We already knew we hadn’t achieved readiness now, of course. What about May 1, the target date set by the White House in its supplemental “Thirty Days to Flatten the Curve” guidance? That may be “overly optimistic” too, Anthony Fauci tells the Associated Press. The US will still be missing one key element essential to a full reopening of its public squares, even by then:
Dr. Anthony Fauci, the government’s top infectious disease expert, said Tuesday the U.S. does not yet have the critical testing and tracing procedures needed to begin reopening the nation’s economy, adding a dose of caution to increasingly optimistic projections from the White House.
“We have to have something in place that is efficient and that we can rely on, and we’re not there yet,” Fauci said in an interview with The Associated Press. …
Fauci said a May 1 target is “a bit overly optimistic” for many areas of the country. Any easing off the strict social-distancing rules in place in much of the country would have to occur on a “rolling” basis, not all at once, he said, reflecting the ways COVID-19 struck different parts of the country at different times.
Among Fauci’s top concerns: that there will be new outbreaks in locations where social distancing has eased, but public health officials don’t yet have the capabilities to rapidly test for the virus, isolate any new cases and track down everyone that an infected person came into contact with.
“I’ll guarantee you, once you start pulling back there will be infections. It’s how you deal with the infections that’s going count,” Fauci told the AP.
Key is “getting people out of circulation if they get infected, because once you start getting clusters, then you’re really in trouble,” he added.
In other words, we’ve flattened the curve and gotten more health-care resources in place. If we want to prevent another logarithmic curve, however, we need to identify and isolate individuals who are carriers of the virus during the contagious, asymptomatic stage. The only way to do that is to have lots of testing capacity on line, and that is still not yet in place, not even in the nation’s hot spots.
It may be coming soon, however, thanks to an explosion of private-sector innovation. Wired reports today on the capacity about to be unleashed after a poor start to the effort:
A new trend promises to open up these bottlenecks. A wide range of companies are developing tests that can be deployed to hospitals, doctor’s offices, airports and—maybe—even people’s homes. These machines, generally the size of a countertop kitchen appliance, can be used to test patients right at the point of care, yielding results within an hour. The FDA, in full catch-up mode, has recently handed out emergency approvals for four of these decentralized testing platforms, which are starting to expand and diversify testing capabilities. These emergency approvals let companies provide testing based on preliminary data on the devices, before the conclusion of a lengthy FDA review, for as long as the health emergency continues. …
As the spread of the novel coronavirus slows, mass testing will play a key role in helping countries gradually emerge from economy-crushing lockdowns, say public health experts. “Testing should be able to help us assess what areas of the country or world may no longer require social distancing,” said Joseph Petrosino, a microbiologist at Baylor University, in Houston. “It will also alert us to when and where new waves of infections are emerging, so that targeted regions may be required to lock down, and not entire nations.”
And as the world comes out from its shell, the fast, decentralized tests may take on particular importance. “These tests should first be deployed at airports, train stations, and cruise terminals where large jumps in virus spread could be at risk. Local surveillance at the workplace or schools is also important if people begin reporting symptoms of disease,” said Petrosino. “Having rapid tests readily available could help us with general surveillance practices once we are able to return to normal—or whatever the new normal looks like.”
Several promising new technologies have been accelerated in this process; Karen Townsend will write about one in particular which might make testing as simple as it gets. Even if full capacity with these tests comes tomorrow, however, we don’t know how reliable it will be, and likely won’t for several weeks. Some tests might perform magnificently, but some might generate too many erroneous results to be useful. The return to normal depends on reliable widespread testing, which is why Fauci thinks May 1 will be an “overly optimistic” target date for a full reopening.
However, we probably won’t try to turn on everything overnight, either, nor everywhere. Some areas will have already hit the back end of the infection curve and can take a few more risks, while others might want to hold back a bit. The plan for reopening the economy doesn’t have to be an either/or, argues Avik Roy in a new essay. We will need to have robust testing in place, but we can reopen most businesses while preventing mass transmission events like large public gatherings and requiring negative COVID-19 tests before accessing air and train travel.
If May 1 is “overly optimistic” for a full reopening, it’s also overly optimistic to think that we can put off restarting the economy much beyond that. This new world will involve more risk-taking, but that will be true no matter when we go back to business.
Just for fun, here’s Fauci explaining for the umpteenth time that he works at the pleasure of the president, and that he’s had no indications of displeasure. Maybe it’s overly optimistic that the national media will start focusing on the disease rather than inventing stupid political games.