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Comment by skohan | Hacker News Reader

Whereas in the US necessary flights have been cancelled left and right. I had to take a series of flights in the past two weeks, and it was an absolute mess. By the third trip, I honestly had no expectation that my flight would take off on time, if at all.

That and getting a PCR test this week in the NYC area seems totally non-functional. Appointments have to be made days in advance, for results which can several days to come back. It's a far cry form Germany where I can get same day service at any number of testing centers, and pay to get expedited results if I need to.

How can these systems be so broken, and why isn't capitalism solving them?

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Any place in the US that requires appointments has never been reliable for me. If I went that route I would have to wait weeks to months to get a vaccine or PCR test.

Instead, poorer neighborhoods usually have hospitals or health centers that offer walk-up or drive-through services for vaccinations and tests. Sadly, most of the people in those neighborhoods don't use the services, so if you go right when they open you can get vaccinated or a PCR test with barely any wait. I waited 5 minutes to get my vaccine in Miami, and I waited about 15 minutes in a drive-through in Boston to get a PCR test with results the next day.

I dont understand.

COVID tests are completely free, subsidized by the government. You can get COVID tests at very high prices on the "black market". If you don't want to pay those prices, you stand on line at the free testing areas.

Why do you think capitalism is broken here when its working just fine. The supply of testing is too low since its free to take them officially and there is massive demand

Are you talking about PCR tests, or antigen tests?

All I can tell you is that this week, my Aunt and I were both flying out of EWR. She needed a PCR test for the flight which was supposed to be Tuesday, and she started looking on Friday, but it was almost impossible to find anywhere with an appointment available before Thursday. And even those gave a very fuzzy 1-3 day estimate for results, which is quite unhelpful when you have to take the test within 72 hours of departure.

She spent an entire day trying to find somewhere which would take walk-ins, and eventually found a place through a fiend-of-a-friend-of-a-friend who could get her in, although she did have to push the flight back by a day.

From my perspective, this just seemed totally broken. I don't understand how there could not be a vendor, easily discoverable through Google which could deliver same-day or next-day results at whatever price the market would bear, even if it was $300 or $500 or whatever.

It felt like being in a developing country where things just can't be depended on to work properly.

You can order at-home rapid antigen supervised (over webcam) tests to your home that are accepted for flights. Not sure it would come over night though.

But you're right it is totally broken: they should be auctioning these PCR testing slots to the highest bidder. But of course then there would uproar about "price gouging."

Somewhat similar to how everyone is complaining they can't find PS5s and yet Sony is unwilling to raise topics because the optics would be bad.

Are you sure there are at-home antigen tests which are universally accepted for international travel? I have been on a number of international flights during this period, and having read the entry requirements for a few different countries, this would be the first I have heard of this.

Yes, however I just checked and they seem unavailable at the moment.

> the government

Which of the many governments in the world are you talking about?

So the post is talking about NYC, which exists in the USA, so I presume its fairly obvious what Government

If you haven't been for a covid test lately, especially in a populated area, things have changed significantly. Lines are 4-12 hours long and often run out of tests before they can get to everyone. There are no appointments available. Urgent Care centers are overrun and can't handle nearly as many tests as people are requesting.

How does this disprove market theory. The tests are free due to subsidizing. High demand leads to shortages.

Because one of the options you stated (waiting in line) isn't even an option in a lot of areas.

This specific scenario has nothing to do with market theory. It's a combination of regulation, subsidization, and infrastructure. We're not buying playstations.

Are PCR tests free in the US? I found tons of paid testing services when looking, they just didn't have capacity.

Yes they're free. I haven't paid for an antigen test or PCR test and I've had probably half a dozen of each.

They’re covered by insurance…try being a visitor to the US then an antigen test will cost you $150+.

They're also covered if you don't have insurance, but yeah that could be completely correct if you're not a citizen/resident of the US. Bummer.

The tests are free to the person testing. They don't magically appear out of thin air. The government is buying them via the normal capitalist system but there aren't enough because the manufacturers can't make enough to meet demand.

(In part, because major manufacturers closed factories and destroyed inventory between spikes. https://www.nytimes.com/2021/08/20/us/abbott-covid-tests.htm...)

I'm a bit baffled as to why the Defense Production Act hasn't been utilized more during the pandemic for stuff like this.

The government is subsidizing testing so very few people, even those who would could afford it otherwise, will be willing to pay for it. With no cost, controlling demand becomes a function of time instead of price. Whether this is a better solution is up for debate but capitalism isn’t filling the need efficiently because, well, it isn’t even close to a free market.

I would think that in a city like New York with multiple large international airports, there would be plenty of people willing to pay to get the PCR tests they need to get on an international flight on time. There must be thousands of people per day who need to get a test to get on a flight at EWR or JFK.

Currently that appears not to be the case, and there is no simple and reliable way to guarantee getting a test on time.

This seems to be a market failure, and it is not obvious to me why the market has not stepped in to fill this gap.

My local airport has PCR tests available with results in 35 minutes for $200. Every time I've looked, they have tons of appointments available for the same hour / within a few minutes.

And outside of the airport, last time I flew United directed me to some options that were $150, but had results the same day. At least where I live, there are definitely quicker options if you are willing to pay.

> why isn't capitalism solving them?

Because there's no money in it. We're likely going to have a surge of cases over January (judging by what happened in South Africa). If I'm a test maker/provider, I'm not going to spend a week ramping up production, have the extra tests arrive in two weeks, just do be on the downside of the surge. It's the same reason I didn't build up more capacity in October. There's a vaccine and boosters are starting. Why would I take a gamble on a new variant?

One role of government is to step in when markets fail. We saw test shortages a year ago, and a new variant was an eventual likelihood. The government needed to place the test orders so that the risk didn't get shifted to markets uninterested in that risk. This is almost entirely a failure of government leadership.

To its credit, the US government did a really good job ordering vaccines. It's just handled testing very poorly.

You can definitely pay to get your PCR test expedited all over the place. It's around $200 to $300. Ask on the NYC subreddit.

Hell… I work in a bacterial genetics lab, maybe I should just be doing qPCR and making some bank on the side.

I've flown quite a bit in the past year - while there's been more cancellations than pre-pandemic, the last few weeks are outliers.

"Capitalism" can't produce new staff instantly at any price when staff are in industries that require substantial training/testing prior to being allowed to work after hiring (or after any long furlough/hiatus of not working, even if they remained officially employed).

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Anyway, you've got a perfect storm of issues.

Airlines have depleted crews from cutting too deeply in the early pandemic. Training/retraining large numbers of people takes lots of time, only so many people are actually qualified to teach or test them.

Airlines were already running what staff they have with as minimal spare capacity as they could get away with to meet demand that's come roaring back far faster than expected, especially for the holiday season. The US is currently running ~83% of 2019 passenger loads (12/20-1/4 passenger count in 2019/20 - 36.6m, 2021/22 - 30.7m), per the TSA checkpoint numbers.

And then....you have a new COVID wave that's leading to substantial portions of the workforce coming down with it and being unable to work for at least a week during their absolute highest load period.

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Are the airlines entirely "not at fault"? No. They cut too deeply in the early pandemic. And they've been too greedy chasing $$$ for renewed demand and added too many flights too quickly, cutting their spare capacity for issues that could crop up to nothing...and now they have.

But the severity of this COVID wave is significantly worse (in terms of # of people infected at once, not referring to illness severity) and pretty much every area of the workforce (that's actually in-person) is having similar issues. Many public schools in the US are basically just functioning as babysitters this week if they're open because they have too many teachers and students out to actually run classes normally.

> How can these systems be so broken, and why isn't capitalism solving them?

I’d wager it’s because free markets solve problems not entrenched cronies with political strings.

Capitalism? The US healthcare system is the most socially funded healthcare system in the world by a long shot. Not much capitalism to be seen there.

Try the take-home tests. Buy them days or months in advance. Get results within minutes.

I've looked multiple times at dozens of stores. In my area of the U.S. they can't be found in stock.

Yes. That's the whole buy them months in advance part so you are prepared everyone in the US apparently forgot about. I feel like I was raised in a different generation.

Preparation is a thing. It was quite obvious we were likely to have a covid spike this winter. Anyone without a stock of antigen tests at this point has simply been irresponsible as it was trivial to buy a few boxes at $14/ea at walmart the past 6mo.

only to discover that the countries you are flying to don't accept antigen tests, and that stock you just bought is useless?

Does any airline on the planet accept a quick test done at home without so,e sort of validation? Highly doubtful.

Yeah I am not sure these tests are good for anything these days except for personal responsibility.

$14 is more than a day's food budget for quite a few low income families. Not everyone can afford to speculatively buy antigen tests.

You realize if everyone was a "prepper" then you wouldn't have any tests either, right? Supply doesn't magically increase if people flood the stores a month or two early.

Very late reply, but this is only true on a theoretical level, and not in this case.

Abbott both destroyed unsold inventory (6-7mo from expiration dates) and closed down one of their production facilities they stood up for these tests due to lack of demand over the summer.

If everyone was a "prepper" (no, I don't think having some basic $7 tests sitting in your medicine closet really reaches this point at all, this is called "being prepared" and used to be a civic duty taught to children) the production would not have stopped, and they would not have let 2500+ workers go they are now scrambling to get back.

tldr; production was there, it was ended due to lack of demand. Yes, some (many) folks are in a financial position where $14 is a large expense, but those are outliers and certainly not the folks asking if I have any tests on hand right now.

Amazon has them and estimates 2 weeks out. I placed an order around Dec 25 and got them about 9 days later. That might not help right now, but it's not like the pandemic is going anywhere by the time I expect to get them (even w/ the delay)

Are there at-home PCR tests which are valid for international travel?

I doubt it...my wife just traveled in December and she had to show results from an actual testing company or hospital. I don't think they would accept a photo from a home test? That seems ridiculously easy to fake - both the result, and it being your test.

There are antigen home tests valid for travel (https://www.emed.com/airline-travel); you take the test on a webcam and they watch for the entire 15 minutes until the result appears. If you move/obscure the test it is invalidated.

Not sure if there are proctored PCR versions. They'd have to go in the mail to a lab, but the test proctor could watch you seal it with a uniquely marked seal or something; that should ensure the sample that arrives at the lab is the same as the one you swabbed on camera.

Sorry, didn't notice the PCR qualifier.

PCR.

There are no "take-home" tests with "results in minutes" that use PCR technology.

I was in London and Belfast last week between December 24th and January 1st, travelling from the U.S. (SFO airport)

I had to take a PCR test within 48 hours of boarding, and I had to take a PCR test upon landing in London, and was asked not to leave my hotel room until the results came back -- nearly two days later. They checked my vaccination and PCR test result before I boarded the plane, and passport control at the airport asked to see confirmation that I had a PCR test scheduled.

Before returning from the U.K. to the U.S. I was allowed to take a "rapid" test, but it had to be supervised either in-person or with a "tele-medicine" service that watches you over a video camera.

If I had tested positive, I'd be required to quarantine for 10 days in the U.K.

There was no requirement to test after landing, but I did--three times. NHS gave out rapid tests in "7-packs" and I was able to get 4 packs.

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