But it won’t be. We are at a critical point for deciding what to do about that. It’s time (past time, really) for the federal government — Congress as well as the president — to step up and nail down the parts of a response strategy that only they can carry out.
Enduring the first wave of a novel infectious disease — with more than 18,000 already dead in the United States in little more than a month — will not mean that we’ve made it to the end of the road. Remember, the vast majority of our population remains susceptible to the disease. In Europe, scholars estimate that, as of March 28, 15 percent of the population in Spain had been infected, approximately 10 percent in Italy and approximately 2.7 percent in Britain. To date, Italy has seen more than 18,000 deaths.
Herd immunity requires somewhere between 50 and 67 percent of the population to be infected and then recover. Italy would need to go through what it’s just been through another four or five times to get to that level. I know I don’t want to achieve herd immunity this way.
The only alternative to repeated applications of collective social distancing as a method for controlling the disease is massively scaled-up diagnostic testing and tracing. Note: I did not say immunity testing. Too small a percentage of the population has been infected for immunity testing to be the way out. Also note: Collective social distancing is already a significant infringement of our civil liberties — particularly our right of association.
How big a program of diagnostic testing do we need? Imagine 2 to 8 percent of the population being tested every day, as a recent white paper by Microsoft’s Divya Siddarth and E. Glen Weyl models. That’s certainly millions and probably tens of millions of tests each day.
To achieve a testing program at this scale — a scale never before achieved anywhere consistently over time — we have to solve the coordination problems currently afflicting the supply chain and last-mile test administration problems.
The best way forward would be establishment of a Pandemic Testing Board, akin to the War Production Board that the United States created during World War II. The Pandemic Testing Board would consist of leaders from business, government, academia and labor and would be tasked with developing the scale of tests needed and scaling up the infrastructure needed for deployment of the tests. I’ve submitted such a proposal to Republican and Democratic members of Congress alongside Weyl, American Affairs editor Julius Krein and Vanderbilt law professor Ganesh Sitaraman.
A Pandemic Testing Board could be created on either a national or a federalist model. With the national model, the president or director of the National Institute of Allergy and Infectious Diseases would appoint board members. With the federalist model, Congress would pass a law authorizing the states to create an interstate compact. The lead states would select the board. With a federalist approach, the board would serve the states —– rather than work through the federal government — but it still would be funded by a congressional appropriation.
What would it do?
First, it would carry out a Pandemic Testing Supply Initiative.
That means the board would have authority to identify supply-chain elements necessary for manufacturing, procuring, scaling and deploying any items related to testing. It would have the power to procure these materials via contracting with producers and servicers, and the power to mandate production or services, akin to authorities in the Defense Production Act. Contracting firms would be required to follow all existing labor laws, including maintaining collective bargaining agreements.
At the same time, there would also need to be a Pandemic Testing Deployment Initiative. To deploy testing at scale, there would need to be sufficient personnel to test individuals outside of hospitals and doctors’ offices. So the Pandemic Testing Board would:
- Craft recommendations for states to use the National Guard to deploy testing in conjunction with business, labor, nonprofits and academia.
- If necessary, be authorized to create a Pandemic Response Corps, made up of tested civilians, to assist.
- Make recommendations on tracking the spread of the virus.
- Before disbanding, craft recommendations on long-term preparedness.
One way or another, we have to ride out this pandemic. We are in only the first wave. I, for one, would much rather ride it out with a massively scaled-up testing regime than with repeated applications of stay-at-home orders. Even from a civil liberties angle, I prefer the former to the latter.
What path do you want Congress, the president, our governors and our mayors to choose?