Free, Widespread Testing Is The Only Way America Goes Back to Normal
The difference to the economy is 15–19 trillion dollars over the next year
Most people assume that our COVID-19 lockdown will only need to last 2–3 weeks, or maybe a month.
Unfortunately, the latest research which informed the Trump Administration’s latest federal recommendations shows that even with 5 months of lockdown and social distancing, the virus will simply rebound as soon as the lockdown is lifted. After all, as soon as people are free to go out and mingle again, they’ll just start spreading the outbreak again.
The lockdown will need to last indefinitely until a working vaccine is tested and widely deployed. This is projected to take 12–18 months.
This is the logic behind the theory that China can’t really end their lockdown and will simply be hit with a second outbreak.
But they can, and it’s because they have changed one key variable: they now have cheap, widespread testing.
What’s The Real Point of Testing?
Some people ask, why do we even need to test? After all, when I have the flu, I don’t need a test to tell me I have the flu, I just conclude from symptoms that I have the flu and I stay home and rest. Similarly, if I go to the hospital with COVID-19 symptoms, I still receive care if I need it regardless of test results.
The point of testing is so that we can detect asymptomatic carriers and isolate them before they infect anyone else.
Try the following thought experiment:
Imagine we had a magical way of immediately identifying anyone who was infected with COVID-19, whether they showed symptoms or not. Like a glowing dot appeared over their head.
It would then be easy to know who we should ask to self-isolate, or simply to avoid them when you saw them coming. Transmission rates would drop because we would all avoid anyone who was infected. We could go about our daily lives almost completely unaffected, secure in the knowledge that everyone are interacting isn’t infected, because we can tell who is.
No need for lockdown, no need for social distancing, because all we’d have to do is “socially distance” ourselves from the easily-identifiable infected people until they’ve recovered.
Free, widespread testing is the practical way that gets as close to possible as this hypothetical “magic” way of identifying everyone who is infected.
If we achieve a sufficient amount of ongoing test coverage (as some countries have), we will be able to rapidly identify infected cases, isolate them, and everyone else can get on with living normal lives.
It needs to be free because the poorest people are just as able to infect others as the wealthy. It needs to be widespread and easy so that people are willing to do it.
Lockdown does not defeat the virus. It merely buys time for deployment of a vaccine or widespread testing.
Some people assume “if we just lockdown for 2–3 weeks, everyone who has the virus recovers, and it’s over.”
That almost works, but not really: no lockdown is 100% complete (otherwise people starve). There is always going to be a small amount of transmission going on so once you lift the lockdown, the small number of people who missed begin infecting others again, and you have another outbreak.
But what if you could identify those infected people first??
That’s what the testing is for.
The lockdown buys you time to ramp up factories to manufacture tests, set up testing checkpoints, and educate your populace on the testing.
Before the lockdown, you had no testing. After the lockdown, you have free, widespread testing. That is the key variable you changed: you use the testing to identify the remaining infected people and isolate them. You then keep on testing so that the handful of odd cases that pop up from time to time are identified quickly and isolated, so everyone else can keep on living and working normally.
Economic collapse averted.
We can either lockdown until we have a vaccine (12–18 months), or we can ramp up free widespread testing (1 month) and get back to business.
The economic difference to the United States of losing only one month to COVID-19 vs losing 12–18 months of economic output can be measured in the trillions of dollars.
The average GDP per capita in the US is somewhere around $60,000 / year, or $177 / day.
The actual cost (not the price insurance bills you) to test a patient is as low as $53 per test. Manufactured at scale, we’d certainly be able to achieve prices that low or lower.
Businesses have reported drops in revenue between 75–95% as soon as lockdown measures (“shelter in place”) were enacted in the San Francisco Bay Area.
Even if we tested every single American every single day for 12 months (highly optimistic) before vaccine deployment, the difference between doing that and allowing most people go to back to work vs having to remain in lockdown over the year is between 9–13 trillion dollars.
In practice, we probably wouldn’t need to test everyone every day — even testing everyone once a week would be more than sufficient, in which case the difference rises to between 15–19 trillion dollars over the next 12 months.
For reference, the 2019 GDP of the US was 21.4 trillion dollars.
If you want a geopolitical argument for this, China is already beginning to end their lockdown and send people back to work, because they can test and track people who are or may be infected.
This means that China lost about 1–2 months of productivity, but they will be back at full capacity quite soon.
The US can lose 1 month of productivity, or it can lose 12–18 months and give up its position of economic leadership to China.
Update 24-Mar-2020: The cost of a test is now as low as $15 per test. The makes the economic margin of getting this done ever larger.
Update 20-Jun-2020: Holy crap the US really screwed this one up.