Pivot, cure covid and lockdowns

With covid-19 cases, hospitalizations and deaths climbing, policymakers understandably want a response that protects lives and livelihoods. Many have resorted to an old playbook of blunt mandates, including late-night curfews, travel restrictions, as well as school and business closures.

And while we wait at home, our leaders have pinned hopes on a vaccine that remains months away from being widely available.

Unfortunately, these are public health tools predicated on the assumption that it is impossible to know who has the virus. Therefore, we must treat everyone as infected.

This doesn’t need to be the way. The technology exists to equip everyone with knowledge of their covid-positive status using self-administered rapid tests. In fact, the Trump administration recently purchased 150 million rapid tests to distribute to those most in need.

But this is nowhere near enough to collapse the outbreak’s spread. That would take, according to Harvard epidemiologist Dr. Michael Mina, half the population testing themselves with a rapid test every four days.

That requires more tests — a lot more — to transform the response to the virus. Paul Romer, a Nobel laureate in economics, argues we need to test 50 million people per day, an investment he estimates could cost $45 billion over the course of three months. This is a snowflake in a

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storm compared to what has been spent to date in the response and the lives lost already.

Such a model would follow that being used by the NFL, which administers tests to players and other essential employees daily and requires a negative test before entering a NFL facility, along with other mitigation measures including social distancing.

What’s in the way? Regulatory barriers, direct funding, and leadership.

Realizing the promise of these tests must begin with the Department of Health and Human Services adjusting its regulatory posture. For example, one of the cheapest, most effective rapid tests — delivering results for $5 in 15 minutes — can give results at home, but HHS hasn’t cleared it for home use. Not even under the supervision of a medical provider via telehealth.

Instead, users have to mail it into a lab, when what’s needed to keep pace with the disease are tests with near-instant results that can be done by anyone. This restriction could be understandable if the test is difficult to perform, but it’s not.

Joe Biden has called for implementing widespread testing; Donald Trump should join him in that call. We have no time to waste. As we have entered a season of rising cases, we have already reached unprecedented caseload levels.