Social isolation, which according to some sources, seems to be slowing the rate of infection and new hospitalizations in some parts of the US, is starting to settle in, at least where I am. It no longer feels abnormal to stay in whenever possible, to pay ahead at local food shops and have people put food in my car from a distance. But now the questions are emerging: “When will this all end.” “When can my kids go back to school (said with a little desperation in parents- which I totally understand).”
None of these questions can be answered with any confidence without more testing. Without it there is too much we don’t know. The one that troubles me: how many asymptomatic folks walk among us? Studies and reports show a wide range from 5-80 percent, in part hampered by different inclusion criteria and small sample size. But one thing is clear, the models we use to predict the path of this disease are nothing without good data. An expert on the subject, John Ioannidis, comments that in the three populations where almost everyone was tested, the Diamond Princess cruise ship, the Italian town of Vo Euganeo, and San Miguel County, Colo, the number of infections versus those with severe symptoms looks much different than the picture than the one emerging in the US right now.
Why the difference? It seems that testing criteria in many parts of the country are still restrictive due to lack of available testing, with many healthcare workers unable to be tested, even with symptoms. The CDC guidelines puts at the bottom of the priority list those without symptoms, making a true denominator almost impossible to achieve.
So for the time being, we still can’t go back to normal. Not without a map. And it seems like little whispers of impatience are emerging. To really contain this crisis and show a way out, we need testing to be widely available.