I’m not an epidemiologist. Neither is Larry Kotlikoff. He’s an economist, a professor at Boston University. His work has been featured in many of my columns. We’ve written three books together. That happened because I admired his part in creating generational accounting.
Larry called a few days ago.
It wasn’t to talk generational accounting or the problems facing Social Security or the future burdens we’re putting on our kids – our usual topics.
No, he called to say why we need universal and repeated testing for Covid-19. You can read what he’s written on the subject in his Forbes column, here.
Here’s the problem.
We may need to test people seeking hospital admission because they feel they have Covid-19. But that testing is only for hospital admission purposes. It serves only to admit those with the virus.
It puts everyone else back into circulation. So, admission testing serves no broader purpose. The people asking for the test have already self-identified as having the virus. Many will have it, some won’t. It leaves everyone else in circulation, including the multitude who may have the virus and not know it.
If we want to knock back the virus without croaking our economy, we need to do more than social distancing. We need proactive identification of those with the virus. Indeed, universal and regular testing for Covid-19 may be the way to avoid a recurrence of the pandemic.
Universal testing offers a big prize
It would allow us all to get back to work again. It would have to cost a ridiculous amount not to be worth doing. It would be good for the economy. It would be good for our minds and hearts.
Think about the difference. Without universal testing, we can only slow the virus from spreading by staying at home. With universal and repeated testing, most people could go about their regular daily lives. That would include work. Only those who tested positive would be taken out of circulation to self-quarantine or be hospitalized.
Ironically, I’ve written about a version of this in a column about missing bullets and downed aircraft during the Battle of Britain. You can read the column here, but here’s the CliffsNotes version.
The Battle of Britain
During World War II a group of experts was assembled to figure out how planes could be armored so that fewer were shot down. The group assembled a bunch of returned planes with battle damage and measured every bullet hole. But Abraham Wald, a renowned mathematician/statistician said they were looking at the wrong bullet holes. They needed to be looking for the missing bullets. They would be found on the planes that had NOT returned. Basically, they were focused on the wrong “sample.”
Mutual fund performance figures are misleading for the same reason. The most commonly used figures calculate only the performance of the surviving funds. They don’t include all the missing funds that didn’t survive. Over three-, five- and 10-year periods, many don’t survive.
After the “death peak”
In the long hangover period after the coming “death peak,” we need to ramp up for regular and near-universal testing. It can be done. Iceland is doing it now.
According to NBC News, Iceland has tested a far greater proportion of its population than anywhere else on earth, including South Korea, and it’s also testing thousands of ordinary members of its general population who are non-symptomatic.
If you think of people as aircraft on a mission, hospital testing only confirms illness. But regular testing of everyone would identify and remove from circulation the human ‘bullets’ that unknowingly carry and spread the virus.
Related columns:
Scott Burns, “The Missing Bullet Holes Problem,” 11/13/2015 https://scottburns.com/the-missing-bullet-holes-problem/
Sources and References:
Laurence Kotlikoff, “Group Testing Is Our Surefire Secret Weapon Against Coronavirus,” Forbes 3/29/2020 https://www.forbes.com/sites/kotlikoff/2020/03/29/group-testing-is-our-secret-weapon-against-coronavirus/#3d7f5a2e36a6
Vivienne Walt, “Why Iceland’s approach to coronavirus testing may be better than America’s,” 3/27/2020 https://fortune.com/2020/03/27/coronavirus-testing-us-iceland-cdc-trump-decode-covid-19-tests/
Willem Marx and Mac William Bishop, “Iceland employs detective work, testing and quarantine in coronavirus fight,” 3/25/2020
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(c) Scott Burns, 2020