Test, Trace And Isolate

“It is certainly true that we need to get back to work. It’s a shame that we don’t have the testing that would inform us how to get back to work the safest way possible,” said Dr. Paul A. Offit, co-inventor of the vaccine for rotavirus.

Like COVID-19, rotavirus is highly contagious and can be fatal. It causes severe diarrhea. Until the vaccine arrived in the mid-2000s, hundreds of thousands of children worldwide died from it each year. In developing countries, it still takes a toll.

Dr. Offit was on the Sunday “Today” show, and host Willie Geist was questioning him about the specter of “packed New York parks” and shopping malls reopening around the United States.

Dr. Offit, of the Division of Infectious Diseases at Children’s Hospital in Philadelphia, said that without widespread testing for COVID-19 — to know who has it and who doesn’t — the nation is going to “learn the lesson the hard way.”

Test, trace and isolate.

That — short of breakthroughs in a vaccine and treatment — said Dr. Offit, is when will we be “truly safe to get back to pre-coronavirus lives.” It is the smart way forward.

Consider the article in The Atlantic last week headlined: “What’s Behind South Korea’s COVID-19 Exceptionalism?” The subhead: “Seven weeks ago, South Korea and the U.S. had the same number of virus deaths. Today, South Korea has fewer than 300, and the U.S. has more than 70,000.”

It noted that “by the end of February, South Korea had the most COVID-19 patients of any country outside China. New confirmed cases were doubling every few days. …

“More than a dozen countries imposed travel restrictions to protect their citizens from the Korean outbreak, including the U.S., which had, at the time, recorded an official COVID-19 death toll low enough to count on one hand. But just as South Korea appeared to be descending into catastrophe, the country stopped the virus in its tracks.”

The major cause of the spread in South Korea, said the article by Derek Thompson, was a religious event involving 1,000 “worshipers in a large windowless room.” The result was “a trail of pathogens that would lead to thousands of infections, triggering one of the largest coronavirus outbreaks in the world.”

South Korea learned the identity of those at the event and embarked on testing. “Individuals with the most serious cases were sent to hospitals, while those with milder cases checked into isolation units. … The government used a combination of interviews and cellphone surveillance to track down the recent contacts of new patients and ordered those contacts to self-isolate as well.

“Within a month, the Korean outbreak was effectively contained. In the first two weeks of March, new daily cases fell from 800 to fewer than 100.”

The day the article came out, “the nation of 51 million reported zero new domestic infections for the third straight day.” (Since The Atlantic piece, however, an infected person not wearing a mask went into several clubs in Seoul in one night and infected 40 club-goers. Seoul’s mayor immediately responded by ordering the closure of all clubs and bars in the city.)

The call for testing, tracing and isolating has been sounded eloquently and forcefully by New York Governor Andrew Cuomo — and he has set into motion a massive program to do it.

“Testing, tracing and then isolating … that is going to be the key going forward,” said the governor at one of his daily briefings on the pandemic. The most hard-hit areas have been in New York City and Nassau and Suffolk counties.

“You test the person,” said Mr. Cuomo. “If the person winds up positive, you then trace that person’s contacts. … This entire operation has never been done before. So it’s intimidating. You’ve never heard the words ‘testing, tracing, isolate’ before. No one has. …

“We want to operate on a tri-state basis,” he continued. “… The virus doesn’t stop at jurisdictional boundaries. Well, I’m at the Town of Brookhaven. I stop here. No, the virus doesn’t say that. The virus just spreads. …

“This is going to be a massive undertaking. Good news is that [former] Mayor Michael Bloomberg has volunteered to help us develop and implement the tracing program.” There will be an “army of tracers” — thousands of tracers.

It’s not just South Korea that has successfully beaten back COVID-19 with the “test, trace and isolate” formula. Among other countries with similar programs has been Iceland. “With testing, Iceland claims major success against COVID-19” was the headline of a recent Associated Press account.

The big problem for the United States, as the recent lead front-page headline in The New York Times declared: “Testing Scarce As States Weigh Reopening.” Thus, in so much of the United States, as reopenings happen, areas are flying blind, leading to what Dr. Offit projects will be learning “the lesson the hard way.”