We’re Woefully Short of COVID-19 Tests and Using the Few We Have to Test the Wrong People

Ezekiel J. Emanuel (oncologist, bioethicist, and vice provost of the University of Pennsylvania) and Paul M. Romer (professor of economics at New York University), in a must-read piece for The Atlantic:

Current guidelines from the Centers for Disease Control and Prevention give priority first to hospitalized patients and symptomatic health-care workers, then to high-risk patients, specifically those over 65 and those suffering from other serious health conditions, with COVID-19 symptoms. Under this system, asymptomatic individuals are not tested, even if they had contact with people who tested positive.

This is an enormous mistake. If we want to control the spread of COVID-19, the United States must adopt a new testing policy that prioritizes people who, although asymptomatic, may have the virus and infect many others.

We should target four groups. First, all health-care workers and other first responders who directly interact with many people. Second, workers who maintain our supply chains and crucial infrastructure, including grocery-store workers, police officers, public-transit workers, and sanitation personnel. The next group would be potential “super-spreaders” — asymptomatic individuals who could come into contact with many people. This third group would include people in large families and those who must interact with many vulnerable people, such as employees of long-term-care facilities. The fourth group would include all those who are planning to return to the workplace. These are precisely the individuals without symptoms whom the CDC recommends against testing.

We need to vastly increase our testing capacity and invert our who-should-be-tested priorities. This is easily understood, eminently fixable, and should be uncontroversial.

Saturday, 18 April 2020