Seconding Paul Romer's Proposal of Universal, Frequent Testing as a Way Out
Link to Paul Romer’s Twitter thread on his proposal for universal, frequent testing
Paul Romer has proposed testing everyone for COVID-19 every two weeks and frontline workers as much as every day. Simulations like the one illustrated in his brief video above indicate that testing everyone frequently and totally isolating those who test positive could be effective at keeping the novel coronavirus in check. I think this is a very promising way to get out of the pandemic earlier than the deployment of a vaccine without having to keep a big chunk of the economy shut down. Let me share some specific thoughts I have about Paul Romer’s proposal:
This should be obvious, but this is not something we can do right now. We need to massively scale up the materials for doing tests for having the novel coronavirus and the number of people trained to perform the test. This will take some time. But given a few months to scale things up, it seems to me we ought to be able to do any number of the tests at a roughly constant marginal cost.
Relative to the large fraction of a trillion dollars per month that it costs the economy to be on COVID-19 lockdown, universal testing is quite affordable. Approximate the US population as 1/3 of a billion people. (We have to test children too, because they could be quite important transmitters of the disease.) To make the calculations easy, but quite conservative, suppose the test costs $90. Then it costs $30 billion every time we test everyone once. Again, conservatively, suppose we need to test people on average 4 times per month. That then comes to $120 billion per month. I would be shocked if that isn’t a lot less than the economic cost of lockdowns. And with different assumptions, the cost of the testing regime could be an order of magnitude less than this $120 billion per month.
The Federal government doesn’t have to be totally on board for this for it to show its worth in states willing to try it. Block grants to states to try various things are well within the range of political possibility. (Much less likely, some states might be able to pass constitutional amendments loosening their budget balance rules for this emergency. Some states may already have loopholes in their balanced budget rules.) Here is how a state could do the job:
Get some of the funds by mandating that health insurance cover these tests. However, many people will need to have the tests paid for directly or indirectly by the state or federal government.
Require that to get a paycheck from an employer in the state, someone must have been tested recently (whatever the result).
Require that children can only attend school and only receive paid childcare if they have been tested recently.
Have a fine for those who don’t get tested.
Require that anyone buying anything in person in the state have a certificate that they tested negative recently. This is key for avoiding transmission from other states.
Paul Romer’s basic idea is not an either-or choice. There is a continuum of possibilities. Most people are now comfortable with the idea of “test-and-trace.” But in any test-and-trace regime, it matters a lot what one does with borderline cases. Doing test-and-trace with a policy of “When in doubt, test; when the test leaves doubt, isolate” is a good part of the way toward Paul Romer’s proposal. The more tests we as a nation produce, the more conservative we can be with our test-and-trace policy, with universal testing as simply a very conservative test-and-trace policy. So you don’t have to sell a universal testing program to begin with. You just gradually make test-and-trace more and more conservative as the number of tests available increases. People have time to get used to widespread testing.
Don’t miss these other posts on the coronavirus pandemic: