The route to reopen?
Testing at scale is needed, but that's not enough.
I wrote an oped on how we can use our digital infrastructure to guide us on the unchartered exit-ramp and avoid a 2nd wave rebound
washingtonpost.com/opinions/2020/… 1/x
Testing at scale is needed, but that's not enough.
I wrote an oped on how we can use our digital infrastructure to guide us on the unchartered exit-ramp and avoid a 2nd wave rebound
washingtonpost.com/opinions/2020/… 1/x
Most are advocating some version of massive testing as the guide. But doing that for a country of 330 million people is very challenging, w/ uncertainties of the tests, the need to serially assess, and to plan for a long surveillance (e.g. 18 months) period
Full text here 2/x
Full text here 2/x
Let's 1st review the tests.
For the virus, there's a problem with false negatives
For the antibody, it's a very challenging assay
And we don't know if having IgG levels confers protection from spreading, or how long it might protect 3/x
For the virus, there's a problem with false negatives
For the antibody, it's a very challenging assay
And we don't know if having IgG levels confers protection from spreading, or how long it might protect 3/x
We don't know the true asymptomatic carrier rate but it's estimated (Fauci) to be 25-50% (a new @NIH study is going after that in 10,000 people) nih.gov/news-events/ne… A single virus test or body temperature as a screen to return to work may not be reliable 4/x
We can use digital markers to identify a cluster where there is a potential #COVID19 emerging outbreak. This could be done via active means of body temp or passive thru smartwatches. Over 100 million Americans have a smartwatch or fitness band that captures resting heart rate 5/x
This would enable a more precise approach for extensive testing (for infection + antibody) & contact tracing, quarantining.
There are clever ways to use smartphones for tracing contacts; we don't have enough people to do that! 6/x
blog.google/inside-google/…
There are clever ways to use smartphones for tracing contacts; we don't have enough people to do that! 6/x
blog.google/inside-google/…
All of this brings up issues of privacy. It is notable that in Germany, the @rki_de(CDC equivalent for the US) got behind a smartwatch app and quickly over 160,000 participants opted-in. Mandatory geolocation apps, such as used in China would not be acceptable in the US. 7/x
While many countries were able to get ahead of their outbreak (South Korea, Taiwan, Singapore, Hong Kong, Iceland) the US, Italy, Spain, UK and others did not. @IHME_UW estimates that if we (US) reopens in May we will fully rebound. So when and how? 8/x
This week, modeling from the China data @TheLancet called for "real-time monitoring" to prevent a 2nd wave.
Testing for infection and/or antibody cannot be considered as a real time surveillance tool. At best, it is a one-off, not continuous metric
9/x
Testing for infection and/or antibody cannot be considered as a real time surveillance tool. At best, it is a one-off, not continuous metric
9/x
To sum up, sure we need massive testing. But digital surveillance is an orthogonal means that can help track a large population, all of whom are eager to return to work and life as it existed pre-#COVID19. It should be part of the exit-ramp plan 10/x
