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U.S. Needs 20 Million Coronavirus Tests Per Day to Reopen Economy, Harvard’s Safra Center Says

University Hall, an administrative building, is located in Harvard Yard.
University Hall, an administrative building, is located in Harvard Yard. By Jenny M. Lu
By James S. Bikales and Kevin R. Chen, Crimson Staff Writers

A report released Monday by Harvard’s Safra Center for Ethics estimates that the United States will need the capacity to test up to 20 million people per day for the novel coronavirus in order to fully reopen its economy.

The center’s “Roadmap to Pandemic Resilience” — written by a group of economics, public health, technology, and ethics experts — details a plan to open up the U.S. economy in phases. The plan aims to fully reopen the economy by August, though it notes specific timelines may vary by region.

The report advocates for a testing, tracing and supported isolation approach to the virus, rather than extended social distancing. The main steps of that approach entail dramatically ramping up coronavirus testing, tracing the contacts of those who test positive so they can also be tested, and isolating confirmed cases. All the while, the report urges aggressive vaccine development.

The U.S. tested roughly 311,000 people for the virus Wednesday — the most tests it had conducted in a single day. Testing rates have typically hovered at around 150,000 per day since late March, according to the COVID Tracking Project.

Researchers at the Harvard Global Health Institute released a separate report Saturday estimating that the country needs to perform between 500,000 to 700,000 tests per day to reopen the economy.

The Safra Center, meanwhile, estimates the U.S. needs the capacity to test between 2 and 6 percent of the population — or between five and 20 million people — each day to fully reopen.

“We do not propose a modest level of TTSI intended to supplement collective quarantine as a tool of disease control,” the report reads. “Rather we recommend a level of TTSI ambitious enough to replace collective quarantine as a tool of disease control. TTSI should replace stay-at-home.”

Many public health experts are currently arguing that the U.S. should continue with social distancing until a vaccine is developed. Some Harvard researchers have said that social distancing measures may be necessary until 2022.

The Safra Center’s report argues that by instead using a TTSI program, the U.S. could avoid intermittent cycles of opening up and shutting down that a social distancing approach may cause.

“It allows us to steadily reopen the parts of the economy that have been shut down, protect our frontline workers, and contain the virus to levels where it can be effectively managed and treated until we can find a vaccine,” the report reads.

The report argues that though there will be financial and logistical difficulties in implementing such a plan, social distancing would ultimately be far costlier.

“Creating the complex supply and delivery chains required for testing at this scale will require a rapid coordination of business activity unprecedented since World War II,” the report reads. “But the cost of such a testing and tracing, or TTSI, program—$50 to 300 billion over two years—is dwarfed by the economic cost of continued collective quarantine of $100 to 350 billion a month.”

Government professor Danielle S. Allen, who directs the Safra Center and was the lead author on the report, wrote in an emailed statement that implementing large-scale TTSI programs will be “mission critical” to allowing schools to open on time this fall.

“All organizations and businesses would need to plan for changes to operations to accommodate and institutionalize what’s necessary to operate in a context where a disease of this kind is still circulating,” Allen wrote. “For all arriving students, including international students, it would presumably be necessary to establish protocols for quarantine and/or testing upon arrival.”

The report acknowledges that the plan is unlikely to succeed without the coordination of industry, academia, and government.

Allen wrote that the Safra Center has been in contact with numerous government officials regarding its recommendations.

“We have been communicating regularly with staff for the White House Task Force, staff for the National Governors Association Task Force, a national network of mayors, members of Congress in both parties, and staff at the CDC,” she wrote. “As a first step, we would really like to see the CDC adjust its guidance so that guidance supports both therapeutic testing for symptomatic individuals and also disease control testing, including of asymptomatic individuals. Currently the guidance supports only the former.”

—Staff writer James S. Bikales can be reached at Follow him on Twitter @jamepdx.

— Staff writer Kevin R. Chen can be reached at Follow him on Twitter @kchenx.

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