Thread by @RanuDhillon

There's a way we can stall the epidemic within a few months

If we locked down everywhere with active transmission - stringently except people who *absolutely* need to work - for 2 weeks, everyone could be tested daily using rapid paper-strip tests

https://twitter.com/RanuDhillon/status/1254778882483339267

At the end of the 2 weeks, even with lower sensitivity of the tests, we should find nearly every infected person

We could then isolate (ideally in separate housing) those infected & follow & test people in contact with them & so on until each transmission chain is burned out

The 2 weeks would be enormously painful but, given the stakes & the cost of our crushed economy, it would enable us to find & break off most transmission (some may linger due to imperfect execution, missed cases, unreported positives, etc.)

After the 2 weeks, we should continue to mask, avoid 3Cs & do the other things that we know to guard against resurgence but, once a sufficient drop in transmission is confirmed, we could likely resume more and more of our lives including schools

To do something like this would obviously be a massive undertaking:

- We'd first need to validate the rapid strip tests. To push past overly bureaucratic process, we could take current tests to any hotspot state & within days test them side-by-side with PCR on thousands of cases

- We'd then need some period of time to mass produce the tests that we'd use. We'd need billions of test strips. We should use the Defense Production Act & whatever else necessary to get it done as quickly as possible

- While tests are being mass produced, we'd have to engage the public on the plan, issue instructions & training on how to do the test themselves & set up systems by which positive cases are reported, confirmed by PCR, contact traced, etc.

We'd also need to put in place proper surveillance systems to monitor for new cases & outbreaks after the 2 weeks including some level of ongoing serial rapid strip testing. There will likely be some cases still & those can easily cause resurgences if not caught quickly

- If too complex to do this nationwide at one time, it could be done sequentially by region. In fact, this could allow lessons to be learned from initial rollout & mirrors what was sometimes done for vaccination campaigns

globalhealthdelivery.org/files/ghd/file…

Downsides:

- some would likely refuse or be unable to do the testing or not report if they are positive

- even if transmission initially went down, it could rebound if cases remain & ongoing control not in place. If this happened, the massive effort may not have been worth it

Whether or not you think this approach is too ambitious or worth pursuing, there are surely similar & other variations to consider

We have the tools & know-how to stop this epidemic; we just need to put together the plan & systems to make that happen

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