefinitely prolonged the pandemic. This policy would tackle that issue

by offering criteria-free COVID-19 testing. Criteria-free meaning that individuals need not be

Oregon citizens, actively exhibit COVID-19 symptoms, have come in contact with persons

confirmed with COVID-19, or have health insurance in order to receive a free COVID-19 test.

The expected results of this policy being implemented include an overall decreased rate of

spread, less hospitalizations, and less deaths attributed to COVID-19.

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The Issue

Barriers to COVID-19 testing have arguably worsened the spread of the virus throughout

the United States. By limiting access to testing, asymptomatic and symptomatic individuals alike

can unknowingly pass on the virus to others. Transmission of COVID-19 is especially an issue

amongst those who were not offered the luxury of working from home: essential workers. These

people have spent the majority of their time during the pandemic in public-facing roles, and they

happen to be made up of primarily racial and ethnic minorities (Rogers, 2020). Along with the

threat of contracting COVID disproportionately affecting communities of color, it is also

arguably more difficult for them to acquire a test as well primarily due to financial

disadvantages. The strict criteria pertaining to health-insurance validity bars many individuals

from obtaining necessary testing, which continues to perpetrate the spread of the virus and

elongate the duration of the pandemic.

Background

In early January of 2020, a cluster of cases attributed to a new virus spread rapidly across

the world, resulting in what would become known as the COVID-19 pandemic. The virus has

been identified as an upper respiratory disease and can be spread by particles from an infected

person’s mouth or nose when they cough, sneeze, speak, sing or breathe, and can quickly be

transmitted to others in close proximity (Coronavirus Disease, 2021). While some infected

persons can be asymptomatic, the symptoms of most cases range from mild to severe and include

fever, cough, loss of taste/smell, difficulty breathing, and chest pain among others (Coronavirus

Disease, 2021). About 5.27 million people have died worldwide in the last two years, and many

more have suffered long-term effects as a result of contracting the virus (Mayo Clinic, 2021).

The nation continues to try and protect the public from transmission and infection.

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Some people are more likely to become infected with COVID-19 than others. The CDC

identifies older adults and individuals with underlying conditions as the most vulnerable to

illness, hospitalization, and death (COVID-19 Risks and Vaccine Information). Additionally,

more studies have come out identifying people of color and poor people as especially susceptible

to the virus as well due to a variety of social and economic factors. One study found that the

mortality rate was higher in Black and Hispanic workers in the United States than white workers,

because the former is more likely to occupy essential, public-facing positions (Rogers, 2020).

Additionally, marginalized populations' average living conditions, access to healthcare, and

reliance on minimum-wage work with little-to-no excess and/or supplemental income has

exacerbated the effects of COVID-19 in these groups (Thakur, 2020).

The United States has attempted to curb the rate of COVID-19 cases, hospitalizations,

and deaths in several ways. First, they have encouraged social-distancing measures at the state,

local, and personal level. While some states have implemented little-to-no social distancing

protocol, others have legally limited it through indoor occupancy restrictions and the shutdown

of nonessential businesses (Chiu, 2020). In the same fashion, many places have mandated mask-

wearing, given that COVID-19 is transmitted through upper respiratory droplets (Chiu, 2020 and

State COVID-19 Data and Policy Action, 2021). And finally, testing for and the virus in

individuals has been the primary way to ensure that those who are infected do not continue to

pass it on to others, and vaccination against COVID-19 makes it much more difficult to contract

and transmit the virus.

Guidelines and criteria for COVID-19 testing has evolved significantly over the last two

years as more was learned about the emerging virus. Due to vaccines now being on the market

and mandated by several employers and private businesses, the current standing criteria for

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needing a COVID-19 test include 1. Being in close contact with someone who tested positive for

COVID-19 and 2. Having symptoms related to COVID-19, both despite vaccination status

(COVID-19 Testing in Oregon). However, this criterion fails to include asymptomatic essential

workers who may be coming in contact with individuals who have COVID-19 but are never

notified, or others who are worried they may have unknowingly come across the virus in their

daily life. Additionally, the cost of COVID-19 test is only covered through many private

insurances when an individual’s visit meets the criteria (COVID-19 Testing in Oregon). Those

who don’t meet the criteria or do not have health insurance must pay out of pocket for the test.

This puts essential workers, people of color, and poor people at a significant disadvantage.

Policy

This policy proposes that the State of Oregon offer free COVID-19 testing to every

individual regardless of citizenship status, proof of health insurance, previous contact with

someone confirmed to have COVID-19, or symptoms concurrent with the COVID-19 virus.

Implementation of the policy is anticipated to increase the rate at which individuals are getting

tested and would especially benefit racial/ethnic minorities and low-income individuals in the

state of Oregon by removing barriers and expanding access to much-needed testing. And, since

People of Color and poor people are also incredibly susceptible to contracting the virus,

becoming hospitalized, and experiencing negative outcomes, the rate of cases, hospitalizations,

and deaths state-wide should decrease as a result.

The implementation of Free and Accessible COVID-19 testing would require structured

and intentional marketing to the public. The policy should first be highlighted in a public service

announcement by Governor Kate Brown. The initial proposal would be covered by several news

outlets and televised for at-home viewing. Next, employers (especially those which could be

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described as essential) should be encouraged to announce the policy to their staff members and

used to further endorse the policy’s agenda. Finally, the policy should be taken to social media

through the Oregon Health Authority’s official pages. Facebook, Twitter, and Instagram should

be appropriately utilized to reach targeted demographics. Marketing should include quick facts

about what the policy includes and resources for testing locations, and potentially answer some

anticipated questions. By allowing the public access to the overview and details of the policy,

and actively encouraging people to take advantage of its benefits in order to protect themselves,

they in turn protect their communities.

The key to ending the global pandemic is increased testing, which in the United States

can only be done through ensuring that every individual has equal access to a test. Coupled with

the preventative strategies already in place (mask mandates, encouraged vaccinations, social-

distancing protocols), increased testing should result in an initial increase in positive cases and

an increase in isolations, but quickly followed by a decrease in transmission rates,

hospitalizations, and deaths. If the public does not know where COVID-19 is due to a lack in

testing, then it is difficult to keep themselves as safe as possible. But, by offering free and easily

accessible tests, then individuals can confirm that they are COVID-19 negative before they

attend places of work, grocery stores, and family and religious gatherings. It is important to

identify if someone is at risk of spreading the potentially fatal virus. Eliminating systematic

barriers to identifying that risk is a top priority

Budget

The budget for policy implementation would need to include the cost of marketing and

access to free COVID-19 tests for those who need them, which would primarily be in low-

income communities of color. The cost of marketing to targeted communities could be

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effectively covered through the application of Community-Based Grants, and it is anticipated

that annual cost would be approximately $3 million, based on a rough estimate fraction of the

average, annual cost of state marketing attempts in total. Additionally, CBO’s could cover the

cost of testing for uninsured individuals (COVID-19 Funding for Community-Based Testing).

Policy implementation also requests a portion of OHA’s overall budget from different

divisions, such as the Public Health, Health Equity Division, and Oregon Health Plan for a total

of $30 million annually to ensure the components of community outreach, education, and

COVID-19 testing for uninsured individuals (Oregon Health Authority 2021-23 Ways and

Means Reference Documents).

Outcome

By allowing people to have access to testing as soon as they feel ill, when they are

asymptomatic and suspect they have come in contact with COVID-19, or regularly as a

precaution, then individuals in need of care or isolation can be quickly identified and encouraged

to stay-in-place, reducing the chances of spreading the virus to someone else, or becoming

severely ill and in need of hospitalization (NIH Leadership, 2020). The outcome of this policy

implementation could be directly measured by the number of cases, hospitalizations, and deaths

that are already being recorded in each county of Oregon. It is expected that upon the initial

implementation there would be a rise in cases as more people obtain access to testing and

somewhat-inevitably test positive. But following the small spike, there would be a general

decrease in each of the variables being measured as more people get tested and continue to

isolate if they test positive.

Observing general trends by county could also aid in discovering which communities still

need to be targeted with marketing and information about the policy. If it is discovered that some

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variables (cases, hospitalizations, deaths) are increasing rather than decreasing, then marketing

focus would shift to those areas in an attempt to get more people tested and isolated. It is

unlikely that the number of cases would reach pre-pandemic numbers for quite some time, given

immigration into the state, public distrust in testing and vaccines, general public discontent, and

other outlying barriers not listed in this policy, but the goal is to get as close as possible.

As mentioned previously, the communities disproportionately bearing the burden of the

disastrous effects of COVID-19 have been ethnic and racial minorities due to their

predominantly public-facing and essential occupations, as well as historically inequitable access

to healthcare. Free and quick testing will allow the state to protect its most vulnerable

populations, which can be quantitively measured through a reduction of cases, hospitalizations,

and deaths.

Stakeholder Engagement

The stakeholders of the Oregon Health Authority include Oregon legislators, OHP

providers and members, state and community advocates, the local and federal government, and

most importantly – Oregonians (External Relations Division, 2020). First, the policy would

break ground by receiving public support. Hosting town halls, visiting essential workers at their

homes and places of business, and harnessing the power of social media by spreading the plan to

communities that may not physically be reached will aid the policy in being brought to the

attention of Oregon legislators, all while requesting and receiving feedback and criticism of the

policy agenda, and making changes where they are necessary.

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References

Chiu, W. (2020). ‘State-level Impact of Social Distancing and Testing on COVID-19 in the

United States’. National Institutes of Health.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7362894/

‘Coronavirus Disease’ (2021). World Health Organization. https://www.who.int/health-

topics/coronavirus#tab=tab_3

‘COVID-19 Funding for Community-Based Organizations’. Oregon Health Authority.

https://www.oregon.gov/oha/PH/ABOUT/Pages/Community-

Engagement.aspx?wp984=p:2#g_6f6eff26_69ca_40bc_a7fe_33815a23cee4

‘COVID-19 Risks and Vaccine Information for Older Adults’. (2021). Centers for Disease

Control Prevention. https://www.cdc.gov/aging/covid19/covid19-older-adults.html

‘COVID-19 Testing in Oregon’. Oregon Health Authority. https://govstatus.egov.com/or-oha-

covid-19-testing

‘Oregon Health Authority 2021-23 Ways and Means Reference Documents’. Oregon Health

Authority. https://www.oregon.gov/oha/Budget/2021-2023-WM-Reference-Doc.pdf

‘External Relations Division’ (2021). Oregon Health Authority.

https://www.oregon.gov/oha/ERD/Pages/index.aspx

NIH Leadership. (2020). ‘Why COVID-19 Testing is the Key to Getting Back to Normal’.

National Institute on Aging. https://www.nia.nih.gov/news/why-covid-19-testing-key-

getting-back-normal

Rogers, T. (2020). ‘Racial Disparities in COVID-19 Mortality Among Essential Workers in the

US’. World Medical and Health Policy.

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https://onlinelibrary.wiley.com/doi/full/10.1002/wmh3.358?casa_token=OYsvT2QLnhc

AAAAA%3ADnLN-ZabjSkGC-

h3qWQHVI9TJQTJN818lwIkuwyRH4X47W40iqA2vKjO7gUpmfRxbGxMZx2eiG_Jlfg

‘State COVID-19 Data and Policy Actions’ (2021). KFF. https://www.kff.org/coronavirus-

covid-19/issue-brief/state-covid-19-data-and-policy-actions/

Thakur, N. (2020). ‘The Structural and Social Determinants of the Racial/Ethnic Disparities in

the US COVID-19 Pandemic. What’s Our Role?’. American Journal of Respiratory and

Critical Care Medicine. https://www.atsjournals.org/doi/full/10.1164/rccm.202005-

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