The Most Important Policy Decision In Our Lifetimes

A lightly edited version of this twitter thread:


In a week dominated by horrible news, there are signs that the Senate may make the right choice when it passes a new response to the pandemic this July:


The Feds are moving past denial:

“Asked why the administration’s stance has changed now, Dr. Fauci referred to the alarming rise in infections nationwide. ‘Obviously, things are not going in the right direction,’ he said.”

https://www.nytimes.com/2020/07/01/health/coronavirus-pooled-testing.html


Data are forcing a switch from dogmatic polemics in support of contract tracing to pragmatic questions about what will work:

Paul Romer (@paulmromer):
NYC Contact Tracing June 1-20

Only 37% of cases known to be infected offered a contact

7,584 cases

  • 1,164 no phone number
  • 172 not reached
  • 2,451 did not complete interview
  • 989 did not offer a contact

2,808 offered at least 1 contact

https://www.nychealthandhospitals.org/test-and-trace/data/


Contact tracing is not working:

‘Dr. Fauci acknowledged that the country was not adequately isolating people. But, he added, above a certain level of infection, “the core paradigm of identification, isolation and contact tracing just doesn’t work.”’

https://www.nytimes.com/2020/07/01/health/coronavirus-pooled-testing.html


Fauci is also signaling a switch toward “pooled” (or “group” or “batch”) surveillance testing:

‘“We’re in intensive discussions about how we’re going to do it,” Dr. Anthony S. Fauci, … said in an interview. “We hope to get this off the ground as soon as possible.”’

https://www.nytimes.com/2020/07/01/health/coronavirus-pooled-testing.html


Universities with credibility (including Stanford and Cornell) are simply ignoring the mindless guidance from the CDC and adopting testing programs that screen everyone on campus frequently:


Cornell:

“Our modeling shows that this testing must be done early and often … [but] testing every student is impractical and cost-prohibitive. An essential part of an effective screening strategy, then, is pooled testing”

https://www.wsj.com/articles/why-cornell-will-reopen-in-the-fall-11593535516


Supporting analysis for Cornell’s decision

https://people.orie.cornell.edu/pfrazier/COVID_19_Modeling_Jun15.pdf


Stanford Medical Center:

To reassure its staff that it could reopen safely, Stanford Medical Center tested 11000 staff members and continues to test patients before they arrive for elective procedures.

https://med.stanford.edu/news/all-news/2020/05/stanford-health-care-resumes-most-procedures.html


Even Giroir, who has been one of the holdouts against more testing, is coming around

‘In a call with reporters on Wednesday, Adm. Brett Giroir, deputy secretary of health and human services, said he expected [pooled testing] to be up and running by the end of the summer.

https://www.nytimes.com/2020/07/01/health/coronavirus-pooled-testing.html


Giroir goes on acknowledge where pooling is likely to be adopted and distance himself from the CDC:

‘“My assessment is that the data is very strong,” he said. By the time students return to universities, “pooling will be very mature.”’

https://www.nytimes.com/2020/07/01/health/coronavirus-pooled-testing.html


Growing recognition that there are synergies between pooling and frequent retesting:

“The strategy could be employed for as little as $3 per person per day, according an estimate from economists at the University of California, Berkeley.”

https://www.nytimes.com/2020/07/01/health/coronavirus-pooled-testing.html

http://faculty.haas.berkeley.edu/ned/GroupTestingInAPandemic.pdf


Senator Rubio, a Republican, says that he will back Federal funding for pooled testing.

Marco Rubio (@marcorubio):
In addition, will ask the federal government to help fund 7 help states coordinate “pool testing” for our universities, schools, emergency responders & health care workers

This will allow them to conduct exponentially larger number of tests regularly & identify & stop outbreaks
https://twitter.com/marcorubio/status/1278659465408057350


Together, these signs suggest that the Senate will make the right choice next month when it considers the most important policy decision in our lifetimes:

Matching the $75 billion in funding for tests proposed by the House.


Universities can pay for surveillance testing, but K12 schools, facing budget cuts and layoffs, cannot reopen as Stanford Medical Center did or as Cornell will unless the Feds provide the funding for the tests.


If K12 schools do not have the funds to implement a program of surveillance testing that keeps infected teachers and students out of the classroom, they will follow the CDC guidance, and keep relying on remote learning programs.


Remote learning is failing all students

Remote learning is harming students from poor families to a much greater extent than students from affluent families chair More on Reopening Schools


With the type of pooled surveillance testing that Cornell is adopting, this nation can reopen schools safely and get all children back into the learning environment that works – a real classroom.