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If the goal is to stop deaths and prevent economic damage, then what is the alternative to testing (both for antibodies and for active presence of the virus), a
by rapjr9 7y ago
If the goal is to stop deaths and prevent economic damage, then what is the alternative to testing (both for antibodies and for active presence of the virus), assuming that testing everyone in the US multiple times in the near term is not possible? Without testing a lot of people will not willingly return to work, which is already hurting the economy. Without testing we don't know the new places where the virus is spreading until a week or two later, so reactionary measures like contact tracing don't work as well. Total lockdown reduces deaths, but destroys the economy and reduces the scope of life.
Maybe we need to use the tools we already have, such as flu surveillance and data from hospitals, to detect excess non-flu infections. We seem to be able to do flu tests, are they more scalable so that at least flu can be ruled out in many cases?
If widespread testing can not happen because we can't build factories to make reagents/swabs/tubes/PCR array machines/etc. fast enough, we need to start thinking of alternatives. We don't actually seem to understand yet how the virus spreads, too many clinicians trained in handling infectious disease are getting sick despite PPE. If the new small antibody test results are right, then the virus is spreading much faster than can be accounted for via droplet spread as the main mechanism; we may have to consider birds, mosquitoes, surfaces, skin touching, and other methods as possible common spreading mechanisms. If we understood transmission better then it might be possible to tell people how to truly protect themselves, and then they could go back to work. So understanding transmission better is something that could be used in addition to whatever testing is available in order to prevent deaths and economic damage. But people may not follow the new rules based on that understanding, so get the social scientists involved to get the message across. Get OSHA involved to set best practices for workplaces. It seems like there is probably a lot that can be done, even without testing, and at present we may have to assume testing will not be sufficient in the near term (3-6 months).
But someone has to start thinking about these things and doing them, and I'm not seeing any evidence of this in the news. Given that contact tracing is not already ramping up (I've seen only Massachusetts as having a plan to scale it up but I tend to only see East Coast news) I have to wonder if anyone is even thinking about alternatives to testing if testing at scale is not possible.