NEW YORK – Amid a skyrocketing surge in the number of COVID-19 cases caused by the Omicron variant recently, testing once again took center stage to track and stop the spread of the disease – and the nonprofit Rockefeller Foundation has taken up the cause, unveiling a program to send out more than a million antigen tests with a specific focus on at-risk populations.
Through $7.45 million in funding from RF Catalytic Capital, a charitable offshoot of the foundation, Project Access COVID Tests (ACT) will deliver an initial 1.1 million iHealth antigen tests to residents in Arkansas, Illinois, Maine, Michigan, New Mexico, and Ohio that live in zip codes that are most vulnerable to COVID-19, based on the US Centers for Disease Control and Prevention's Social Vulnerability Index and state data on the COVID-19 burden. The index ranks subdivisions of counties based on a variety of social factors, including socioeconomic status, household composition – such as single-parent households – and disability, minority status and language, and housing type and transportation.
According to Mara Aspinall, an advisor to the Rockefeller Foundation and professor of practice at Arizona State University's College of Health Solutions, Project ACT is intended to "ensure more and more tests are in American hands." Despite the White House's push to get 1 billion at-home tests to Americans, there are "still communities that are underserved," she said, and this project is an "opportunity" to get tests to those people.
Most recently, the number of COVID-19 cases have plateaued or receded. Still, with the unpredictability of the pandemic and other new variants possibly on the horizon, the demand for testing could rise again suddenly.
While the Project ACT pilot program is being rolled out only to six states, Aspinall said the foundation hopes to expand it to more states in the future. The first states were chosen because they expressed initial interest, she added. Working with state health departments to determine the appropriate zip codes was essential, Aspinall said, because "states know their communities best" and it's up to them to determine which people need tests the most.
Aspinall said the program was modeled after the CDC and the National Institutes of Health's Say Yes! COVID Test program, which distributed free at-home tests to five separate communities in the US to study the effects of testing on reducing the spread of SARS-CoV-2 and to identify the best ways to promote testing and distribute test kits.
After requesting proposals from antigen providers who had received Emergency Use Authorization from the US Food and Drug Administration, the Rockefeller Foundation chose iHealth's antigen tests because the company was able to meet the demand and had a relatively quick manufacturing turnaround, Aspinall said. iHealth also provided a 10 percent donation to cover an additional 100,000 tests, the foundation said in a statement.
The total cost for each test for the Rockefeller Foundation through the program is $6.50, cheaper than most retail tests. On iHealth's website, a pack of two tests retails for $17.98.
Health technology company CareEvolution and Amazon are handling the logistics and distribution for the program. CareEvolution is in charge of running the program's website, while Amazon will deliver the tests to residents through its "well-honed delivery system," Aspinall said.
Residents of the included zip codes can request an order of five tests using the program's website, and there are no restrictions if the residents have also enrolled in the federal program to receive antigen tests, Aspinall said. An internet connection is required, since the tests can only be ordered through the website, but Aspinall said the foundation has found "few challenges with access," noting that most people have a smartphone or another way to reach the internet. She added that only a few hours after the announcement at the end of January, orders had already started to come in for the tests.
In addition to providing the initial funding for the program, the Rockefeller Foundation coordinated the response and found the vendors. However, Aspinall said that while the next stage of the program will still be coordinated by Rockefeller, states will pay for the tests themselves. The second stage will also likely add tests from different providers beyond iHealth. Several other developers have expressed interest in participating, and the foundation is working with them to determine test availability and logistics for the second phase, a spokesperson for Rockefeller said.
The foundation hasn't yet announced the opening of the second phase because it is "waiting to see how quickly we can move" through the initial pilot program, Aspinall said. A "substantial number" of the tests have been delivered, and the foundation is in the process of "completing the necessary partnerships" to launch the second phase, the foundation spokesperson added.
A spokesperson for the foundation said via email that "while the first phase of the initiative was philanthropic, our intent was to build a model that can be sustained with funding from interested states." She noted that the foundation will use RF Catalytic Capital as "the vehicle to aggregate funding from the individual states who are continuing in or newly joining the program – leveraging that collective purchasing power to negotiate better pricing for an 'all-in' package that will include tests and delivery/logistics."
In essence, RFCC "will be the mechanism that is used to take in state resources and then pay for the various components … on the states' behalf," she said.
Aspinall was careful to note that Project ACT will not replace other programs, including state-specific initiatives, saying that "it's important to enable as many programs" as possible. It is still hard to get tests on retail shelves, so programs like these provide "additional material" to ensure tests are available.
"We are not done" with the pandemic and it "is not done with us," Aspinall said, even as COVID-19 case numbers decline. "Testing needs to be the foundation of the nation's response" to the pandemic, and "it's the key to the beginning, middle, and most importantly, the end of the pandemic."