States fight for rapid antigen test supplies as federal government sits back

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States are struggling to secure supplies of rapid antigen tests after being been forced to compete in a tight global market as the federal government refuses to purchase the kits for widespread use, despite public health experts saying they are a vital part of the future fight against the pandemic.

The country’s leaders are also yet to outline national guidelines for using rapid antigen tests after committing to work on a plan in November as pathology systems around the country continue to buckle under the strain of PCR testing demands.

A stockpile of COVID-19 rapid antigen tests on display at Southon’s Chemist in Sydney.Credit:Cole Bennetts

The NSW state government announced on Tuesday it had placed an order for 20 million tests which are expected to arrive by the end of January and will be provided free of charge to people. The Victorian state government put in a large order for rapid tests before Christmas but has not confirmed the number of tests on order or when they are expected to arrive.

“It has been very challenging to find supply,” NSW Health Minister Brad Hazzard told The Age and The Sydney Morning Herald on Tuesday.

PCR testing facilities in the ACT and NSW have been forced to close early as thousands of people line up for tests ahead of intestate travel and as states battle unprecedented COVID-19 case numbers.

But state governments have found it difficult to secure as many at-home tests as they need on the international market because they have been bidding against each other at the same time over the Christmas period.

Queensland’s Health Minister Yvette D’Ath said a move away from pre-travel PCR testing – pencilled in for January 1 – hinged on the availability of rapid testing kits in other states.

“There’s no point shifting from one type of test to another type of test if you’re not confident that that test is going to be available,” Ms D’Ath said on Tuesday morning.

The NSW order will not arrive in one batch but will be spaced out due to supply limitations.

NSW Premier Dominic Perrottet said the tests would be widely available but would have some conditions placed on their use.

“These tests will be used for people going to high-risk settings – to go to hospitals, visiting elderly relatives, going clubbing,” he said on Tuesday.

Mr Perrottet’s office did not respond to questions about where the government had purchased the tests.

The NSW Premier said more details would be announced in the coming days.

“I want to get as many rapid antigen tests in the homes of people right across our state … and we will move through the best distribution model to make sure the people who need those tests have access to them,” he said.

Countries including the UK and Singapore have made rapid antigen tests freely available for residents. They have been used in conjunction with PCR tests for much of 2021.

Epidemiologist and World Health Organisation adviser Professor Mary-Louise McLaws said Australia was well behind on broadening the use of rapid tests.

“PCR tests should be perfectly used for diagnosis of somebody who has symptoms … everybody else should be using a rapid antigen test,” she said.

Deakin University’s chair of epidemiology Professor Catherine Bennett said PCR testing should be reserved for those at high risk of serious COVID-19 so they can receive potentially life-saving medical treatments as early as possible, keeping them out of hospital or intensive care.

“We have to preserve PCR testing for where it counts,” she said.

In advice provided to national cabinet before its meeting last week, the country’s chief health officers recommended increasing the use of rapid antigen testing, including for essential workers and in high-risk settings for transmission.

A federal government source speaking anonymously said states had known for weeks that supply was tight and were aware from October that the tests would be available for at-home use by November.

“There’s a lead-in time to manufacture and deliver the tests, and unfortunately no one seems to have thought about that in Victoria,” the source said.

The federal Department of Health said the federal government provides rapid antigen tests for some aged care facilities and also provides reimbursements for tests used in disability care, but said people should purchase their own as “Medicare does not fund clinic goods”.

“Medicare does not fund bandages or medicines, but it does fund the service provided by a doctor in changing a bandage or prescribing a medicine. This also applies to rapid antigen detection devices or screening tests,” a department spokeswoman said, adding people could purchase RAT kits through retailers.

Grattan Institute health economist Stephen Duckett said the Commonwealth should be responsible for procuring rapid tests because it has greater purchasing power and could place orders of greater volume.

He said governments around Australia had been slow to recognise the importance of at-home tests, and argued they should be made free.

Professor Bennett said states should provide free rapid antigen tests as they were the ones deciding public health measures, but Professor McLaws said the federal government should be footing the bill.

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