State will distribute 2.1 million free COVID-19 rapid at-home tests to hardest hit communities, Baker says

Governor Charlie Baker took questions about COVID-19 testing during a press conference at the State House on Monday.Pat Greenhouse/Globe Staff

Governor Charlie Baker announced Monday that the state will distribute 2.1 million free at-home COVID-19 tests in an ambitious effort to slow the spread of the coronavirus as a winter surge looms.

The tests, which provide results in 15 minutes, enable people to find out if they’re infectious before gathering with others. But at $25 to $30 a pair, they are expensive and often in short supply.

Baker’s program will provide the tests this week to 102 communities with the highest percentage of families living below the poverty level.

The Baker administration is also negotiating with manufacturers to buy more tests in bulk so that other municipalities can obtain them at discounted prices, using federal pandemic relief money.

“This is not just a one-time distribution of a one-time test,” Baker said at a press briefing Monday.

The news came as COVID cases and hospitalizations continued to climb in Massachusetts to rates not seen since last winter. In its first report since Friday, the state reported 11,078 new confirmed coronavirus cases and 1,355 patients hospitalized with COVID-19 on Monday.

Baker announced his plan just a week after Boston Mayor Michelle Wu said she would distribute 20,000 free rapid tests to city neighborhoods with the highest rates of COVID-19.

At the news briefing, Baker said that hospitalizations in Massachusetts remained below last year’s levels and were being driven primarily by the unvaccinated. “The vaccines protect against serious illness and death,” he said. “If you look at the hospitalization rates of the vaccinated and the unvaccinated in Massachusetts, if the unvaccinated got vaccinated, we drop our hospitalization rates by 50 percent.”

Public health experts applauded the program but emphasized that it should not substitute for masking and vaccination. They also cautioned that people need to be educated about how and when to use the tests.

“We’re really glad to see that the administration is taking this step to making rapid tests more accessible,” said Carlene Pavlos, executive director of the Massachusetts Public Health Association. “This is a good thing, especially with the emphasis on providing it to the hardest-hit communities.”

But she called it “disheartening” that Baker, at Monday’s press briefing on the new initiative, reiterated that he had no plans for a statewide mask mandate. “We need all the tools we can bring to bear,” Pavlos said.

In defending that decision, Baker said: “Keep in mind that we’re in a very different place than we were in before. Five million people are fully vaccinated, a million and a half of those are boosted. Over 6 million people have at least one dose.”

Asked about Baker’s test distribution plans, Dr. Ashish Jha, dean of the Brown University School of Public Health, had a succinct answer. “I love it,” he said.

“Rapid tests are a very powerful tool for keeping infection numbers down,” he said. “I love the fact that the Baker administration got 2 million of these things.”

Jha said the brand Baker is deploying, made by iHealth Labs, is high quality and easy to use. But people are accustomed to taking tests only when they’re sick, he said, and may not understand how to use the rapid tests effectively.

“We need to wrap around a lot of education and other tools,” Jha said. “The biggest risk by far is that people will not end up using these tests. If they’re used widely, I’m very confident that it will make a difference.”

The tests should be taken immediately before attending a group activity. People who test positive should skip the event and isolate for 10 days. A negative test means that you are not highly infectious.

The state spent $10 million on the tests and will seek reimbursement from the Federal Emergency Management Agency, Secretary of Health and Human Services Marylou Sudders said. They can be used on people age 2 and up. “People who do test positive should isolate for 10 days,” Sudders said, and should contact their health care provider or local board of health if they need assistance.

The Massachusetts Emergency Management Agency will deliver the test kits to the 102 communities, which include Boston, Bridgewater, Brockton, Cambridge, Chelsea, Chicopee, Everett, Fall River, Framingham, Fitchburg, Lawrence, Lowell, Lynn, Malden, Methuen, Springfield, and Worcester. But the state will leave it to local officials to decide the best way to get them into the hands of people who most need them.

Sigalle Reiss, president of the Massachusetts Health Officers Association and the director of Norwood’s health department, first learned of the program in an e-mail Monday morning. “It’s a good idea, but it comes down to the details,” she said. “It’s standing up a whole new program that I haven’t had time to do the groundwork for.”

She expressed appreciation for flexibility but said “some consistency and guidelines would be helpful to make sure they get into the right hands.”

Mike Armano, director for the Lawrence Board of Health, said the tests would be especially welcome in Lawrence for the convenience and privacy they provide. “We have a very fast city and a very tired city,” he said. “People are running from one shift to another, picking up their kids.” The tests, he said, will be “one of many risk reduction efforts.”

IHealth is one of several brands of at-home tests that can be bought in pharmacies or online. A user swabs their nose and places the swab in a testing liquid. Results appear after a few moments on a plastic stick, similar to a pregnancy test.

A positive result means a person has a large amount of virus in their nose, which indicates that they can spread it to others.

The tests, said Gigi Gronvall, senior scholar at the Johns Hopkins Center for Health Security, “are great at telling people if they are [infectious] to others at that moment.”

But Susan Butler-Wu, associate professor of clinical pathology at the Keck School of Medicine of USC, cautioned that a negative test should not be seen as “a free pass” to take risks.

“We have to be clear about the limits of what testing can and can’t do,” she said. It’s possible, although less likely, to have a lower level of virus and test negative but still manage to infect somebody.

And the testing program, Butler-Wu added, “needs to be coupled with social supports” for people who test positive and may not have space to isolate in their home or the ability to take off from work.

One concern about home tests is that the results won’t be shared with public health officials, potentially hindering disease surveillance. But Rachael Piltch-Loeb, a research associate in the Department of Biostatistics at Harvard T. H. Chan School of Public Health, said the benefits of home tests outweigh that disadvantage. “The reality is that if you have to wait two hours in line to get a test from a clinic that will then report to the state, you may never take that test,” she said.

On Martha’s Vineyard, the popularity of home tests has already started to raise concern among health agents, said Maura Valley, Tisbury’s health agent, who also coordinates COVID-19 issues for the Vineyard communities.

“I think we need to have a plan for either a way for people to let us know they tested positive or information given out with the tests about what to do if they test positive,” she said. “I think it needs to go beyond saying ‘here’s a test.’”

Travis Andersen of the Globe staff contributed to this report.