Test Everyone.
The only hope we have to save lives and end the global economic crisis is through mass coronavirus testing at an unprecedented scale.
The world economy has been in free fall for the past week as we learn how hard this virus is to contain and the unprecedented steps governments are taking to control the rate of infection.
Social distancing and shelter-in-home orders will certainly save lives and is the right thing to do now. It’s a moral imperative for us to avoid a healthcare system overrun like Italy. But folks should understand, unless we want another Great Recession, or worse a Great Depression, there needs to be a Plan B to deal with the virus that doesn’t shut down the economy and it needs to start happening now.
Why is COVID-19 so hard to contain?
Many people are comparing COVID-19 to past pandemic pandemics the world has faced.
The main reason COVID-19 has been so hard to contain is that many people who contract the virus and spread it either have no symptoms (either by being completely asymptomatic, or through the delayed 2–14 day window it takes to show symptoms of infection.) So while you might think you are perfectly healthy, you’re secretly spreading it to those with you on the bus, at work, or at home.
What health officials have taken away from China is that the number of people spreading the virus is MUCH higher than the number of positive tests.
China has certainly contained the coronavirus. The numbers coming out of China look incredibly compelling. South Korea has seen similar success in combating the virus in their country.
China has stopped the spread within their country but they only did so by imposing social distancing measures and randomly testing and isolating those with the disease.
The key to China’s and South Korea’s success was testing.
Officials in the U.S. still haven’t gotten the message on testing. It’s been reported that passengers on the Grand Princess were encouraged by health officials to not get tested if they were asymptomatic. This is exactly the wrong thing to be doing. The whole reason COVID-19 has been hard to contain is it spreads when people are unaware they carry the virus, knowing this inevitably leads to the conclusion that testing is our only reliable path to getting life to normal.
Flattening the curve: Saves lives, dooms economies
The current strategy in the United States, and elsewhere, is to adopt social distancing measures to spread out the number of cases over time and not overwhelm our healthcare system.
To be clear, in absence of a better strategy we have a moral imperative to comply with these measures or risk infecting and killing a large percentage of the population.
That said, flattening the curve as presented by others greatly distorts the timeline necessary to impose social distancing measures.
Happy Version:
Realistic Version:
The sad truth is that flattening the curve, while it will certainly save lives, is on its own inadequate to combat COVID-19. While it’s not even known if our approach was in time or enough to not overwhelm the healthcare system, what’s becoming clear is on our current path life will not return to normal for a very long time.
Even if social distancing measures we’ve adopted today are enough to not overwhelm the health care system there is nothing to stop the virus form re-entering exponential growth after social distancing measure are relaxed.
The approach some have proposed that social distancing measures will be necessary on a periodic basis to keep the pandemic in check until an effective treatment or vaccine can be developed. Given how many people are already unemployed from social distancing measures taken today, the truth is that any prolonged or periodic social distancing measures necessary on a time scale to secure a vaccine will devastate the global economy.
We need a better solution.
What hope do we have?
There are some reasons to be hopeful in the present situation. Medical trials for a vaccine against COVID-10 have already begun, and there’s even early evidence we might develop effective treatments for those afflicted. These are key steps that will aid the world in avoiding deaths from the virus and eventually building herd immunity which is the likely endgame for this pandemic.
Unfortunately a vaccine is more than a year away and any breakthrough in treatments short term just cannot be counted on. We have no other choice than to follow the models of successful countries and aggressively test the population. There simply is no other proven way to defeat this virus and given how far behind the United States and other countries are in combating the virus, we need to ramp up testing to never before seen scales to successfully change the from a strategy of distancing to one of containment.
Testing Works. Case Study: Vò, Italy
In the small town of Vò, Italy, researches were able to test all 3,000 inhabitants and found most carriers of COVID-19 were asymptomic. While reporting has been unclear to whether these inhabitants were asymptomic (scary) or pre-symptomatic (expected with known incubation window) what is clear is that the town was able to contain further outbreaks of the disease by identifying everyone who had it.
The same technique can be applied on the global stage, but would require an enormous mobilization effort.
What needs to happen?
Assuming no magic cure happens in the short term, the only path forward for the world is for world leaders to fund and allocate resources towards testing every household in an affected area.
Every. Household.
1. Produce LOTS of tests.
President Trump should immediately utilize his invocation of the Defense Production Act, which is currently geared towards manufacturing of Personal Protect Equipment for healthcare staff, to the private industry to manufacture COVID-19 tests in the 10s to 100s of millions. This is the scale necessary to change the current strategy of “flattening the curve” to a strategy of containment that will allow commerce to begin as usual.
2. Reach all affected households.
There needs to be a way for all households in affected areas to get tested. Whether through massive drive through testing sites, or mailing self-testing kits to homes, the effort to make tests available at the scale necessary to combat the virus will be massive and requires a large allocation of resources.
3. Enforce compliance with testing.
If you live in an affected area, you should not be able to go outside unless you’ve tested negative for coronavirus. Key to stopping the pandemic in China was testing individuals and:
- Enforcing isolation to those who test positive (either through distancing or providing masks for those sick.)
- Not introducing individuals into the population until they test negative. Merely waiting two weeks is not enough, waiting until individuals affirmatively no longer shed virus into the community is key to preventing further spread.
This is exactly the opposite of what we’ve seen on the Grand Princess cruise ship where individuals either avoided tests to not be subjected to quarantine or explicitly told by officials to not take the test if they were asymptomatic.
We now know this contributes substantially to the spread of the virus.
4. Tell the world the plan
Stock markets hate uncertainty. We’ve seen unprecedented losses to the stock market and unemployment has already spiked to a surprisingly high degree.
Markets will react positively if there’s light at the end of the tunnel for the current crisis. A strategy of social distancing will not provide that, but a global mobilization effort to contain the virus through massive distribution and enforcement of testing will.
How can I help?
- Share this article.
- Call your local, state, and federal representative and tell we need tests manufactured on an enormous scale.
- Stay inside.