I agree with Allison Schrager’s assessment from her op-ed in the Wall Street Journal:
Almost everything about the novel coronavirus is uncertain. It was unexpected, though perhaps more of a surprise than it should have been. Public-health experts have been warning for years that a pandemic could happen. But every few years come warnings of potential catastrophes that never seem to materialize.
Among the unknowns about the virus: the true hospitalization and death rates; how infectious it is; how many asymptomatic patients are walking around; how it affects young people; how risk factors vary among different countries with different populations, pollution levels and urban densities. It seems certain the virus will overwhelm hospitals in some places, as it has in China and Italy. We also don’t know how long these extreme economic and social disruptions will last. Without reliable information, predictions are based on incomplete data and heroic assumptions.
This uncertainty makes it much harder to manage the virus, or to strike a balance between public health and the economy. What happened in 1918 or 1957 isn’t particularly instructive. The virus is different. The world is different. So is our health-care system.
The goal should be to move from uncertainty to risk, which will take time and data. The way forward is testing as many people as possible—not only people with symptoms. Some carriers are asymptomatic. California is starting to test asymptomatic young people to learn more about transmission and infection rates. Testing everyone may not be feasible, but regularly testing a random sample of the population would be informative.
This helped in South Korea, which tested thousands of people a day. South Korea has managed to slow the rate of new cases and gather data about how the disease has spread, its effects on different populations, and the mortality rate in that country. More testing would also help spare the world from future shutdowns if the virus reappears before there is a safe, effective vaccine.
Every medical test has some rate of false positives and negatives. The error rate for Covid-19 tests may be especially high. Scientists are still learning about how long the virus lives in the body. Administering tests takes skill and is prone to human error. We don’t know how reliable tests were in China; studies suggest the false-negative rate there is between 3% and 50%—an enormous range. If tests aren’t reliable, the supposed source of certainty can create even more uncertainty. The Food and Drug Administration must balance the urgency for more testing with caution to ensure new tests meet its standards for accuracy.
Policy makers should throw as much energy as possible into getting accurate data. That would allow the world to assess the real risk of the coronavirus. This may lead us to continue to take drastic action to limit its spread, or it may allow us to temper our response, managing the risk at a much lower cost to both society and the economy. Whatever the response, it will be appropriate, based on an assessment of risk—not uncertainty and fear.
What is needed is not just diagnostic testing but epidemiological testing. Right now I believe that most elected officials are acting from political calculus or just plain panic rather than responding to COVID-19. I’m not sure how else you can explain that Illinois is “locked down” (population 12 million/1,200 COVID-19 cases) while Washington State (population 7 million/2,200 COVID-19 cases) is not.