Caitlin Rivers, PhD+ Your Authors @cmyeaton Outbreak science + epidemiology + health security. Assistant professor at Johns Hopkins Center for Health Security (@JHSPH_CHS). ELBI alum. Apr. 20, 2020 1 min read + Your Authors

All proposed plans for reopening, incl ours, rely on testing + contact tracing. The US is at ~ 1M tests/wk. @ashishkjha thinks we need 3.5M/wk minimum. Others wants several times that. Whatever the goal, it’s clear what we have is not enough. But when is that capacity coming? 1/

We have been plateaued at 1M for a while, and there don’t seem to be coordinated efforts to ramp up. Test kits, reagents, swabs, personnel, PPE have all been identified as bottlenecks. Our options for reopening without widespread testing aren’t great. 2/

We could continue staying at home until case counts fall to a point where our test capacity is enough. For reference, ~2% of tests come back positive in South Korea, and ~ 7% in Germany. In the US it’s currently ~20%. 3/  https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html 

If we use those as guides, at 1M tests/wk we wld need just 20k-70k cases/wk. This week we added ~200k cases in the US. How long would it take to get from here to there? Hard to say. Italy took ~3 weeks to cut incidence from 6k to 3k. But we have much further to go than half
4/

Are there other test-sparing strategies that would allow us to reopen safely? Not that I have thought of. A combination of physical distancing, testing, contact tracing are what all the other countries that have successfully slowed spread have used. 5/

We need a realistic understanding of our timeline for testing capacity so we know what we are working with. And we need to continue to push for innovative ways to expand that capacity so that test, trace, isolate can be options for controlling spread when incidence declines. 6/6


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