Mass testing is the best hope for normalcy after quarantine
I'm sure something everyone has wondered at this point is simply what the plan is after the lockdown. Out of what's circulating in public policy circles, Paul Romer's plan is the probably the one with the most appealing results
https://paulromer.net/covid-sim-part1/
Basically, mass random testing--specifically, 7% of the population is tested every day, or 21 million, selected randomly.
Of course, 21 million random tests is an absurd number. But if it could be done, people could to some extent resume life, if the simulations hold to reality.
On the other hand, plans like
https://www.aei.org/research-products/report/national-coronavirus-response-a-road-map-to-reopening/
https://ethics.harvard.edu/covid-19-response
Have a few things in common. For one, they all involve incredibly advance and detailed contact tracing. They rely on the proliferation of mass surveillance similar to HK, where all US citizens would have to install apps, for instance, that track their location and ping them when they have been in contact with a COVID19 positive patient.
They also involve extreme limitations on travel, and one of them even has the forced drafting of immune citizens into the medical and food industries.
It's estimated about 80% of the economy could continue, and they will last until the minimum of vaccine (18 months - 2 years) or 14-20 months (herd immunity is achieved).
What does everyone else think? What do you think we should do after the lockdown?
When someone tests positive, all the people who interacted with that person need to be notified so they can be tested. Normally this is done manually but it only takes a few cases to overwhelm the system, unless you put a massive number of people on the job.
That's not impossible because there are a lot of people who could be hired, but it seems very inefficient to do it that way when most people have smartphones and we have computers that could do the work. I don't think it's any more private to have human workers do it either.
I think the main practical issues with IT contact tracing is that, let's be honest, do you think Americans will obediently install tracking apps on their phone? There are people knocking down 5G networks. Do people trust the Trump administration? According to polling, the majority do not. Which isn't great for this.
Romer showed that if we could do such massive testing, then contact tracing will be unnecessary, because every person in the US will get tested once every 14 days in expectation. You don't have see if you're likely to have covid, you just know because you got tested.
But whether or not 21 million tests per day is practical is another matter.
The basic idea for the Apple/Google proposal is that the app will exchange random-looking numbers (that change every hour) via Bluetooth with any nearby phone and the history of these exchanges gets stored on the phone. Unless someone tests positive, nothing else happens.
When someone tests positive then the numbers they've sent get uploaded to the cloud, and anyone's app can check for any numbers they've seen and notify the user. (I assume a medical worker has to do the upload to cut down on the risk of trolls playing games.)
I'm not a lawyer but I doubt it would be illegal since it's anonymous until something happens, and the notifying is the same thing that would be done if it happened the manual way. There might be other security issues, though.
The illegal part would be making the software compulsory.
I think Romer's simulation is too simple to be much of a guide. In particular there is no accounting for real-world geography or interaction patterns. Such things should be treated like a back-of-the-envelope calculation that could be way off.
I also wouldn't underestimate the difficulty of getting everyone to be tested often, particularly if it's as unpleasant as current tests. Getting notified of a possible contact would encourage people to get tested despite the unpleasantness, or at least stay home for a while.
I don't expect everyone to install an app. After all, not everyone even has a smartphone. But if there is a popular app that's widely used (or multiple apps that interoperate based on a common standard) then it will help, particular for contact with strangers where doing it manually isn't even feasible.
I wouldn't expect a government app in the US. If Apple and Google provide apps then it won't be like it's coming from the Trump administration. Governments could encourage it though, maybe require it for some activities. I would also expect Google's app, at least, to be open source, and maybe some people will run a fork that they like better.Edit: the announcement says "using apps from public health authorities". Hmm.I expect we will probably see a combination of approaches. If someone wasn't using the app then they will try to do it manually. Some attempt at random testing might be tried too, in some places.
Did you see this recent post about exactly this topic? It seems that Apple and Google are already working on automated contact tracing via mobile phones.
FYI: @stu2b50
Coincidentally, I just watched this video about mass testing in South Korea. I saw this post after I'd posted that video.
In short, testing and contact tracing is how South Korea is keeping the COVID-19 coronavirus under control. This is working in the real world.
I see no reason why we can't implement this in other countries. The only limiting factor is the number of testing kits available. But if South Korea can manufacture hundreds of thousands of kits, so can most industrialised countries.
I say go for it!
The issue is that SK and HK are very different politically and culturally to the US. While the Google & Apple initiative is cool, it's still optional. For contact tracing to be effective it needs to coordinated and run by federal health officials and it needs to be universal.
And in the US, there is actually a lot of groups that would refuse to install a contact tracing app produced by the current administration.
People who dislike/distrust the Trump administration
People who dislike government oversight
Conspiracy theorists
Privacy enthusiasts.
It's surprisingly bipartisan, if you think about it.
I didn't realise you were looking only for solutions that would apply to the USA. You should have specified.
Given how well Australians and New Zealanders have cooperated with their respective lockdowns, I could see them also cooperating with widespread testing and contact tracing (manual, not automated). We don't have the same level of anti-government bias that America does.
I think you mean partisan.
No, bipartisan. People on the left who dislike and distrust the Trump administration. Libertarians on the economic right who dislike government intervention. And the niche QAnon conspiracy people who.
The nation can finally be united in disobeying proper public health policy!
Is that what it is? It sounds more like a cop-out to accept the Patriot on megasteroids because everything else was 'too hard' or 'too expensive'.
Other countries have managed to get things to a point near sanity without going full China, why is the US so incompetent?
The plans are based around the countries (+ mildly autonomous city + autonomous region) that handled the outbreak the best: South Korea, Hong Kong, and Taiwan. Other than Greenland, where obviously exceptional circumstances are at play, no one area is the where the former is at containment.
Part of the issue is that "everything else" is just Romer's plan. There is no "else", every other public policy involves extensive IT contact tracing.
If you can't do the level of testing Romer suggests, which is genuinely may not be physically possible, then you can't release the lockdown without some way to do this kind of contact tracing to prevent further outbreaks.
Using SK/HK/Taiwan as a model for a country like the US is quite literally insane. They are tiny, and have pre-existing surveillance culture (and often to their detriment).
The closest analogy in geography and population distribution I know of would be Australia, just scaled up. You continue a region-based lockdown, with people not allowed to move between states, cities, etc - you keep the border to the country locked down, so no flights in or out, and that lets you manage your contact tracing manually by keeping the scope down. The economy still takes a major hit, but not one it can't survive for even 5 years.