Our governments at all levels face a difficult challenge — how to control the spread of COVID-19 without overwhelming our healthcare system. By now everyone has seen this graph — our hope is to flatten the infection curve over a longer time horizon to keep the peak at or near our hospital capacity.
In addition to hygiene requirements, we are using blunt instruments to stop the spread of COVID-19 because we don’t know who is infected:
- Widespread nationwide social distancing
- Increasing mandates to shelter-at-home (as of this writing, Governor Gavin Newsom just ordered state-wide shelter-at-home for 40 million California residents)
While these actions are necessary to save lives, they are having a devastating impact on our economy. Entire industries and sectors are shutting down, from air travel to restaurants. Unemployment filings have skyrocketed — in Pennsylvania, roughly 70,000 people applied for unemployment benefits in a single day, six times the total from the last week. All of this is roiling the stock market, down roughly 30% from its peak. Most large financial institutions have declared we’re already in a recession, with estimates on the GDP shrinking anywhere from 5% to 13% in the next quarter.
The shocking and immediate decline in economic output has forced our government institutions to manufacturer a bailout much larger than the one during the Great Recession — the Fed dropped interest rates a full point to near 0% and announced a $500 billion QE program. Congress is working on a $1 trillion “Phase Three” bill to offset our economic fallout, which may include direct payments to citizens.
The current COVID-19 remedy is producing tremendous collateral damage. We do this because we want to save lives, and this is more important than the economic impact. But the question is whether we can find a way to be more targeted in our intervention, instead of taking a carpet-bombing approach. Can we balance our population’s physical health with their financial health without risking lives?
I read a really interesting article about a small town in northern Italy, a town called Vo, near the epicenter of that country’s COVID-19 outbreak. They tested all 3300 residents and imposed strict quarantine / isolation measures for all those infected and those in close contact to the infected. In the 2nd round of testing, there was a 90% drop in positive cases and new infections were halted.
The key to this approach was population-wide testing. What if this approach could be applied at scale? The main problem in the US has been a shortage of tests and processing facilities, but this appears to be easing. Millions of tests are coming online from companies like Roche and private labs like Quest and LabCorp are ramping up processing capabilities. While there are still constraints and questions of false positives and negatives, millions of tests are on their way.
Now, we can’t immediately test all 330 million people in the US, but if we can accelerate nationwide testing to include all those with symptoms AND all those who are asymptomatic but in close contact with someone infected, we can use the approach applied by Vo in Northern Italy.
How will we identify those who came into contact with infected people at scale? One effective approach would be the use of smartphone geo-location data. Roughly 70% of the US population has a smartphone, and Big Tech companies can provide anonymized datasets including phone numbers and geo-location coordinates, allowing us to run models to identify people at risk for exposure. We can tweak our models to extrapolate for those without smart phones. Notifications can be sent to at-risk people so they can quickly obtain an available test and take the appropriate self-quarantine / isolation measures. Indeed, there has already been discussion of using Big Tech data to combat COVID-19.
For this to work, our population will have to set aside their privacy concerns for the benefit of targeted testing and quarantine at scale. If there was ever a time to place national security and population health above privacy, this is the time.
If we can mobilize this approach, we can replace the blunt nationwide measures in favor of targeted quarantines and isolation. Further, we can anticipate trouble spots and flood those areas with medical supplies. The hope is for an approach like this to restart large parts of the economy without increasing the risks of overwhelming our healthcare system, preserving both physical and financial health for the vast majority of our population.