This whole “we have to test!” nonsense really has my goat. As I’ve written in the past, medical testing of any kind is of absolutely no use unless there’s a possibility of doing something differently as a result of how the test comes out.
The WHO’s strategy involving testing is this: test, isolate and trace new cases to suppress the spread of the virus.
Quite obviously, once the disease has spread to enough people, it becomes impossible to trace how one individual might have infected another individual. And as soon as you find the second individual, that person will have infected others and on an on you go. You can test until the cows come home in New York but it’s not going to have any effect because you can’t actually do anything quick enough to stop the spread.
The only thing you can do at this point is to self-quarantine in hopes that you personally won’t get the disease. Which, of course, is what we’re all trying to do.
The captain of the U.S.S. Theodore Roosevelt, Captain Crozier, found this out the hard way:
Inappropriate Focus on Testing. Testing has no direct influence on the spread of the COVID-l9 virus. It merely confirms the presence of the virus. Due to the close quarters required on a warship and the current number of positive cases, every single Sailor, regardless of rank, on board the TR must be considered “close contact” in accordance with the NAVADMIN. Testing will only be useful as the ship returns to work after isolation or quarantine to confirm the effectiveness of the quarantine period. Our focus now must be on quarantine and isolation in strict compliance with CDC and NAVADMIN guidance.
On Twitter, Dr. Robert Epstein believes he has the plan which is that everyone should be tested simultaneously and then the ones who are positive self-isolated. Will this really work? No. Why?
- You can’t test every one in the country simultaneously! America is a pretty big place!
- If you did, everyone that tested positive would have to immediately go into quarantine without touching another human being. Ideally, you’d want the testing to be at home and they just stay put.
- Everyone else in the house would need to be removed. Or, I suppose, you just lock them in as well and let them eventually get sick.
And now we come to compliance. Those who are being quarantined can’t leave their homes — period — which means that someone needs to deliver basic essentials — either through a civilian or government entity. If you leave your house and you’re positive, regardless of whether you think you’re dressed appropriately or not, you need to be arrested and returned to your home.
Once you become sick enough for hospitalization, if it comes to that, the best way is for an ambulance to come get you, prepare you for transport and then take you to the hospital. All of this was detailed in If You Test Positive in South Korea, Then What?
Dr. Epstein noted this morning that Telluride, Colorado is doing testing of all their residents.
Progress! Telluride, Colorado is the first US town to begin testing all 8,000 of its residents for #coronavirus. When all carriers self-isolate, transmission STOPS COLD.
— Dr. Robert Epstein (@DrREpstein) April 2, 2020
Will this work? Maybe, kind of. The good news is that Telluride is not an aircraft carrier so social distancing is quite easy. Telluride is also a ski town and people who live there are wealthier than the average American. The median household income of a Telluride resident is $61,875 a year versus the U.S. average of $53,482 a year which means they have more financial resources to ride out a quarantine.
Most importantly, however, is that if you get 100% testing compliance and 100% quarantine compliance, this is only a snapshot in time. As soon as someone else rolls into town, they need to be tested before they can enter. With Telluride this is actually possible since there’s really just one road in and out of town. What you would need to do is stop all traffic, including delivery vehicles, outside of town and give them a test before you let them enter. Again, doable but only because you can control access and the town is very small.
Let me also reiterate that testing to confirm a medical diagnosis, for use in areas like Idaho where it is still possible to trace, and developing data for modeling and other purposes are all appropriate.
Rather than inventing additional non-workable solutions with a large number of “unintended consequences,” let’s listen to the president, stay at home, practice social distancing, and we’ll get through this.