In recent weeks, as the omicron variant spread rapidly across the United States, Americans have found that the economic cost of the pandemic is increasingly falling on their shoulders.
As Covid-19 cases have increased, public health experts have urged people to dump their drug masks in favor of higher-quality options and to test more often to curb the virus.
The Centers for Disease Control and Prevention updated its mask guide on Friday to note that the N95 or KN95 disposable masks offer the "highest level of protection" against the virus.
For some, the extra financial burden is an annoyance - but still affordable. For others, the prospect of paying $ 1 for a single disposable mask or $ 24 for a test kit is an economic impossibility, which raises the speculation that the pandemic will continue to exacerbate inequalities.
During the pandemic, three-quarters of workers said it was very or a little difficult to make ends meet, 40 percent said they could not come up with $ 400 in case of an emergency, and about 20 percent said they went hungry , because they could not afford enough to eat, according to the Shift Project, an ongoing study of American hourly wage workers run by Harvard University sociologist Daniel Schneider.
Most also do not get paid sick leave and continue to work when they are sick because they cannot afford to miss a paycheck, he said.
"These are the workers who are facing the virus and we are asking them to buy high quality masks and pay for quick tests?" said Schneider. "For many of these workers, it's just not an option - it's about food on the table. And when faced with the impossible choice, handing over pandemic prevention to poor workers is really unrealistic."
The White House also announced that private health insurance companies would be required to refund up to eight home Covid-19 tests a month, and later this week the Biden administration will make up to four tests available to U.S. residents via an online portal . President Biden also said Thursday that his administration planned to make "high-quality" masks available to the public free of charge, but declined to provide details, including when the masks would be available.
Yet workers and experts have expressed frustration that the state and federal governments are not moving faster and more transparently to provide rapid tests and high-quality filtration masks, such as N95 and KN95, to residents at low cost or for free, especially in recent months as the number of cases and hospitalizations increased in the highly contagious omicron variant. Many cannot afford to wait to be reimbursed or do not have health coverage.
In some cities, local mutual aid groups - many set up amid the George Floyd protests in the summer of 2020 - have been working to fill the gap. Organizers in Portland, Ore., And Seattle have donated their own money in the effort and issued calls for cash and test kits to hand out to the needy.
The founders of the groups said they were hoping to raise enough money to cover their expenses, but in the end they said they could not ignore that tests had become unavailable to them without financial means.
The founder of the Seattle Rapid Test Bloc, who asked to remain anonymous for fear the personal publicity might bring, said people in the community had donated tests and cash for the effort. The group also charged $ 2,000 for 100 tests on a credit card and hoped to cover the cost through fundraising. By the weekend, it had raised $ 1,200.
"We know we are everything we have and everything we can trust and therefore we have to be a community and take care of each other because no one else is," said the group's founder, who noted , that the price of 100 tests had increased by $ 500 since the order. "It's a shame to be at this point and know when the government or someone does something, it's going to be too late."
Sam Stettiner, who is disabled and lives in Brooklyn, said fear of the disease and anger and sadness over the reaction, especially on behalf of the disabled, had almost defined his time during the pandemic. He said it has been difficult to procure tests and the price is hard to swallow because his chronic illnesses make it impossible for him to work.
Having enough supplies for himself is a challenge, but he also wants quick tests available for the various home helpers who come to his apartment - especially after one came despite being ill.
"Cost is a big issue for me and I think for a lot of other people who have low fixed incomes," Stettiner said. "We can not necessarily spend hundreds of dollars on refills, and at the same time we need to go to high-risk environments more often than non-disabled people for medical appointments and procedures we cannot skip."
Some members of Congress are putting increasing pressure on the Biden administration to take greater steps in response to the ongoing spread of the virus.
Rep. Ro Khanna, D-Calif., Joined Senator Bernie Sanders, I-Vt., And other Democrats last week to push for a bill that would give three N95 masks to every person living in America. They have also been pushing to expand access to rapid testing.
The hope, Khanna said, was that the federal government would use the Defense Production Act to expand the number of rapid tests and masks available and then provide them for free to anyone in the United States who needed them.
Even allowing people to get reimbursed tests they have purchased through their health insurance companies does not go far enough, he said, noting that there are many here who have neither health coverage nor time to mess with their insurance companies.
"Many people do not have the money to pay in advance and wait for reimbursement," Khanna said, adding that even he had waited months to be reimbursed for tests covered by his insurance. "That's why I think it's so important for the government to buy them, send them to people and allow people to order them online or by calling a hotline and then delivering them in grocery stores, at health centers, at post offices - it should just be ubiquitous. "
In a Friday text, Khanna sounded more optimistic after a meeting with White House officials regarding the need for a more aggressive and fair response, especially in their efforts to provide high-quality masks to Americans.
"I had a good call with the White House. They understand that," he said in a text message.
The details of this announcement remain unclear, but it is likely to come shortly after the Biden administration begins distributing the free home tests - up to four per year. household.
But the 500 million tests that the administration is handing out are not close enough, say many experts, especially for families who have children in school and parents back at work.
"It's good, but it's really just a drop in the bucket," he said Dr. Eric Feigl-Ding, an epidemiologist and senior fellow at the Federation of American Scientists. "Considering we have to test millions and millions of people regularly, 500 million tests are about one and a half per person. That's really insignificant."
This is a particular challenge for students and workers, as some schools and employers require those who test positive or have been in close contact with someone who has to give a negative test to return to the classroom or their workplace. For low-income workers, the inability to pay for tests or find tests can promote a cycle of poverty, as many have not paid for sick leave or the ability to pay for childcare.
Consumers in other countries seem to have much cheaper or even free options. In India and Germany, tests can be purchased for a few dollars apiece. The UK sends quick tests to residents who request them, or they can be picked up from a number of pharmacies or central hubs.
Demand in the US is too high compared to the available supply, said Feigl-Ding, who said he knew people who had bought a large number of tests because they wanted to use them for parties.
"We have to invoke the law of defense production to make them cheaper and ensure that there is no price cut," he said. "We have to make them available at the bottom of the cellar. The pandemic profiteering is just not acceptable and it is actively hurting economic progress because it is hurting our recovery."
But it does not appear that Covid tests will be cheaper.
Walmart and Kroger said they raised the prices of quick tests after an agreement they had with the Biden administration to sell tests at cost price expired.
Tricia Moriarty, a spokeswoman for Walmart, said the company was one of only a few retailers participating in the White House program to sell Abbott BinaxNow tests at cost for three months. Although she said there was an ongoing demand and that the company had set purchase limits, she acknowledged that Walmart had raised its prices.
"When the 90 days expired in mid-December, we still kept the product priced at cost price through the holidays," she said via email. "Now that we're back to our original $ 19.98 price, we think we're still the lowest price compared to other retailers."
At Kroger, another company that had agreed to keep its prices down, spokesman Kristal Howard also stressed that the grocery chain was one of three companies that had reduced the cost of quick tests. She said they added tests from other manufacturers to store shelves to increase product availability.
"It should be noted that we fulfilled our obligation to the Biden administration to sell at cost price for 100 days, and that pricing program has now been phased out and prior retail prices ($ 23.99) have been reinstated," Howard said in an email .
Still, critics have said, Walmart and Kroger's own retail workers will likely have to work several hours to afford a single test kit at those prices.
Increasingly, strategies to prevent pandemics - masks, quick tests, work from home and paid sick leave - have become a luxury, Schneider said.
"It's a world upside down because frontline workers who are actually out there facing risk and facing the public can not afford tests, are not thoroughly tested by their employers, lack the resources and time to go in search of "This pandemic prevention strategies and are least likely to have paid sick leave and have to work personally," he said. "It's exactly the opposite."