From the first moment that social distancing guidelines were
considered, critics said that such steps were “just buying time.” Which
is exactly correct. Diseases like COVID-19 can’t be wiped out by social
distancing, but these steps can slow the rate of transmission, reducing
the number of cases at any given moment and providing an opportunity for
other actions. Those other actions are led by testing.
No one wants to put an entire city, county, state, or nation on lockdown. The only reason such steps are necessary is simple: We do not know who is actually carrying the virus. If it were possible to put everyone with an active infection into isolation, the rest of the nation could go back to work and the chain of transmission can be genuinely broken.
But the problem isn’t the time purchased by social distancing. It’s the time wasted by Donald Trump. By failing to prepare for the pandemic when it first became a threat in January and continuing to snooze through February despite a wave of cases that was building both outside and inside the United States, the nation entered March with an epidemic already underway and testing that was utterly inadequate to find active cases and isolate them.
Now America is paying for the time Donald Trump wasted playing golf and holding rallies. Because the level of testing it will take at this point is genuinely enormous.
At the time South Korea brought the epidemic within its borders firmly under control, it had conducted just over 500,000 tests. It has continued testing since that point, and has now conducted another 100,000. On Monday, there were only 10 new cases of COVID-19 in South Korea, all of them with known sources.
No one wants to put an entire city, county, state, or nation on lockdown. The only reason such steps are necessary is simple: We do not know who is actually carrying the virus. If it were possible to put everyone with an active infection into isolation, the rest of the nation could go back to work and the chain of transmission can be genuinely broken.
But the problem isn’t the time purchased by social distancing. It’s the time wasted by Donald Trump. By failing to prepare for the pandemic when it first became a threat in January and continuing to snooze through February despite a wave of cases that was building both outside and inside the United States, the nation entered March with an epidemic already underway and testing that was utterly inadequate to find active cases and isolate them.
Now America is paying for the time Donald Trump wasted playing golf and holding rallies. Because the level of testing it will take at this point is genuinely enormous.
At the time South Korea brought the epidemic within its borders firmly under control, it had conducted just over 500,000 tests. It has continued testing since that point, and has now conducted another 100,000. On Monday, there were only 10 new cases of COVID-19 in South Korea, all of them with known sources.
By that same point, the United States had conducted over 5.5 million tests. That’s not only a higher level of testing than South Korea, it’s a higher level when considered against the size of the relative populations. South Korea tested about 11 people out of each 1,000. The U.S. has testing about 17 per 1,000. But it’s not enough. It’s not nearly enough.
Fiddling away the entire month of February and continuing to provide inadequate numbers of tests since then has meant that testing has completely failed to describe the scope of infection at any point. Pair that lack of testing with no federal coordination of test results, no federal case tracing, no effort to standardize where and when tests are administered, and the result is a nation where 10 million tests can be done … and it will not, cannot be enough.
The percentage of positive tests in South Korea is 1.7%. Australia, which has also managed to bring the rate of new cases to a tiny number thanks to widespread testing and effective case tracing, has a positive percentage of 1.2% over 500,000 tests. Both countries used social distancing guidelines to buy time, but they also used that time, acting quickly to bring in a strong, federally-managed testing program. The total number of deaths in South Korea is 243. In Australia, it’s 83.
Had the United States engaged in an active program of testing and case tracing in February, it is almost certain that the total number of cases in the United States could have been held to a level similar to those in South Korea and Australia. And the number of Americans dead at this point would be less than 1,000.
Instead, Donald Trump played golf through February, then bumbled through March talking more far more about chloroquine than testing, then spent much of April saying that testing was a problem for the states. That one factor—the complete failure to implement a federal testing campaign—is the biggest reason that 56,000 Americans are dead. And counting.
To reach a level of 2% positives, the United States would at this point need to conduct 45 million more tests—and that’s if it didn’t discover any new cases of disease. In reality, America is likely to need well over 100 million more tests. And it must pair those tests with an equally massive effort at case management, isolation, and follow-up. What was a huge task two months ago has been made almost overwhelming by pure time-wasting. And it still has to be done.
As The New York Times reports, Trump’s return to the evening self-congratulation session on Monday included word that the government intended to test at a rate that eventually reaches about 2% of the population in a week. That level of testing would have been wholly adequate two months ago. But is laughably inadequate now and becoming more inadequate by the day.
As economist Paul Romer noted, testing at a 2% level isn’t even enough to test the nation’s healthcare workers once a week, even if their patients were completely ignored. He believes the number of required tests now needs to be 50% of the population each week. That’s 163 million tests a week. That’s probably not impossible, but it is certainly daunting.
Think of the possibilities as a triangle: in one corner is social distancing, in another is testing, and in the third is deaths. The more strictly social distancing is carried out, the less testing is required and fewer deaths occur. Or adequate testing means less requirement for social distancing while keeping deaths low. Or the choice can be made to have inadequate social distancing and inadequate testing, which simply results in more deaths.
That third option isn’t the option the United States is about to choose—it’s the option Donald Trump already took.
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