With the rapid spread of the omicron variant of the coronavirus, Americans are again bemoaning their struggle to access COVID-19 tests quickly and cheaply.

The run on rapid tests has prompted pharmacies to start rationing kits, and there are long lines at testing sites in major cities.

Those difficulties largely stem from depending on private industry during a public health crisis.

Early in the pandemic, the federal government went big on supporting companies that were developing vaccines. But testing? Not so much.

Those priorities created uncertainty for makers of COVID tests, per Lindsey Dawson, an associate director at the Kaiser Family Foundation.

“Companies were concerned that they didn’t have a market and, in many senses, this is a natural response from a private company with a fiduciary and not a public health responsibility,” she said.

That uncertainty came to a head this spring, after people started getting vaccines — but before the delta variant came along. 

Dr. Bob Wachter, chair of the department of medicine at the University of California, San Francisco, said that prompted the federal Centers for Disease Control and Prevention to discourage vaccinated Americans from getting tested, even if they had COVID-19 symptoms.

“They believed that if you are fully vaccinated, you are not capable of transmitting the virus,” Wachter said.

Demand for tests tanked. Some manufacturers even cut back production. But when the delta variant emerged, the CDC reversed itself, and some firms started to ramp up their operations again.

In moments like this, Wachter said, it’s essential for the private and public sectors to work together. “It really has to be a partnership, and I think this worked extraordinary well with vaccines,” he said.

And many economists say getting testing right is key to sustaining the economic recovery and safeguarding the progress made so far.