200.001 Covid19 Suppression Plan

As of March 23, 2020, only a tiny fraction of our nation’s population are infected with the coronavirus.  Unfortunately, many of these infected people are asymptomatic and don’t know they’re infected. Each such person may be inadvertently infecting 10 to 20 additional people every day.  Therefore the key to stopping the exponential growth of this pandemic is to find all the infected people and stop them from infecting others. Nothing else matters as much because these asymptomatic super-spreaders will infect everyone in months if we don’t stop them.

The Problem with a Lockdown-Only Strategy.

Iran, Italy, and Spain all tried lockdowns but it did not stop their epidemics. Why? Lockdowns don’t work on their own!  They destroy a nation’s economy and don’t stop covid19 from spreading. Asymptomatic super-spreaders defy the lockdown because they don’t know they’re infected.  Singapore, Taiwan, and South Korea were able to mange their own covid19 outbreaks without shutting schools, churches, or bars and without closing any non-essential businesses.  How did they do it?

A Better Way: Test, Track, Publish.

Singapore, Taiwan, and South Korea followed a system of  “test, track, and publish”. Test, track, and publish manages the viral spread without needlessly shutting down a nation’s economy.

The key elements of this strategy are (1) to test everyone and (2) track every infected person.  In addition, it is vital that (3) we publish these results so that everyone can have confidence that the system is operating correctly and people are doing their jobs.

Here is how we can enact Test Track Publish in the United States right now.

Test Everyone, Multiple Times.

  1. Provide free open drive-through testing 24/7.  Everyone can get tested at any time, without any preconditions.  No doctor’s notes. No symptoms required. At the time of testing, contact information (location, email, cellphone) is requested with a promise that the information will be used solely for managing the epidemic.

  2. Everyone who tests receives a receipt, a “Tested” sticker, and a free N95 mask (see below for how we can supply these masks).

  3. Provide free mail-in test kits.  Everyone can order a test kit that will be sent to their house so they can swab themselves and mail in their results (see below for how we can ramp up supply of home test kits).

  4. Test results are transmitted electronically via SMS or email. Test results are also available at any testing location by providing the original testing receipt.

Track Every Infected Person

  1. Everyone who tests positive must 

    1. Immediately self-isolate and report their location.  Upon entering self-isolation, they would automatically qualify for paid sick leave and free healthcare.

    2. Be asked to optionally install a mobile app that tracks their location.

    3. Be visited periodically by a health care worker who validates their position, educates them, traces their recent contacts, logs their symptoms, and helps them manage their illness.

    4. Remain in self-isolation until confirmed via test that they are not infectious.

  2. Every known contact of an infected person will be

    1. Promptly contacted by health care workers

    2. Required to immediately be tested (or retested)

    3. Required to self-isolate until they have a confirmed negative test result

  3. Health authorities must

    1. Maintain a meticulous timeline for each tested person, including the dates and results of all tests, the location of each tested person at all times, and the symptoms exhibited at all times.

    2. This data to only be used to manage the pandemic.

Publish the Results.

For each locality, publish daily information on testing and infections down to zip+four.

  1. Daily testing effort

    1. total testing capacity by location

    2. number of people tested

    3. distribution of daily test outcomes (positive, negative, other)

  2. Daily data on all currently infected people (current and totals)

    1. Location of all infected people to zip+four

    2. Location type (home/work/hospital/other/unknown)

    3. Current health status: asymptomatic/mild/severe/critical

    4. Ultimate infection outcome: recovered/death

Educate the Population.

  1. Everyone must be tested, multiple times.

  2. People are encouraged to wear their “Tested” stickers.

  3. Everyone must wear an N95 respirator in public when within 6 feet of others.

  4. People without respirators must stay at least 6 feet away from all others in public.

War-Time Production.

To execute this plan, we need to dramatically increase the production of N95 masks and covid19 test kits.

The N95 mask production ramp is already underway, with 3M, Honeywell, Moldex  and other US companies on track to manufacture hundreds of millions of industrial N95 masks.  In addition, Chinese manufactures are able to produce immense quantities of industrial KN95 masks, which are functionally equivalent to N95 standards.  If necessary, a small change in US law would allow existing KN95 masks to achieve N95 certification during this crisis. Previously, these companies were prohibited from selling their industrial N95 masks to healthcare workers.  See https://www.washingtonpost.com/business/2020/03/19/change-us-law-will-make-millions-more-masks-available-doctors-nurses-white-house-says/

There are hundreds of efforts underway to increase covid19 testing capacity.  If the CDC is unable to provide the required number of tests, we can purchase testing capability from the WHO and from Chinese and South Korean companies.  The Bill Gates Foundation has already developed a home testing kit. China has a covid19 test that returns results in 15 minutes! If South Korea, with a population of 50 million, can test 10,000 people per day we should be able to test 50,000 people per day.  Where there’s a will, there’s a way.