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1/It’s easy & obvious to say we need more testing to stop this epidemic. (I have been guilty of this too.)
When we say ‘test, test, test’ or ‘mass testing’, we need to be clearer on what that means, what we need to be possible, what’s possible now & what might be possible when.
When we say ‘test, test, test’ or ‘mass testing’, we need to be clearer on what that means, what we need to be possible, what’s possible now & what might be possible when.
2/ If testing capacity were unconstrained, we could widely test people wherever cases are for 2 straight weeks, find virtually all transmission chains & use isolation & contact tracing to follow them out to their end.
The epidemic would be over within weeks.
The epidemic would be over within weeks.
3/ However, we need to understand what can realistically be done while doing all we can to push ‘what is realistic now’ closer to ‘what is needed now.’
To do mass testing in NY/NJ alone would require orders of magnitude more testing than the 100K/day we now do nationally.
To do mass testing in NY/NJ alone would require orders of magnitude more testing than the 100K/day we now do nationally.
4/ The $80 trillion question is how much testing capacity can we expect to have within what time horizons.
This dictates when/how we relax social distancing, what overall strategy should be & what other interventions need to considered/pursued.
This dictates when/how we relax social distancing, what overall strategy should be & what other interventions need to considered/pursued.
5/ We should target testing strategically to optimize care & transmission control. As it increases, we can widen who we test to find more transmission chains starting w/those hospitalized, high-risk situations (ie, nursing homes) & expanding form there. (More details soon.)
6/ From SK & Germany, this will likely require testing asymptomatic/mildly symptomatic transmitters who may drive up to 80% of transmission.
If not enough capacity to test them yet, we need to know when we will so can strategically utilize & amplify other measures in interim.
If not enough capacity to test them yet, we need to know when we will so can strategically utilize & amplify other measures in interim.
7/ In meantime, we need to understand several key questions regarding testing capacity. Ordinarily, one could assume people in gov't are on top of this but that has not been our experience during this epidemic so far.
8/ What are the bottlenecks to increasing testing?
To what extent can they be resolved w/money, removal of institutional barriers or process/manufacturing innovation?
How much is constrained by raw shortages related to global supply chains difficult to solve (quickly)?
To what extent can they be resolved w/money, removal of institutional barriers or process/manufacturing innovation?
How much is constrained by raw shortages related to global supply chains difficult to solve (quickly)?
9/ When will we have a forecast on expected testing capacity over the coming months?
This is something we should already know &, if not, be pressed to figure out.
This is something we should already know &, if not, be pressed to figure out.
