In the past few weeks, we’ve seen different government and
media pundits present the public with only two choices for moving forward in the era
of COVID-19 virus infections. These appear to by false choices, resulting from an overly partisan and political application of our current understanding of how to minimize the spread of the COVID-19 virus while facilitating the full reopening of the economy and society. Specifically:
1. We should focus on
public health to minimize infection spread and deaths, and not remove the stay
at home orders until the level of infections declines, and accept a prolonged
negative impact on the economy; or
2. We should move to
open up businesses now with the use of personal protective equipment for
employees, limiting the number of customers in the business at one time, and
requiring customers to wear masks, and accept a possibly prolonged increase in
the number of deaths.
As I listen to and read opinions from a variety of public
health and infectious disease experts, I hear most of them advocate that we
take the following actions to mitigate the spread of an infectious virus:
1. Because an aspect
of this virus is that many people can be infected and infectious to others and
not be aware of it and not show any symptoms of the infection, the first action
to mitigate the spread and minimize deaths was to separate everyone from
everyone else. When we can’t identify
who is infected and infectious to others, the only way to protect those who
aren’t infected is to isolate everyone.
2. People who are
infected and become physically ill are currently where we focus most of our
testing. That process helps confirm the
cause of an observed illness, and enables us to take action to protect our
health care workers and other patients, where people who are ill need to go to
get care.
3. To open offices,
restaurants, stores and importantly, schools and day care centers successfully,
we don’t just need to remove the closure orders. We also need to give employees, customers,
teachers and parents confidence that they can return to offices, restaurants
and stores, and send their kids to schools and day care centers without
exposing themselves and/or their families to people potentially infected with
COVID-19 but not showing any symptoms. This is because studies have shown that between 1 in 4 or 5 of people showing no symptoms actually tested positive for COVID-19 infection. Until we have a vaccine, that confidence will likely require the regular
testing of employees, teaches, administrators and other staff members, and
students, and the requirements that customers who have not been tested should wear
masks and practice social distancing.
However, the President and many governors have stated that
this level of testing is not possible, and even if it was possible, it is not
practical. Thus, our leaders are saying
we must accept the risks of exposing ourselves, our workforces, our teachers,
and our children to people who might be infected without symptoms, so that the
economy doesn’t stay depressed. Let’s
explore the problems that have been raised with possible and practical
broadscale testing:
1. Testing is not
considered possible because it’s never been implemented at this level, and thus
we don’t have the materials to make testing kits, nor the manufacturing
capability to produce the kits in massive quantities, nor the distribution
systems to conduct tests, nor the analysis capabilities to read tests.
But we have faced and overcome those kinds of challenges many
times before in our history. If the
President would mobilize the country’s public and private sectors to work
together to create the sourcing, production, distribution and testing
capabilities required, there is no doubt that America has the integrity and
collective skills to implement the nationwide testing program described
above. The program requirements can be
quantified, the details can be defined, and our country has the expertise to
create the solution. We just need the
leadership to set it as our goal, and the system management expertise to
implement it as quickly as possible.
2. Testing is not
considered practical because it would cost too much money to implement. There are no inexpensive options to combating
the virus and the economic crisis it has spawned. So let’s do the math. If conducting a test at large scale might
cost between $50 and $100 each, and we need to test 200 million people
initially, and then repeat the tests every 2 weeks for the next 12 months, that
would be 5.2 billion tests in a year. At
the maximum estimated price of $100 for each test, that is $520 billion.
How does that number compare to what we’ve spent in the
CARES and PPP packages for just 8 weeks?
The best number I can find is $2.2 Trillion, plus a reported $4 Trillion
in capital infusion to the banking system from the US Treasury. And that spending did nothing to enable the
economy to open and recover.
The $520 billion spent on testing would enable businesses to
open, but not just at 25% or 50% capacity, but at full capacity. Given the
small profit margins in most restaurants and small businesses, it is unlikely
that many such businesses could survive very long at such reduced business
level. But the only reason to open
slowly is because we don’t know who is walking around infected with the virus
but showing no symptoms, possibly leading to a wide spreading of the virus. If we eliminate that unknown factor, it is
quite likely that we could fully open the economy with safety for all involved.
An additional point not yet
discussed publicly yet: our leaders and
many people seem quite willing to take the risks of contracting the virus
themselves as businesses reopen, and quite willing to take the risks of
spreading the virus to others in their communities. But I wonder if parents will be quite so
willing to risk their children contacting the virus by sending them to school
without a broadscale testing program in place.
And we are just a few weeks away from the decision timing for the
opening of schools in August.
I won’t go into possible explanations
for why President Trump and many other leaders have rejected the advice to
mobilize the country to implement broadscale testing to enable opening of the
economy and society to take place with a reasonable level of confidence in the
public of participating safely. My hope
is that by looking at the economic numbers of the broadscale testing option,
instead of just looking at the health data, our leaders might realize,
finally, that testing is the critical element to a faster and more complete
opening of the economy.
The Administration seems to have
recently discovered the importance of testing to prevent the spread of the
virus in the West Wing offices in the White House. Hopefully they may soon realize that the time
and energy spent denying the value of testing for the rest of the country,
while focused on denying the health risks of the virus and advocating for an
opening to the economy over overblown health concerns, is a false choice that
can only divide the country.
Eventually, the science of the
spreading of this virus without testing or social isolation will result in
greater economic loss over time, as customers don’t have confidence in their
safety, and have concerns about greater loss of life. We can
only hope that a practical, non partisan, non political application of the available information on how to minimize the spread of the COVID-19 process, and of appropriate confidence in American ingenuity and the ability to accomplish
what seems impossible, will soon win out.