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Please read my initial comment again. I'm not arguing for the US, in its current state, to adopt the Taiwanese strategy. Once community spread is such high as i

Please read my initial comment again. I'm not arguing for the US, in its current state, to adopt the Taiwanese strategy. Once community spread is such high as it is now, another strategy is needed. And I'd say the current lockdown & reopen has been proven inefficient in sufficiently many places now. Michael Mina has a much different idea: Cheap mass testing at home, regularly, for the whole family. Even with less sensitive quick tests it should be possible to suppress ~50% of new transmissions this way, which could bring case numbers down to traceable levels in 1-2 months. The key would be cost and availability of these tests - that's a problem that can be solved, as production is simple and is already currently costed at $1 a pop. From a regulatory standpoint it should be treated more like toothpaste and less like a medical good (i.e. certify the efficacy but don't go overboard). After all else has pretty much failed, all western governments are now just betting on the vaccine. This is a dangerous proposition - all you need is a resistant mutation and we're back at square one. Plus, vaccination at current rate will take 1-2 years - I don't think that's a good place to be in both in health terms and economically. There needs to be a backup plan put in place, as well as lessons learned taken for the next pandemic.

timr 6y ago
> Cheap mass testing at home, regularly, for the whole family. Even with less sensitive quick tests it should be possible to suppress ~50% of new transmissions this way, which could bring case numbers down to traceable levels in 1-2 months. I agree it's a good idea, but doubt that it would bring case numbers "down to traceable levels"...we know that the vast majority of transmission (>70%) is happening in the home, and the vast majority of interactions (>90%) don't produce more than a single infection. You essentially have to catch the connecting edges on a sparsely connected graph -- you don't have to miss very many for the problem to be unsolvable. I do think it would go a long way to making life more normal. It's completely idiotic that we're killing restaurants (for example) when we could be making mandatory rapid testing a pre-requisite to indoor dining, instead. The same goes for nursing home and hospital staff -- nosocomial infection has been a huge problem, and most fatalities are out of nursing homes. I get why you don't want to depend entirely on quick tests that have an elevated false-negative rate, but when it takes days to get back a PCR result, it's useless for screening staff.
- m_mueller 6y ago
  I think that the >70% number is misleading. It's 70% of cases for which we have data where the transmission happened. For a good majority of cases the transmission happened at an unknown place. It's just that for those where it is known, most are happening at home (as opposed to e.g. at work). Those unknown transmissions are what you want to attack with a mass testing regime. That seems entirely doable, given cheap and simple testing at home.

timr 6y ago

> Cheap mass testing at home, regularly, for the whole family. Even with less sensitive quick tests it should be possible to suppress ~50% of new transmissions this way, which could bring case numbers down to traceable levels in 1-2 months. I agree it's a good idea, but doubt that it would bring case numbers "down to traceable levels"...we know that the vast majority of transmission (>70%) is happening in the home, and the vast majority of interactions (>90%) don't produce more than a single infection. You essentially have to catch the connecting edges on a sparsely connected graph -- you don't have to miss very many for the problem to be unsolvable. I do think it would go a long way to making life more normal. It's completely idiotic that we're killing restaurants (for example) when we could be making mandatory rapid testing a pre-requisite to indoor dining, instead. The same goes for nursing home and hospital staff -- nosocomial infection has been a huge problem, and most fatalities are out of nursing homes. I get why you don't want to depend entirely on quick tests that have an elevated false-negative rate, but when it takes days to get back a PCR result, it's useless for screening staff.

m_mueller 6y ago
I think that the >70% number is misleading. It's 70% of cases for which we have data where the transmission happened. For a good majority of cases the transmission happened at an unknown place. It's just that for those where it is known, most are happening at home (as opposed to e.g. at work). Those unknown transmissions are what you want to attack with a mass testing regime. That seems entirely doable, given cheap and simple testing at home.