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The United States wants a national control plan. In the absence of this, this is what local governments, establishments and Americans want to know.
By the Editorial Committee
The editorial board is an organization of opinion hounds whose reviews are reported through experience, research, debate and long-standing safe values. It’s separated from the newsroom.
Six months after the start of the global coronavirus pandemic, Americans seeking to navigate daily life remain trapped among a transparent ideal: the country will have to monitor as many other people as imaginable to detect the virus, as regularly imaginable, for as long as possible. imaginable, and the truth that there aren’t enough controls in the United States to do that.
Widespread testing is the key to opening schools and businesses safely. This is the only way to know where the coronavirus is spreading, whether efforts to achieve it, and what precautions are needed in a given network paint at any given time. But investment deficits and bottlenecks mean that almost every single entity in the country is far from achieving this goal.
By the highest estimates, the U.S. It is achieving an average of less than five million tests consistent with the week, well below the 30 million consistent with the week that experts expected to do this fall. In some communities, it’s still difficult to locate a test. In others, the effects take a week or more to reappear, making them as useless as possible.
These gaps have left establishments and Americans facing a series of difficult-to-solve questions: when are others being screened without symptoms? Who takes precedence when materials are limited? What types of coronavirus tests are used under what circumstances?
There seems to be a consensus on these issues. Some schools require initial tests for returning teachers and students, even in places where testing is hard to come by. Others are Array even where transmission rates are high. The N.B.A. It tests the entire world meat packaging industry is Array, and while Trump’s management would strive to provide the nation’s nursing homes with quick evidence at the point of service, as is urgent, it has not been able to do the same with other houses in the congregation, such as prisons, where epidemics have devastated people.
Much of this discord could have been avoided if the United States had developed a national testing strategy at the beginning of the pandemic, with local, state, and federal officials coordinating to eliminate bottlenecks in the source chain and public and personal entities that combine to expand. immediate testing at the point of service.
There is no shortage of roadmaps to design the field correctly. Management can simply dust off the national testing plan created through its own advisors. Or you can simply resort to the list of organizations, adding the Rockefeller Foundation, which have developed proposals. But even at this level of the pandemic, with the loss of thousands of lives and livelihoods, federal leaders are acting too slowly.
Amid this gap in leadership, and the abundant confusion about testing across America right now, this is what heads of state and locals, parents, business owners, and Americans have in mind.
What do the federal government deserve to do? A joint report from Duke University and the Johns Hopkins School of Public Health calls for a $75 billion investment in a national detection strategy. That’s a lot of money, but it’s worth little to pay for the coronavirus epidemic in the United States.
Even if federal leaders don’t invest that much, they deserve to at least encourage more corporations to temporarily control others. As Bill Gates and others have suggested, corporations deserve to be reimbursed through insurers, or paid through the federal government, depending on how temporarily they can provide check effects: Gates suggests paying more for the effects that come within 24 hours, except for those that take 48 hours, and nothing for those who take longer (because until then those effects are useless).
What can state and local governments do in the meantime? As frustrating as it may seem, some checking corporations have been reluctant to increase the production of immediate checks at the point of service because they are not sure that those additional checks will be purchased. Heads of state can dispel some of these doubts if they come together to make procurement promises with corporations, as some have already begun to make.
Heads of state and premises also deserve broader surveillance methods for tripping over coronavirus outbreaks, such as wastewater analysis. And they deserve to do all the knowledge they have about the number of cases, positivity rates, etc., in the most public and usable way possible.
What about individual establishments? Until the testing capacity is greatly expanded, it will almost design a meaningful testing strategy for schools, offices and other establishments, not only because the effects will have to arrive temporarily to be exploitable, but also because any successful strategy will require repetition testing. Several months.
Given this scarcity, individual entities deserve to take into account a specific surveillance strategy, in which a proportion of other asymptomatic people (students, staff, residents) are systematically evaluated. This would require completing with quick testing at the point of service (most likely you do what’s called antigen testing) and exercise others to administer them; obstacles, of course. But it would help the government stumble upon outbreaks imaginable.
Should schools require exams? The Centers for Disease Control and Prevention recently reported that universities do not want to test at the forefront, i.e. evaluate staff and academics before they are authorized on campus. The C.D.C. argument is that such evidence has not been studied in particular for this coronavirus. “It’s like watching seat belts save lives in Cleveland, but by refusing to take them to Cincinnati because it’s another city,” says Carl T. Bergstrom, a biology professor at the University of Washington. “It makes a lot more sense to say, “Entry testing is a smart practice. We perceive that this is not feasible in many places, but we still think that everyone deserves to try. »
Schools deserve to be aware of the availability of local checks when setting their check needs and deserve to consider implementing their own specific tracking systems where imaginable, perhaps through year-over-year decision, or elegance through elegance, to find out when to reopen. it’s safe. Schools in communities where the virus spreads unchecked deserve not to open.
Given the scarcity and delays, when are other people tested? Ideally, each and every user in the United States would get tested every day, because we know that at least a third of inflamed and contagious people have no symptoms.
But there’s just not enough capacity to do so many checks. Since the effects that take more than two days to arrive are in fact useless, it makes sense to take control in certain circumstances. If you think you’ve been exposed to coronavirus and can’t quarantine without problems until the threat of contagion has passed, you’ll need to get what’s called a PCR control: it’s the maximum, not unusual control type at this time, to be available at peak control sites—to find out if you have an active infection and if it poses a threat to others. Ideally, I would do a check twice: from time to time after exposure and back about a week later. (It takes several days to expand an active infection)..
Getting tested when you have no symptoms or transparent exposure is, at this stage, price-limited because this cannot be done systematically. But it would possibly be a smart concept to be evaluated if you are making plans for friends or family members who are elderly or immunosuppressed. Ideally, in this scenario, you will get two PCR tests, one week apart, and you will be quarantined while you wait for the results.
Unfortunately, those two scenarios assume that you live in a domain without long times, which is a major assumption right now. Yes, it’s incredibly frustrating.
What is the point of making an investment in testing if a vaccine is on the way? A vaccine will not necessarily need rigorous testing. Implementation will not only take time, but if a vaccine is less effective at one hundred percent, evidence will still be needed to monitor the spread of the virus in communities.
In other words, the coronavirus won’t go away soon. If leaders, at some point, need to keep schools open, restart the economy, and return to a general life, they will have to start solving those problems.
Jeneen Interlandi, a member of the editorial board that writes about health, science and education, will answer questions about this editorial in a long-running article. What would you like to know about testing methods and funding?
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