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I'm no expert. But I've listened to enough experts to be confident of the following points about testing. First, we need a lot more testing capacity. But dramatically higher testing capacity is only threshold necessity. In itself the number of tests doesn't get you through ...
2/ the lengthy period we're facing between the end of this initial outbreak and being able to get to an interim new normal we'll have to live under until there's a COVID vaccine or very effective therapy. In short you need a system, an integrated system of ...
3/ surveillance testing operating around the country. And that will have to be both testing for the virus and testing for the antibodies. One of the things I've learned in recent weeks is that there are very different kinds of testing. You have diagnostic testing to ...
4/ guide the treatment of individual people. And then you have surveillance testing. The tests themselves are likely the same. And some tests when they're administered are for both purposes. But you're accomplishing different things with these different purposes.
5/ Before you can reopen the economy to any significant extent you need to have a system in place where you have very good visibility into how the disease is or isn't circulating in the population and the ability to isolate people very quickly if they're contagious.
6/ If you don't have that visibility you're just cueing up a replay of the disaster we're going through now. If you're waiting till people start deluging the emergency rooms again you can't modulate social distancing or policy in any way. You have to be able to monitor ...
7/ closely to know when to ease up or clamp down in a given city or state. And that requires a system of testing, not just enough tests when people can get one if they feel sick or just want to put their minds at ease. In fact - and this part is more me speculating - it's ...
8/ hard for me to see how you can have effective surveillance without some level of random (but voluntary) testing of people who aren't sick or don't appear to be. You need to be able to see the first signs of spread. As we've all learned, once it's spreading ...
9/ widely it's too late. So while we appear to be making real progress on flattening the curve, albeit with a daily horror of a couple thousand Americans losing their lives, we need to start planning the restart. It's not about choosing a date. We need a system.
10/ It has to have the capacity for testing at a huge scale over a long period of time. It has to be integrated and effective for surveillance. It's not just having them be available. And it has to be national. It's one country, one integrated system of travel ...
11/ commerce and economy. You can't have a solid system in one state and a bullshit system in the next one. That won't work. It's not about picking a date. You have to have this system in place before you can really do anything.
12/ How to do all that? I'm not the one to ask. For more I follow the people on this list, all of whom are credentialed, knowledgeable and smart. They're talking about it and we should listen. https://twitter.com/i/lists/1233998285779632128
