Testing Is Not the Cure for the Pandemic

August 8, 2020 Updated: August 8, 2020

Commentary

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.

But it’s also important not to allocate all resources to one battlefront while ignoring others. With that in mind, I have serious concerns about a recent plan promoted by the Broad Institute, a biological research organization, and supported by political advocacy group No Labels, as an effective cure for the pandemic.

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.

As I’ve written extensively, scientists and other experts need to have their ideas rigorously challenged. This plan has not been sufficiently challenged; I can find multiple problems with the underlying assumptions. With that in mind, I ask people to challenge my analysis here, but to do so with public links to facts and studies. If I’m wrong, I want to know that.

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.

Some simple math will reveal that the testing cannot stop the virus, though it can slow its spread. If a person’s test result is negative, there’s still a possibility that the person contracted the virus during the one-day waiting period or that the test produced a false negative. Recent studies show that while the RT-PCR tests can have 100 percent sensitivity (i.e., zero false negatives), in practice they have a rate of 20 percent to 34 percent false negatives.

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.

A recent study of passengers on a train found that the rate of transmission among socially distancing passengers was as high as 10 percent but averaged 0.32 percent. Using this very low average percentage, if an infected person comes in contact with 300 people over the course of a week, it would be expected that 1 other person would be infected. This means that 1 percent of the people in public could be infected and the number of infections would double every week. Maybe this is acceptable, but it’s not zero; the virus will continue to spread.

Suppose testing occurred every day instead of every week. Then an infected person might come into contact with only 300/7 = 43 people before the next test showing them positive for COVID-19. That means that every seven people would be expected to infect one person. If 1 million people in a large city like New York tested positive, that would mean 10,000 unaware infected people wandering around, potentially infecting roughly 1,500 people per day. Maybe this is acceptable, but it’s not zero; the virus will continue to spread.

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.

Studies have also found that the virus is shed in human feces, leading to investigations of sewage systems throughout Europe. While it’s believed that the chances of infection from contaminated water supplies is low, there was at least one documented instance of detecting the virus in a river, during the peak of the epidemic in northern Italy.

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.

However, we still don’t know enough about this virus. Some viruses can lie dormant in a person for long periods of time, without detection, which could account for the evidence that some people get reinfected. Some experts believe COVID-19 could result in chronic persistent infections.

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.”

So let’s look at the COVID-19 facts about the United States and other countries. The number of reported cases in the United States is just over 5 million or 1.5 percent of the population. The mortality rate is just over 3.2 percent. Sweden was held up as a positive example of fighting COVID-19 for a long time. As of Aug. 7, Sweden has one of the highest mortality rates at 7 percent. Its infection rate is 0.8 percent.

Germany has also been held up as a role model. Currently, Germany has a very small infection rate of 0.26 percent but a mortality rate of 4.3 percent. France had possibly the most strictly enforced rules on mask wearing and social distancing in Europe and thought the virus was under control, but now there’s been another surge. Other European countries such as Spain and Italy have much higher infection rates and mortality rates than the United States.

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.

Health care in the United States is certainly among the best in the world. According to Dr. Deborah Birx, the coronavirus response coordinator for the White House Coronavirus Task Force, the United States is counting the deaths of all patients with COVID-19 as COVID-related deaths, even if the death might be due to other factors, while other countries are doing the opposite. This is confirmed by the official CDC guidelines on reporting COVID-19 deaths.

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.

Furthermore, recently spikes in the number of COVID-19 cases have been reported in the UK, Belgium, Spain, Germany, France, Italy, Norway, Hong Kong, Vietnam, Australia, China, and Iran. There have been reports of spiking in Saudi Arabia, Lebanon, and even South Korea as well as small spikes in Singapore and Taiwan.

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.

These restrictions must apply to entertainment venues, restaurants, places of worship, and demonstrations of all types, peaceful or otherwise. Yet politicians continue—despite the rhetoric of how harmful this disease is and the dire consequences of not destroying it soon—to make exceptions for large events that they support, including mass funerals, peaceful protests, and violent riots as in Portland, which has now lasted over 70 days, as well as other major cities across the United States, including SeattleOakland, MinneapolisWashingtonAtlanta, and Philadelphia.

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?

Social distancing and wearing masks have already been shown to significantly reduce the spread, and yet we have problems enforcing those simple precautions.

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.

However, there’s another solution that’s less costly and doesn’t require that businesses and universities divert resources from other possible solutions.

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.

Instead, let’s continue research into the virus, increase testing of the population, efficiently allocate resources to medical facilities, educate people to be aware of symptoms, isolate people in high-risk groups, strictly enforce social distancing and mask wearing for all people regardless of the nobility of their goals, and let’s send people back to work.

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.

Bob Zeidman has a Bachelor of Art and a Bachelor of Science from Cornell University. He is an inventor and the founder of successful high-tech Silicon Valley firms including Zeidman Consulting and Software Analysis and Forensic Engineering. He also writes novels; his latest is the political satire “Good Intentions.”

Views expressed in this article are the opinions of the author and do not necessarily reflect the views of The Epoch Times.