Everyone says "we need more testing", but there's actually very little discussion of how that testing would translate into lower transmission. I'm skeptical any program less aggressive than the one proposed here would get R0 < 1.
Testing by itself does nothing to reduce transmission. What it does do, though, is give you the opportunity to identify infected people and isolate them. And if you can identify and isolate them early enough in the course of their illness, you can prevent them from infecting many other people, and that’s what reduces transmission.
Given that it appears people with COVID-19 can shed the disease for many days before showing any symptoms, if your goal is to pinch off outbreaks before they become outbreaks, frequent, universal testing is the only way to get there.
Right, but I haven't seen anything to suggest our current testing plans will be universal or frequent enough to really solve this. So testing more is certainly better than not testing, but without constant testing of non-sick people it's not really going to help much.
Exactly. More testing is good, but actually stopping pandemic will require orders of magnitude more testing, which in turn requires a different approach to testing because the current way we do testing can't scale.
I mean in theory if you had a perfectly accurate test and everyone got tested before coming into contact with others, that gives you an R0 of 0. How close we can get to that standard is obviously very debatable, but simple logic tells us that it certainly could push the R0 below 1 given some (unknown) threshold of test accuracy and compliance.
Is it because the discussion isn't needed? Anyone who is of moderate intelligence and thinks for a few seconds can see the next logical step. I don't know pb and he might be wonderful and original etc, but I have to agree with the original comment - this is just miles from an original idea. The constraint is tests, not ideas of what to do when we have simple/fast/abundant testing available.... "A third solution" makes it seem like it's... an original idea.
I think calling it a third solution is totally fair. Whether it's a novel solution is separate.
The two solutions that are being debated now are (1) staying in lockdown until a vaccine or treatment is available, and (2) reopening and attempting to manage the spread using existing protocols/ideas (relatively low amounts of testing, quarantining after a period of infectiousness, some form of contact tracing, lots of finger crossing). At least, that's generally what I hear being debated: reopen or not, or when to reopen.
The post suggests that if we had quantitatively much more testing, we could pick a qualitatively different third solution -- namely, reopen pretty freely and realistically control the spread.
Sure, you can view that as a variant of the "reopen" option, but in my mind reopening feels very different with a realistic way to isolate people before they've had a chance to spread it very far. It's proactive vs reactive. If we fully reopen with even 2 orders of magnitude more testing than we're currently doing, it's just going to be a matter of closing back up wherever it gets out of hand. In practice, the openness will fluctuate, things will be spread out over time, politicians will continue to do the exact wrong things, and lots of people will continue to die.
In short: (1) stay in lockdown until vaccine/treatment, (2) reopen without a strategy, (3) reopen with a strategy.
Imo, those are the currently discussed solutions because of the lack of available testing. Ie, with the current constraints. It's akin to two people discussing how to use the budget of $1 million and a third saying "I have a third solution: Make the budget $100 million and do everything". Sure, it's not wrong, and it's different to the first two, but... who cares? Everyone kind of already knows if you have the $100 million you have a much better option.
