Maybe you’ve seen Marvel’s Captain America film in which scientists take a scrawny but good-hearted kid and turn him into a superstrong champion. The COVID-19 pandemic and the government’s inept response to it have done the opposite to America’s economy: turned a productive powerhouse into a feeble weakling. How do we get our mojo back, get people back to work, and reclaim our social lives? The best way forward is to get radically more tests to keep the virus out of our system enough to return to full strength.
“Flatten the curve” was never a long-term strategy; it was a panic response to keep the disease from overwhelming hospitals. Through social distancing we did that. The problem is that during the shut-down government took meager steps toward containing the disease once people restarted their social interactions for business and recreation. We still don’t have a real exit strategy.
In Colorado what we have instead of a plan to get our lives back is a long-term plan to live largely like invalids. The state tells us, “Coloradans are strongly advised to continue staying at home to the greatest extent possible, only interacting with your household contacts and only leaving for essential activities.” Businesses operate under severe restrictions. Even drive-in movie theaters had to beg for the privilege to reopen. Government shut down one restaurant for seating guests outside at well-spaced tables.
Yes, we are substantially reopening, relative to the severe restraints of the stay-at-home order, yet we remain largely closed for business and play. It doesn’t have to be that way.
On the way toward explaining why I support mass-testing, I want to review the main ways to approach the disease.
People can slow the disease spread through social distancing, which continues to be Colorado’s main response. But when continued at a high level for a long time, that puts many people in severe financial and emotional distress. We are just beginning to see the economic devastation of this. When this is the main plan, the only way out is a vaccine, which may be months or years away and may never come.
People can improve social hygiene enough to seriously slow the virus. This was important in Hong Kong. As Zeynep Tufekci tells it, “Hong Kong never even had a full lockdown,” and the government acted largely ineptly, yet people “adopted near-universal masking on their own” as an “army of volunteers” made masks, distributed hand sanitizer, and posted information about disease hotspots. As of May 21, Hong Kong, which has more people than Colorado, suffered 4 COVID-related deaths, compared to over a thousand in Colorado.
Of course masks in public is part of Colorado’s response, and it’s required in some areas. But Americans are not nearly as organized as the people of Hong Kong, some chafe at wearing masks—not even the legislature will require them—and from what I’ve seen many people use masks ineffectively. Anyway, one study anticipates “significant impact when universal masking is adopted early” but “minimal impact when universal masking is adopted late.”
One approach is to ride out the disease to herd immunity. That may be the path that Sweden is on. But Sweden has paid a high price in terms of total deaths relative to its neighbors, and Swedes have resorted to moderate voluntary social distancing anyway. New evidence suggests that Sweden is not nearly as close to herd immunity as some people previously expected, meaning the country could have a great deal more pain to go. And herd immunity hardly means the virus goes away; it just means the virus continues to infect people at a lower rate.
Colorado is even further away from herd immunity. Antibody testing in Colorado, which is done mostly for people who think they had the disease, is showing in the range of 7% positives, so we should expect the actual population-wide infection rate to be much lower. We can talk about cocooning the vulnerable, but that’s hard on the vulnerable and hard to maintain if the disease continues to spread through the population at large. The road to herd immunity is paved with tombstones.
That brings us to the strategy I think we should adopt, a variant of the widely discussed test-trace-isolate strategy. The idea is to test to figure out who is infected, trace the contacts of the infected to see who else might have the disease, and then have people with the disease isolate themselves until they are no longer contagious. With a really good test-trace-isolate strategy, we could mostly go back to living normal lives. Right now we have a mediocre test-trace-isolate capacity that requires continued high levels of social distancing.
We can make tradeoffs within the test-trace-isolate strategy. If you have really good contact tracing, you don’t need as much testing. Parts of Africa very effectively used contact tracing during the Ebola outbreak. If you could test everyone nearly every day, you wouldn’t need any contact tracing. Lyman Stone wants to create central quarantine facilities for people infected plus their contacts; that wouldn’t require as much testing. But I think his plan relies on too heavy a government hand.
I like Paul Romer’s plan for mass-testing. Romer, the son of former Colorado Governor Roy Romer and a Nobel-winning economist, writes, “Until a vaccine is developed and deployed, the simplest and safest path to this outcome [Americans’ safe return to work] is a national testing strategy that marshals our existing resources to test everyone in the U.S. once every two weeks and isolates all those who test positive.”
In a recent discussion, Romer indicated that the FDA seems willing to cede more authority to the states. As Romer discusses, the FDA has slowed testing by throwing up regulatory hurdles. As the New York Times reviews, the FDA recently halted a testing program in the Seattle area. Cue Senator Mike Lee, who recently announced a bill “to let states approve and distribute diagnostic tests during [a] public health emergency.”
What I’d like to see is for Romer, Governor Jared Polis, Senators Cory Gardner and Michael Bennet, and Colorado’s U.S. representatives take the stage to announce that Colorado will lead the effort to approve and facilitate economical mass-testing.
As of May 21, labs had tested around 140,000 Coloradans total for the virus, less than three percent of the population. That is a pathetic, shameful, economy-crushing failure. If we want our lives back, we must do better, radically better. Now is the time for mass testing. Now is the time to say, Welcome back, America.