We are now approximately 5 months into the sars-cov-2 / covid19 pandemic in the US. Remember when we were a few days in and we all nodded our heads that after a few weeks of this, we’d be able to get back to “normal”? Well, clearly we are still far from normal with no end in sight. Let’s take stock of where we are right now.

  1. After an initial spike in the northeast (especially New York City), we now see the south and southwestern parts of the country with high caseloads and mortality.
  2. Therapy has improved, especially with proning and steroid use in the ICU. This has brought the death rate down.
  3. There are over 130 vaccines currently being developed, mostly against the spike protein. This protein is the key for entrance into the cells via binding to the ACE2 receptor, but it is still not proven to be the best immunologic target for vaccines (fingers crossed).
  4. The US and other governments around the world have already spent billions of dollars on some of the leading candidate vaccines prior to their full-testing.
  5. All economies have been hit hard by the pandemic so far. Deficit spending and unemployment numbers are through the roof while GDP estimates have taken a nose-dive.

While this vaccine promises to be the fastest ever developed, I think that in the best-case scenario, we still have about a year before widespread production and distribution. What are we supposed to do in the meantime?

The only reasonable way forward is through rapid and inexpensive daily testing.

Yes, it sounds kind of crazy, but there are many groups working on simple tests which could be done in schools and workplaces. This group at MIT has caught my eye. The “STOPCovid” white paper is worth a read, but in summary, they claim to have a working technique wherein a nasal swab or saliva sample is a) lysed to release RNA, b) RNA is reverse transcribed into DNA with a special tag, and finally c) the sample is read visually like a pregnancy test. Sensitivity and specificity in intial tests are incredble at 97% and 100% respectively. Finally, this test can be performed in about an hour and the group claims a preliminary cost of only $10 USD per test.

If this or other rapid tests can be deployed and used daily (or at the very least every few days) on our entire population, we can stop the spread of this insidious infection and open our economies again. Kids can go back to school. Restaurants can increase customer volume. Elderly family members can safely reunite with their children and grandchildren.

The only way we can responsibly relax our restrictive social distancing policies is with rapid and constant testing. I see no other way to proceed as we wait on a vaccine.