Drs. Fauci and Birx, you’re working tirelessly and heroically to battle Coronavirus. Everyone thanks you. But you’re ignoring the plain technique to really save American lives and livelihoods. It’s PCR-based household-group testing. The protocol developed by Cornell’s OR professor, Peter Frazier, can comprise and kill Covid-19 in a single month!
Dear Drs. Fauci and Birx,
You are working tirelessly and heroically to battle Coronavirus. I and tons of of thousands and thousands of different Americans thanks on your efforts. Yet I discover myself completely perplexed as to why you’re ignoring the plain and certain technique to remove the scourge of Covid-19 in only one month.
The answer is PCR group-household testing of all American households each week. Doing so would require operating solely 6 million assessments per week, which is imminently possible. Group testing was developed by economist Robert Dorfman throughout WWII to check for syphilis in military recruits. It’s used routinely to check blood donations. It’s additionally been utilized in PCR testing of animals. Its sensitivity to Covid-19 in has been examined efficiently by Israeli scientists.
Testing all American households each week will not simply save the financial system, which is actually on loss of life’s door. It will save tens of 1000’s of lives. Compared to what you two are successfully sanctioning — every state opens up whereas paying lip service to your hope-filled tips — group testing is a godsend.
PCR group-household testing entails combining (mixing collectively) family samples and performing a check on the mixed combination. Given the brand new Rutgers University saliva check, all family members can spit right into a single container and ship or mail that container to a test-collection web site with a crammed out label detailing all contact info of all family members.
Suppose on the testing facility, the samples from 62 households are combined collectively and examined. Further, assume the mixed pattern assessments destructive. In this case, we are able to free as much as 155 individuals (assuming 2.5 individuals per family) all with a single check! That’s a 155 to 1 effectivity issue relative to testing every individual individually!
If a family assessments destructive, every family member can be notified to proceed to their native pharmacy to obtain a inexperienced wristband coated to vary to purple after one week. After one week, everybody within the family would supply a brand new pattern to a testing facility.
This system is voluntary. But in case you select to have your family examined and obtain your inexperienced wristband, you will be permitted by your employer to return to work, by your academics and professors to return to highschool, and by proprietors to enter their eating places, retailers, cafes, and so forth. You’ll even be allowed to frequent the seaside, attend concert events, go to the films, … .
Any family that assessments constructive will probably be required by the native board of well being to quarantine in place for 2 weeks after which be re-tested. Households that do not voluntarily get examined will probably be free to come back and go as they need. But with out their inexperienced bracelets, they may have a tough time coming into into workplaces and different institutions.
Is there one thing magical in regards to the quantity 62? Yes. It’s the optimum variety of households to be included in a single check in response to a fastidiously labored out protocol developed by Cornell University Professor of Operations Research, Peter Frazier, and his colleagues. (Note, below Frazier’s protocol, the optimum group measurement modifications by the week with the long-run optimum measurement stabilizing round 40.)
Professor Frazier’s protocol has two nice benefits. In the method of doing the group-household testing, it identifies, with no further assessments, exactly these households which can be constructive. It additionally handles false negatives by doing repeat testing. The protocol, which assumes a really conservative 30 % charge of false negatives, prescribes ongoing weekly group testing of all households. This ensures that, over a matter of weeks, just about 100 % of Americans with inexperienced wristbands are really destructive.
Why is 30 % very excessive? First, as a result of most of the false negatives could replicate inexperienced pattern takers who did not correctly swab the very again of topics’ noses. With the saliva pattern, there may be far much less likelihood of accumulating an improper pattern. Second, by combining the saliva of all relations in a single pattern, the probabilities that the complete family pattern will check destructive when a minimum of one family member is constructive is small. The cause is correlation. If one family member is contaminated, the probabilities are increased that different members are contaminated. Moreover, they might have sufficient viral load collectively, whereas individually they might not.
Professor Frazier’s protocol will launch 96 % of the American public again into the financial system in only one month. Thereafter, this share rises. Moreover his protocol works for high and low true nationwide prevalence charges about which we’re nonetheless in the dead of night, however which group testing would shortly reveal. Remarkably, the protocol can obtain the identical four-week launch charge with six million assessments no matter whether or not the diploma of prevalence is increased or decrease than Frazier’s assumed 1 % base case.
Surprisingly, cities or states with increased prevalence require fewer, no more assessments. Intuitively, the upper the prevalence, the bigger the share of households initially quarantined for the 2 weeks assumed for the illness to run its course. Yes, fewer inexperienced bracelets can be issued within the first three weeks, however by week 4, 96 % or extra of all households can be again to doing their regular actions.
How does PCR group-testing evaluate with antibody screening, now out there, and antigen testing, which can turn out to be out there? I’ve seen estimates, based mostly on antibody testing, indicating that from three % to 17 % of the inhabitants has, by now, contracted Covid-19. If we are able to provide you with an antibody check that is extremely dependable and that exhibits that the antibodies are protecting in opposition to reinfection, such people would obtain bracelets that completely keep inexperienced or flip to purple solely after a couple of months. This would cut back the requisite variety of assessments wanted to return 96 % of the inhabitants to regular life inside 4 weeks. We’d want roughly 5 million, not 6 million assessments. As for antigen assessments, they’re, to my data, much less correct than PCR assessments.
Can we produce 6 million assessments per week? Yes! We’re now producing near 2 million assessments per week. Ramping as much as 6 million assessments per week must be straightforward. Our nation constructed B-24 bombers in 53 minutes in WWII and cargo ships in 4 days. Germany will shortly be testing four.5 million individuals per week. Scaled by our relative populations, that is 18 million assessments per week within the US.
The difficulty will not be attending to an affordable variety of assessments in brief order. The query, Drs. Fauci and Brix, is whether or not you’re going to make correct use of these assessments. That means, to repeat, testing all households each week and offering inexperienced turning to purple bracelets. This must be your fixed mantra. If the President drags his toes on this as he is carried out on most every little thing, resign and manage the governors to do that.
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