As you guys know, I’m now a highly sought after corona expert on Twitter. So I want to share some random thoughts that came to me while I was in the loo -

What spare capacity should countries keep in place for a post corona world?

1/n

A lot of things have proven not to have any spare capacity built in. Supermarkets for instance quickly ran out of basic items for weeks. Clippers are scarce. Even computer monitors were scarce. (Remarkably broadband has stood up to the test even with increased usage)

But this is a once-in-100-year event so it’s not realistic to say Wahl should keep a pandemic level stock of clippers at all times just in case. That will be too expensive.

What I think everyone should keep in place at *all* times is massive testing capacity

The reason is because in an outbreak, testing has rapidly diminishing returns. It is very very useful at the beginning of the outbreak but has very little effect once you are say halfway through the epidemic. So that capacity has to be in place, locked and loaded just in case

This is the only answer that makes sense in explaining South Korea and Germany. And is the U.K’s single biggest policy failure so far. Haven’t seen any studies on this but to my mind, testing makes certain policy recommendations work better

At the start, pretty much every country was telling everyone to stay at home if they have symptoms. But imagine a guy who’s tested positive being asked to stay home and someone who just has symptoms being told the same thing. Who is *more* likely to comply?

Shared this story from February. South Korea looked at the pandemic and decided to focus on testing. I don’t know how they came to this decision, but it was a genius move. Because there were many other things to do https://twitter.com/doubleeph/status/1239946685847154690?s=21 https://twitter.com/doubleeph/status/1239946685847154690

Look at this story from beginning of March. Japan chose to focus on things like travel bans and quarantine as a policy response which annoyed South Korea. But who’s laughing now? Japan still has very low testing capacity https://www.bangkokpost.com/world/1873074/seoul-blasts-japans-quarantine-decision

This was a chart at the beginning of the outbreak. The U.K. was one of the largest testers. But within a couple of weeks, it had fallen to the bottom of this chart. The growth in testing did not keep up

The irony is that today, the U.K. is doing more daily tests than South Korea ever did at any point. But we are already past 20k hospital deaths. Germany’s decentralised healthcare system also ramped up capacity at the start quickly.

Germany locked down same day as U.K. and the lockdown there is just as loose as UK’s. They have 6k deaths.

Keep testing capacity warm at ALL times and absolutely ‘waste’ it at the beginning of the outbreak. So that when you tell people to stay home, it carries extra effect

I fear that this is going to be Nigeria’s biggest mistake if this outbreak really gets out of hand. Nigeria’s testing is shockingly poor and there is some sense that NCDC doesn’t want to ‘waste’ reagents. This is the time to absolutely ‘waste’ it

We are not in 1918. Testing to track and isolate people really can’t work effectively in 2020. The best contact tracer in the business was Singapore and they eventually lost control.

It is to get people to better obey the instructions being issued by the government

/end