Lack of information undermines our ability to manage the crisis. And it doesn't have to be this way.
The bottom line of this blog is that we must immediately begin random sampling of the population using both PCR testing that tells up about active infections and antibody tests that informs about who has been infected int the past.
Random sampling of populations is an essential tool for the social, biological, and physical sciences.
Political pollsters randomly sample potential voters to predict the outcomes of elections. They don't provide election projections by counting the number of avowed Democrats or Republicans who come knocking on their door. In a variety of fields, random sampling of populations is a key tool for decision making. But in the coronavirus situation, we are content not to use this powerful tool, even when we make the gravest decisions. It doesn't make sense.
Here in Washington State, virtually all the testing is being used to determine whether individuals suffering from a respiratory illness ailments have active coronavirus infections. There is, of course, good reason to test sick individuals: their treatment plan can be enhanced with such knowledge and their care-givers need to know whether they require protection (PPEs-- personal protection equipment). We know how many folks are getting tested (and not everyone that is sick is getting tested) and the percentage of those tests that are positive for active COVID infections. That is not enough.
The current testing regime leaves decision makers poorly informed. How many individuals currently have active infections, with or without symptoms? How many people have had the virus and are now potentially immune? We don't know. And without such information, it is nearly impossible to project the future.
Epidemiological projection, like numerical weather prediction, is an initial value problem. You start with an estimate of the initial state and your model, which contains information about the processes of the phenomena in question, attempts to project the initial state into the future. If your initial state is uncertain, so is your forecast.
Some researchers are trying to indirectly secure an idea of what has happened using a combination of genetic testing of viral samples coupled with epidemiological modeling. A recent paper by Bedford et al (2020, not yet peer reviewed) suggests that the virus reached Washington State during mid to late January and then spread throughout the local population, asymptomatic for many.
We need random sampling of the population.
This situation of not knowing what is happening in the general population is crippling society's ability to deal with the virus in an informed, smart way. The capability to test is increasing now and our State and nation must give random testing of the population very high priority immediately, securing a significant percentage of the rapidly increasing testing capability to random sampling.
Here in Seattle, we have some of the most sophisticated mathematical modelers, statistical analysts, medical experts, and private sector analytic experts in the world, yet we are content to cripple our economy and deal with such an historic event in nearly complete ignorance of the situation. We, of all places in the world, can do much better. It is time for random sampling of our population for COVID-19 looking for both active and past infections.
Go read the whole thing.
Comments
I believe that even Fauci was on team downplay early on