Friday, March 27, 2020

Daily testing

What's the perfect answer? Larry Kotklikoff has a good candidate: Daily testing.

Imagine everybody gets a test every day. Positive? Stay home and isolate. Negative? Off to work you go. It's over in a month. Nobody who is sick gets anyone else sick.

Testing includes
temperature scans, a quick chest exam by stethoscope, a quick questionnaire about Coronavirus (CV) related symptoms, multiple PCR (swab) tests, antibody tests (as soon as they are available), and saliva and urine tests if such become available. 
Larry has a pretty intrusive regime in mind,
Anyone who is negative on all indicators/tests would be given a badge to wear during the day that would permit them to go work, frequent restaurants, shop, etc. Anyone who is positive on the indicators/tests would be quarantined together with their family members and have their contacts be subject to immediate tracing.
The passive voice (would be) hides a lot of questions -- who is going to do all this and how much interaction does that mean?  But one needn't be so intrusive. At home tests, tests done by employers to everyone who shows up, and proper incentives would do a great deal. (If you are positive you get a free two weeks in a local empty hotel, and full salary.)

More generally, if we really can stop transmission, 100%, for just about three weeks -- so everyone who has got it now is over it -- then it's over. Full stop.

Why not? Well, because we don't have enough tests.

Like all perfect answers, I think this focuses the mind. The shutdown is costing us a trillion dollars a month. Daily testing of everyone would solve it. Why don't we have more tests? Why is the Federal government spending a trillion dollars handing out checks here and sunder, rather than a trillion dollars on one thing, test kits? (Ok, and masks, shields, and ventilators. $500 billion each.)

More realistically still, any public health response has to include lots of random testing, so we know how many people really have it, in each town or neighborhood. If you don't have enough tests so you have to lock down, well, at least do it smart based on real data.

My understanding is that the piece, 3 hours old as I write, is out of date in its claim that the Administration does not want to test. The new letter from the Administration to governors will emphasize random testing as soon as possible, to isolate hot spots.


  1. A trillion dollars? 5% of GDP? Seems excessive, is that figure correct? What do you mean by "cost"?

  2. This wouldn't be perfect. Depending on how the virus develops after initial exposure and when one becomes contagious somebody could test negative when going into work and have the virus when leaving 8 hours later.

    Still, as a practical way to keep businesses open it makes sense.

  3. Spend a trillion dollars on test kits?

    The problem is that there is not enough capital or skill out there to take the money and turn it in to test kits at any price.

    There are a million little old ladies out there sewing face masks. They don't have the fabric that is used in real protective masks, so the amateur masks cannot protect healthcare workers, although they are not totally worthless.

    The real problem was the failure of the Federal Government to engage in planning for this type of emergency.

    It is not like they haven't been warned.

    "Bill Gates warned us of a COVID-19-like pandemic — watch his TED Talk from 2015" by Taylor Soper on March 17, 2020

  4. Testing has been the key to getting this crud at least somewhat under control. What do we have a CDC and an FDA FOR?

    Once again, it can't be just self interest that made the bureaucracies dysfunctional, it must also be stupidity.

    Testing is, like, a junior high school problem!

  5. Instead we could test individuals for antibodies to COVID-19. Some individuals will have natural immunity to the virus for various reasons. They could return to work immediately since they are not susceptible to the virus and cannot infect others.

  6. You know, we have pretty much unlimited testing capabilities already. The tool is called a "thermometer". It shows if you have a fever. It can't say that it's COVID-19, but it's a lot better than nothing. They use these in South Korea a lot to test people at stores. If you don't have a thermometer, a gloved hand to the forehead does just about as well.
    If we quarantined everyone with a fever, it would cost a lot less than a trillion dollars a month.

    1. Since a substantial percentage of COVID-19 positive people are asymptomatic they will not have high temps but still carry infections to others.

  7. Badges? "We don't need no stinking badges!"


Comments are welcome. Keep it short, polite, and on topic.

Thanks to a few abusers I am now moderating comments. I welcome thoughtful disagreement. I will block comments with insulting or abusive language. I'm also blocking totally inane comments. Try to make some sense. I am much more likely to allow critical comments if you have the honesty and courage to use your real name.