Some thoughts on testing and tracing for #Covid19
First, a quick look at the numbers
US daily number of cases reported on April 1: 25.1k
US daily number of cases reported on April 30: 29.5k
In other words, the month of April has been on a plateau.
The above infographic is from WashingtonPost
Next, the numbers about Testing (from @COVID19Tracking data)
First week of April averaged 144k tests/day.
Last week of April averaged 220k tests/day.
What comes next?
Here, I should add the obligatory refrain "I'm not an epidemiologist, but.."
It appears that lockdowns can reduce the increase in the rate of transmission but not enough to get declines in the number of new cases. Bill Gates raised a number of issues in his newsletter on the pandemic. Within the US there are significant differences across regions, and while it appears population density seems to be a factor, others have expressed caution that density is not necessarily an issue. It also appears that Covid-19 is disproportionately affecting underprivileged communities at significantly higher rates.
Clearly we need a comprehensive national strategy to test and trace. Relaxing social distancing too soon would be devastating too, by increasing the death toll even more. Among the more thoughtful proposals to reopen the economy, Scott Gottlieb offers a comprehensive plan about a way out! https://www.aei.org/…/national-coronavirus-response-a-road…/).
Nobel Prize winning economist Paul Romer has written extensively about the need for a national testing strategy on his blog. It appears that the first step is to institute lockdowns in order to flatten the curve. The next step is testing and tracing, so that we isolate as few people (in quarantine) as possible so economic activity can resume. According to Romer, even tests with a 20% false negative is still better than nothing since it reduces the number of people in quarantine.
Luigi Zingales wrote this prescient piece in March arguing for the US to carefully study the model of Veneto in Italy. According to him, "the Italian experience suggests that locking down towns is a necessary but insufficient condition to stop the spread of Covid-19. If 50 percent of the infected are asymptomatic, there is no hope of containing the disease unless we subject ourselves to massive testing."
There are reports that the number of Covid-19 deaths exceed what has been reported! Confirmed and “possible” COVID deaths could potentially now exceed 100,000 in US. This is because many US states did not report deaths (even if doctors diagnosed COVID) since lab tests were largely unavailable. Adding these “excess deaths” underscores how deadly this disease really is.
Source: Washington Post
As Paul Romer writes, "Returning to normal is too dangerous. Lockdowns are unsustainable. Let’s save lives without a depression!"
An update- what does it take to have testing and contact tracing? A contact tracing workforce estimator from GWU here
Sources: FT, Covid19Tracking project, @JeremyKonyndyk