Drs. Fauci and Birx, you’re working tirelessly and heroically to struggle Coronavirus. Everyone thanks you. But you’re ignoring the apparent technique to truly save American lives and livelihoods. It’s PCR-based household-group testing. The protocol developed by Cornell’s OR professor, Peter Frazier, can include and kill Covid-19 in a single month!
Dear Drs. Fauci and Birx,
You are working tirelessly and heroically to struggle Coronavirus. I and tons of of hundreds of thousands of different Americans thanks in your efforts. Yet I discover myself completely perplexed as to why you’re ignoring the apparent and positive technique to eradicate the scourge of Covid-19 in only one month.
The resolution is PCR group-household testing of all American households each week. Doing so would require working 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 economic 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 stuffed out label detailing all contact info of all family members.
Suppose on the testing facility, the samples from 62 households are blended collectively and examined. Further, assume the mixed pattern assessments unfavorable. In this case, we will free as much as 155 folks (assuming 2.5 folks per family) all with a single check! That’s a 155 to 1 effectivity issue relative to testing every particular person individually!
If a family assessments unfavorable, every family member could be notified to proceed to their native pharmacy to obtain a inexperienced wristband coated to alter to pink after one week. After one week, everybody within the family would offer a brand new pattern to a testing facility.
This system is voluntary. But should 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 high school, and by proprietors to enter their eating places, retailers, cafes, and many others. You’ll even be allowed to frequent the seashore, attend concert events, go to the flicks, … .
Any family that assessments constructive shall 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 shall be free to return and go as they want. But with out their inexperienced bracelets, they may have a tough time coming into into workplaces and different institutions.
Is there one thing magical concerning the quantity 62? Yes. It’s the optimum variety of households to be included in a single check in line with 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 dimension adjustments by the week with the long-run optimum dimension stabilizing round 40.)
Professor Frazier’s protocol has two nice benefits. In the method of doing the group-household testing, it identifies, with no additional 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 p.c price of false negatives, prescribes ongoing weekly group testing of all households. This ensures that, over a matter of weeks, just about 100 p.c of Americans with inexperienced wristbands are actually unfavorable.
Why is 30 p.c very excessive? First, as a result of lots of the false negatives might mirror 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 gathering an improper pattern. Second, by combining the saliva of all members of the family in a single pattern, the possibilities that your entire family pattern will check unfavorable when a minimum of one family member is constructive is small. The purpose is correlation. If one family member is contaminated, the possibilities are greater that different members are contaminated. Moreover, they could have sufficient viral load collectively, whereas individually they could not.
Professor Frazier’s protocol will launch 96 p.c of the American public again into the economic system in only one month. Thereafter, this proportion rises. Moreover his protocol works for high and low true nationwide prevalence charges about which we’re nonetheless at the hours of darkness, however which group testing would shortly reveal. Remarkably, the protocol can obtain the identical four-week launch price with six million assessments no matter whether or not the diploma of prevalence is greater or decrease than Frazier’s assumed 1 p.c base case.
Surprisingly, cities or states with greater 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 could be issued within the first three weeks, however by week 4, 96 p.c or extra of all households could be again to doing their regular actions.
How does PCR group-testing examine with antibody screening, now obtainable, and antigen testing, which can turn out to be obtainable? I’ve seen estimates, primarily based on antibody testing, indicating that from three p.c to 17 p.c of the inhabitants has, by now, contracted Covid-19. If we will give you an antibody check that is extremely dependable and that exhibits that the antibodies are protecting towards reinfection, such people would obtain bracelets that completely keep inexperienced or flip to pink solely after just a few months. This would cut back the requisite variety of assessments wanted to return 96 p.c 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 information, 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 ought to 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 folks per week. Scaled by our relative populations, that is 18 million assessments per week within the US.
The subject isn’t attending to an inexpensive variety of assessments briefly 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 pink bracelets. This ought to be your fixed mantra. If the President drags his toes on this as he is achieved on most all the pieces, resign and manage the governors to do that.
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