By now you’ve probably heard a story kind of like this one.
On Saturday, February 29, my wife left a party feeling suddenly ill with a sore throat, acute fatigue, and muscle aches. At the time, we were only just beginning to contemplate the impact a coronavirus epidemic would have on American life, and though it was apparent by then that the government had allowed the disease to spread within the U.S. undetected, the idea that she might have contracted it on the metro, or some other public space, when there were zero confirmed cases in Washington, DC, seemed farfetched.
The next day, fatigue and a dry cough set in, along with an elevated temperature, which, by our measurements, never exceeded 100 degrees Fahrenheit.
Naturally we had questions. Based on what we knew at the time—what we had been told by the government—sheltering in place and eating canned soup didn’t occur to us. But because the government had failed to build testing capacity, we were left to wonder whether she was dealing with a routine respiratory virus or something much more transmissible and potentially dangerous to the community.
So she hunkered down, but I went to the grocery store, to the pharmacy, to my gym.
By that Wednesday night, just as her symptoms abated, mine set in, and in the same order hers did. Sore throat, fatigue, muscle aches; by Thursday morning, dry cough and mild fever. The virus we had, whatever it was, laid each of us out for several days, and left us with a spastic cough that has lingered all month.
Since then we’ve gone back and forth, sometimes more than once a day, wondering if we had the—good fortune? misfortune?—of contracting COVID-19 before DC began climbing the exponential transmission curve. Were we lucky to get a mild case? Did we contribute to the spread here when we were asymptomatic? But without access to testing, all we could do was guess. We’re on the other side of it now, but we still don’t know if we had COVID-19, and we don’t know whether we’re immune.
Like responsible citizens, we’ve adhered to social-distancing recommendations since before the government issued them. But our dilemma exemplifies an under-discussed consequence of the Trump administration’s catastrophic testing failure, one that is already hurting families, public health, the economy, and the very prospect of phasing out of the crisis. Imagine an alternative where, at the first sign of illness, we could have both been tested. Negative, and we’d be in the same predicament as much of America—isolated, waiting to get sick again, but hoping not to. Positive and we both would have entered full quarantine right away; our known contacts could have been monitored; the footprint of our contagion would have been clear; and we (and perhaps several other people in our lives) would soon be free agents. We could visit our family members, near and far; we could patronize the few businesses in our neighborhood that remain open; more importantly, we could help people we don’t know. Multiply that untapped power by thousands or tens of thousands and the scope of the failure becomes a bit more clear.
There are large and growing numbers people sheltered in place across the country, “visiting” loved ones through tiny virtual confinement windows, who might very well be out of personal danger, and of no danger to the broader public. Those who’ve survived COVID-19 can harmlessly interact with people in real life and volunteer to deliver meals to vulnerable seniors or otherwise assist the crisis response. But because there were at first no tests, then few tests, then only enough tests to ration to health workers and the sickest patients, there are many others—and maybe more of them—sitting around waiting for an infection that they’ve already cleared.
The federal government’s position is that asymptomatic people should not be tested; in New York, where testing capacity is greater than anywhere else in the country, those who feel ill, but well enough to recuperate at home, have been discouraged from presenting themselves at hospitals and other medical facilities.
There is one way out of this that doesn’t compound the failures of the past two months, and doesn’t enhance the illusion—promoted by the president himself—that mitigation, and not the virus itself, is responsible for the economic catastrophe new befalling the country.
First, the United States would have to quickly develop the capacity to test for and track the virus—such that asymptomatic carriers can be discovered easily, wherever they are—the way they have in South Korea, Singapore, and Germany. That way we could in theory detect most new infections, and thus the population that needs to be quarantined now, but will be immune in a couple of weeks. Second, we’d have to find the people who contracted the virus back when the administration, following Trump’s lead, tried to artificially suppress the extent of the spread and made widespread testing impossible. That means broadly testing people for coronavirus antibodies using a serology test when one becomes available.
Unless we know who was sick when the virus was spreading most rapidly, we’ll continue to waste our latent capacity, and we’ll lack the awareness we’ll need to know when we’ve reached herd immunity. There is unfortunately no reason to believe the administration will clean up the mess it made with any more skill or efficiency than it demonstrated when it screwed everything up. Trump is manifestly more worried about rattling the CEO class than he is concerned with doing what’s in his power to minimize the toll this calamity is taking on regular people. But the path still exists for now and Trump must be judged not just by how badly he failed to prepare the country for what’s already happened, but by whether he fails to do what must be done to pull the country out of it.