US Adults’ Preferences for Allocating 500 Million Free COVID-19 Tests

17 Pages Posted: 20 Jan 2022 Last revised: 21 Jan 2022

See all articles by Harald Schmidt

Harald Schmidt

University of Pennsylvania

Aleksandra Golos

University of Pennsylvania School of Nursing

Emily Sadecki

University of Pennsylvania - Department of Medical Ethics and Health Policy

Sarah Gollust

University of Minnesota - Twin Cities

Alison Buttenheim

University of Pennsylvania

Date Written: January 19, 2022

Abstract

Complementing other efforts, the Biden Administration recently announced the purchase of 500 million rapid antigen self-tests, to help address ongoing issues with access to COVID-19 tests. A website, launched on Jan 18, 2022 (https://www.covidtests.gov) enables those wishing to receive tests to register their interest. But it is currently not clear how tests will be allocated, particular in case demand exceeds supply. The question of allocation is critical, as the use of websites in the initial vaccine allocation demonstrated inequitable outcomes. On both equity and public health grounds, it is important that more disadvantaged communities are not left behind.

We assessed, in a nationally representative survey experiment fielded from January 4 to 6, 2022 (N=2,019), the public acceptability of 3 major options for allocating tests: 1) First come, first served, 2) Random draw/Lottery, 3) 80% by random draw/lottery, and 20% as a guaranteed amount to more disadvantaged communities (analogous to an approach implemented by the majority of US states for vaccine allocation).

We found significant differences in support across the 3 allocation options, and that 76% of respondents randomized to the equity-promoting frame (and majorities of both Republicans and Democrats) favor additional allocations to more disadvantaged communities larger than 20% (median additional allocations: 44%). We also found that just 29% of all respondents supported sending 4 tests per household—which is the ultimately announced policy—whereas 71% favored adjusting the number sent by household size (e.g., 4 tests for each person in the household).

If the approach of sending 4 tests per household is sustained, the need for adjusting allocations through measures such as geographic disadvantage indices increases in order to advance equity in test allocation, given relationships between household size and economic or social disadvantage.

Note: Funding: No external funding.

Declaration of Interests: No author has any conflicts of interest to report.

Keywords: COVID-19, equity, health equity, rapid-antigen test, home test, allocation, rationing

JEL Classification: I1, I15, I14, I18, H41, H51

Suggested Citation

Schmidt, Harald and Golos, Aleksandra and Sadecki, Emily and Gollust, Sarah and Buttenheim, Alison, US Adults’ Preferences for Allocating 500 Million Free COVID-19 Tests (January 19, 2022). Available at SSRN: https://ssrn.com/abstract=4013115 or http://dx.doi.org/10.2139/ssrn.4013115

Harald Schmidt (Contact Author)

University of Pennsylvania ( email )

Philadelphia, PA 19104
United States

Aleksandra Golos

University of Pennsylvania School of Nursing ( email )

Emily Sadecki

University of Pennsylvania - Department of Medical Ethics and Health Policy ( email )

423 Guardian Dr
Philadelphia, PA 19104
United States

Sarah Gollust

University of Minnesota - Twin Cities ( email )

420 Delaware St. SE
Minneapolis, MN 55455
United States

Alison Buttenheim

University of Pennsylvania

Philadelphia, PA 19104
United States

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