Gongol.com Archives: December 2021

Brian Gongol

December 23, 2021

Health Testing freely

The Federal government is going to "purchase a half-billion at-home, rapid tests this winter to be distributed for free to Americans who want them", according to the White House. It looks like those tests won't be available until January, which is late but better than never. ■ Testing capacity seems to have been a problem for the entirety of the pandemic. The failure to get massive testing capacity rolled out hampered the initial response in spring 2020, regulatory obstacles to testing were still obvious a full year later, and supply constraints (as well as costs) are still seen as a strangely American problem. ■ Of war, James Mattis once noted that "Speed equals success". In a war against an evolving virus, speed is equally important as on the battlefield. The earlier in the process the chain of viral transmission can be broken, the better for minimizing its spread: That means, in order, avoiding exposure, mitigating the exposure that does occur, preventing the advancement from exposure to infection, limiting the exposure of others if infection occurs, and limiting the demand on resources required to promote a quick and maximum recovery. ■ There's only so much that can be done (and for so long) to prevent the first step in that chain -- humans are social animals and we could not have remained locked down indefinitely. Two years after the virus emerged in Wuhan, China's government is still ordering people into lockdowns, millions at a time. To freer souls, that approach seems unbearable. ■ Vaccines are clearly the best tool for mitigating the consequences of exposure; the difference in case rates for the vaccinated versus the unvaccinated is stark -- the unvaccinated are at much greater risk (by maybe six or seven times) of catching the virus and vastly greater risk (by probably ten times) of hospitalization. ■ The news of not just one but two effective antiviral drugs in pill form is terrific, too. The more we can keep the virus from sending people to the hospital, the better. That much seems far beyond dispute. ■ But it still doesn't make sense not to have vastly expanded the country's testing capacity -- and certainly not if the hangup is an antiquated regulatory framework that prioritized box-checking perfection over deployment speed. ■ Even a testing system that produced some errors -- either false negatives or false positives -- would be useful if it were deployed so widely and cheaply that people could economically justify frequent testing. We don't count on seat belts to save every motorist in a crash, but their marginal effectiveness is so great that they save lots and lots of lives at scale. The same kind of math would apply to cheap, virtually unlimited rapid testing; individuals might still get faulty results, but the protection afforded at scale would be useful to public health. ■ Speed often beats perfection, especially in the environment of an evolving enemy like a virus. A virus doesn't "learn" like a battle planner, but it does mutate and adapt to continue the fight. As Dwight Eisenhower said of World War II, "[S]peed must be redoubled -- relentless and speedy pursuit is the most profitable action in war." ■ In a war against a biological outbreak, a Federal regulatory morass shouldn't keep us from trying to fight back. And we should fix whatever has been holding us back, lest some mutant strain of this (or a future virus) find us continuing to fiddle unproductively at the margins.

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