The COVID-19 pandemic has been called one of the biggest challenges in our nation’s history, and to the world. It’s been called a war, and just like in a war, we need to mobilize resources.
The plan touts weekly testing combined with severe restrictions on those testing positive and with few restrictions on those testing negative. I’m a donor and strong supporter of No Labels, and I commend the spirit of the plan, but I find that the details of this plan have not been fully considered and simply will not work.
Imperfect Accuracy and Delay
No current tests are 100 percent accurate—very few tests ever are. Also, the best reported turnaround time for a test is 15 hours, or effectively 24 hours before results can be obtained. The virus has been determined to have a infectivity window of approximately 9 to 12 days, with the first 2 days without symptoms followed by 7–10 days of symptoms, with the exception of some infected people who are entirely asymptomatic. All tests have a certain chance of producing false negatives; in other words, some people may be hosts to the virus even though the test result says the person is free of the virus.Let’s liberally assume that the result is 99 percent accurate. The 1 percent inaccuracy is either because the test was administered wrong, the lab made a mistake, or because the person tested contracted the virus in the period between testing and getting the results. Then one person out of 100 will be in public with the virus, unknowingly.
If the testing occurs once per week, then these infected people will be spreading the virus for much of that week (unless they self-isolate if they are not asymptomatic and symptoms begin). If those infected people go to work or shopping or on public transportation or to a ballgame, they risk spreading the disease.
Means of Transmission
There are still many unknowns about how the virus is spread, and there are reports of possible mutations causing it to spread in different ways. It’s believed that COVID-19 can live for hours or days on surfaces like countertops and doorknobs. This means that even regular testing of people will not find surfaces that contain viruses and could cause infection.Questions of Dormancy
The testing plan relies on the assumption that the virus in an infected person will cease to propagate within about 10 days if it doesn’t find another host. In other words, by isolating an infected person for 10–14 days, that person’s immune system will effectively destroy the virus or that person will die. Either way, the threat of infection from that person is over.Despite Claims, Other Countries Are Not Successfully Testing
There are many claims that other countries have done a better job of controlling the pandemic than the United States. Often, the argument is that they have done more testing. However, even by late May, testing for COVID-19 was highly inaccurate. I personally asked many experts since the pandemic began about whether other countries had more accurate tests than the United States and if so, why didn’t they share their tests with us. The answer I got back was always a simple repeat of the mantra, “We must do more testing.”Asian countries have been held up as examples of success in reducing COVID-19. I won’t count the numbers coming out of China, given the opaque nature of its communist government and its involvement with the spread and coverup of the pandemic.
Singapore has a nearly 1 percent infection rate although nearly 0 percent mortality rate. I suspect that this is more likely due to how they measure COVID-related deaths, because the mortality rate should not be significantly affected by factors other than the natural course of the virus and the quality of health care.
Taiwan and South Korea have admittedly tiny numbers of cases and tiny infection rates. It would be important for us to understand why that is, but it is more likely a result of strong self-isolation enforcement rather than testing. I’ll discuss that issue later in this article.
Enforcement
The most important reason that this testing plan won’t stop the pandemic in the United States is a lack of will to enforce the program. This plan requires everyone in the United States to follow the testing requirements and to allow no one to enter public establishments unless they test negative. This is simply not achievable without a serious change in attitudes. I wish it weren’t so.Many U.S. leaders proclaim that COVID-19 is the greatest immediate threat to the lives of millions of Americans. They say that we need to eliminate this scourge or risk the deaths of our elderly, infirm, and others. I believe this is true, but these same leaders are not acting in harmony with their own passionate words. And neither is the general public.
Enacting this plan would require that politicians, police, military, legal and illegal immigrants, the homeless, majorities, minorities, conservatives, liberals, and everyone else in America comply and enforce compliance. That means that all large gatherings would be illegal—not discouraged but illegal and with strict consequences. No exceptions. That means that all establishments must exclude people based on their test results. No exceptions.
False Sense of Security
If all of the measures required for the plan were to be put in place and were to be strictly enforced, would that end the pandemic? Almost certainly not. As I showed, it would reduce the spread but not eliminate it.The plan would create a false sense of security where people in “virus-free” locations would almost certainly not socially distance and would not wear masks, because they would believe they were in a truly virus-free environment. Or would we need to still enforce masks and social distancing in these places, too? In that case, with the testing not significantly changing the requirements, how is it helping?
Huge Cost
The cost of the plan is estimated at $150 billion. That’s a huge cost. Certainly, it’s significantly less than the trillions of dollars that Congress has been allocating for assistance to Americans and less than the cost of the businesses and incomes that have been lost during these times, and less than the costs of medical care.The Simple Solution
Let’s assume that my previous reasoning is all wrong. Let’s assume that there are significant issues that I misunderstand, and that isolating infected people for 10–14 days is the solution to stopping the pandemic—the key assumption behind this plan. Let’s assume that the government, the politicians, and the American public have the willpower and determination to enforce draconian self-isolation rules for 10–14 days.In that case, all that’s required is to have everyone stock up on food, lock their doors, and wait in their homes for 10–14 days. If the assumptions for the testing plan are all correct, the pandemic will then be eradicated at very little cost.
On the other hand, if my analysis is correct, then nothing will stop the virus until there is a cure or vaccine. We need to keep people healthy and balance that with getting them back to work. We don’t know everything about the virus yet. We shouldn’t create giant, costly systems, diverting critical resources, until we fully understand the virus and the infection mechanisms. Otherwise we’re diverting resources from other potential solutions, including treatments, cures, and vaccines.
Update
The science is changing rapidly. The UK just announced the adoption of tests that claim results in 90 minutes with 98 percent sensitivity, though the data hasn’t been published and independently verified yet. Furthermore, since the tests will not be administered by trained health officials, the rate of false negatives will no doubt be higher than 2 percent. This is a significant step in the right direction, but the UK government is already planning to distribute these unevaluated tests, which could actually accelerate the spread if they turn out to have a high rate of false negatives while people believe them to be 100 percent accurate. Public education, social distancing, and wearing masks is still required so that the tests are used as a guide, not a panacea.An instant test with 100 percent sensitivity is preferred, but any test plan will still be subject to all of the problems I state above. A national test plan will be very expensive and will not eradicate the disease, though it will slow down its spread. And without strict enforcement, for which there is little will among our leaders and our people, a test plan will have little effect. Until there is a cure or vaccine, we will have to learn to live with COVID-19, just like we learned to live with cholera, influenza, polio, AIDS, and other diseases.
