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Free in-home COVID-19 testing is 'exactly what we need' says top doctor

Dr. Mati Hlatshwayo Davis, Director of Health for the City of St. Louis, says free, at-home COVID testing can help reduce the obstacles facing teachers, children, and uninsured Americans in the fight against COVID-19.

Video transcript

- We're going to keep talking about this and what happens next with Dr. Mati Hlatshwayo Davis, Director of Health for the City of St Louis. It's good to have you back here doctor, good to see you. Let's just start with that big headline about having insurance companies reimburse us for the in-home tests.

There are some people are saying, why even create that kind of paper bureaucracy? Why not just have the government buy a bunch of these tests and we can go to a pharmacy and pick them up. What do you think about what the president's proposed and is it sufficient?

MATI HLATSHWAYO DAVIS: Listen, by the theory behind this is exactly what we need. We've been calling for the ability to get people tested for free or at little to no cost for quite some time now, especially in marginalized communities, this provides a barrier to be able to keep our citizens safe. And, you know, in my position specifically as the director of health here in St. Louis, this is a barrier to be able to provide equitable, safe practices for our children and our teachers and schools.

So, definitely something we've all been looking for but you're absolutely right. The implementation strategy needs to be clear here because while the burden of this is being shouldered by the ability to do this through insurance, what of the millions of Americans without insurance? But also for those who do, how does this work?

The paper trail can be very cumbersome for the average American and most people who will be looking for tests will be looking for them very specifically, very quickly and trying to get this done for their families.

So if there is a need upfront for them to shoulder this cost, that could be problematic. I trust though, that this has been thought through by the leadership and at least in my office this is what we'll be asking for more clarity around.

- And the doctor on the travel front, it is the holidays, lots of people are traveling. We have the Biden administration cracking down somewhat on testing requirements, mask mandates. I'm just wondering, what do you think of the administration's plans here? Is it enough? Does it go too far?

So, again, when I first heard about the plans to enforce travel bans on eight African countries after the news of omicron broke, much of my response and many in the public health field was that we have the availability to do testing. We require people to test before they come. We have the ability to check for our vaccines and we definitely have the ability to enforce masking.

And so this is what can be done. We have rapid tests that can give us these responses within hours, if not the same day, and within 24 hours. And so this is the exact right move, but it is not complete. When we call for global vaccine equity, when we call for the ability to not place discriminatory practices on international countries, if we can do this and we can do this globally, why must these travel bans exist?

So I would have appreciated hearing that they had lifted travel bans against those eight African countries, one of which was responsible for us even being aware of the presence of the omicron ban because of the leadership of South African government and the superior genomic sequencing done by Dr. Sikhulile Moyo, a Zimbabwean Botswana based scientist in his lab.

So this needs to be done. However, this is exactly what we need for travel. We have the ability to do these things and the ability to implement them now will be key going into winter and with omicron on our shores.

- Omicron on our shores but Delta is still the big problem in the United States. And I'm curious from your vantage point, right now we're testing but when you get a positive test back, it doesn't say whether it's Delta or some other variant, it just says positive for COVID. So how much more difficult does it make it for people in your position to let us know what's truly happening with omicron as we're still fighting Delta?

MATI HLATSHWAYO DAVIS: So no actually we have the capability to perform genomic sequencing, especially in our watershed areas. Public health the state has reached out to us already here in the city of St Louis and other public health departments about our ability to do so. We have at least 30 different sampling regions within the state that give us the capacity to be able to detect omicron.

So while Delta, and I'm so glad you focused on this because as soon as a new variant comes out, we're worried about what it is and what it might do. And of course, that is appropriate here but there still is so much time and so much science that has to be done for us to understand if this variant is transmissible in an increased fashion, if it causes severe disease, and if it has immune evasion properties.

And that is going to take a few more weeks at least. So, what we do need to do is still understand that Delta is still the predominant variant. But for all of these variants, we have the tools in our toolbox. The ability to vaccinate or get a booster if eligible, the ability to mask, the ability to social distance, especially with winter here with us now, and the ability to wash our hands but also be mindful of the plethora of other respiratory viruses that come with winter.

Get the flu shot and do everything we can to stay safe. And so, absolutely we do have the capacity to detect omicron now here, at least here in the US. But you're right, Delta is the predominant strain that we are dealing with.

- I've said it to you before, I will say it again, I look forward to the day and I bet you do as well, when we can talk about we need to exercise more and get more rest and not have to talk about COVID-19. It's always a pleasure.

MATI HLATSHWAYO DAVIS: Right there with you. Maybe not the exercise but a concert or two would be great, my friend.

- Dr. Mati Hlatshwayo Davis, Director of Health for the city of St Louis, we wish you and your staff and everyone there all the best. Thank you for joining us.

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