4/3/2020 Testing Is Our Way Out - WSJ

This copy is for your personal, non-commercial use only. To order presentation-ready copies for distribution to your colleagues, clients or customers visit
https://www.djreprints.com.

https://www.wsj.com/articles/testing-is-our-way-out-11585869705

OPINION | COMMENTARY

Testing Is Our Way Out

Returning to normal is too dangerous. Lockdowns are unsustainable. Let’s save lives without a
depression.

By Paul Romer and Rajiv Shah

April 2, 2020 7 21 pm ET

A health-care worker administers a coronavirus test in Washington, April 2.

PHOTO: DREW ANGERER GETTY IMAGES

For now, social distancing is the best America can do to contain the Covid-19 pandemic. But if
the U.S. truly mobilizes, it can soon deploy better weapons—advanced tests—that will allow the
country to shift gradually to a protocol less disruptive and more effective than a lockdown.

Instead of ricocheting between an unsustainable shutdown and a dangerous, uncertain return

to normalcy, the U.S. could mount a sustainable strategy with better tests and maintain a stable
course for as long as it takes to develop a vaccine or cure. The country will once more be able to
plan for the future, get back to work safely and avoid an economic depression. This will require
massive investment to ramp up production and coordinate the construction of test centers. But
the alternatives are even more costly.

https://www.wsj.com/articles/testing-is-our-way-out-11585869705 1/3
4/3/2020 Testing Is Our Way Out - WSJ

'A Very Tough Two Weeks'

00 00 / 24 14

SUBSCRIBE

Two types of testing will be essential. The first test, which relies on a technology known as the
polymerase chain reaction, or PCR, can detect the virus even before a person has symptoms. It
is the best way to identify who is infected. The second test looks not for the virus but for the
antibodies that the immune system produces to fight it. This test isn’t so effective during the
early stages of an infection, but since antibodies remain even after the virus is gone, it reveals
who has been infected in the past.

Together, these two tests will give policy makers the data to make smarter decisions about who
needs to be isolated and where resources need to be deployed. Instead of firing blindly, this data
will let the country target its efforts.

Here’s a simple illustration of how test data can save lives. Every day millions of health-care
professionals go to work without knowing whether they are infectious and might spread the
virus to their colleagues. We both have close relatives on the front lines. As soon as one of them
developed a cough, she pulled herself out of service. But at that point she may have been
infectious for several critical days. If she and her colleagues had all been tested every day, her
infection would have been caught earlier and she would have isolated herself sooner.

To be used as a screening mechanism at the beginning of a shift, the test would need to be able
to give a result within minutes. Developers are making progress on speeding up these PCR tests
—so much so that the aforementioned physician received the results from her second test,
conducted five days after the first, before those from the first test. Abbott and Roche, two
pharmaceutical companies, are moving forward with tests that can decrease reporting times
from days or hours to minutes. Now that the doctor has recovered, an antibody test could help
determine when she can return to the frontlines of patient care.

As testing capacity expands, the same tests could be offered to all essential workers, such as
police officers and emergency technicians, and then to other overlooked but critical workers—
pharmacists, grocery clerks, sanitation staff. The next step would be to test people throughout

https://www.wsj.com/articles/testing-is-our-way-out-11585869705 2/3
4/3/2020 Testing Is Our Way Out - WSJ

the country at random to get up-to-date information about who is infected now and who has
ever been infected.

For those who are currently infected, governments can provide immediate assistance to make
sure they don’t infect anyone else, especially family members. Those infected before who now
have antibodies may be less susceptible to reinfection. If that is proved in the weeks to come,
they could also return to work.

Putting this system in place will take resources, creativity and hard work. Test developers will
have to increase the production rate of kits by an order of magnitude. In his work fighting Ebola
in West Africa, Dr. Shah saw how a virus can cause a 30% reduction in economic output. Mr.
Romer’s back-of-the-envelope calculation is that the recession caused by the coronavirus
pandemic has already caused a 20% reduction in U.S. output, which means the country is losing
about $350 billion in production each month. If a $100 billion investment in a crash program to
make antibody and PCR tests ubiquitous brought a recovery one month sooner, it would more
than pay for itself.

Building this testing system would be complicated and require the best of American science,
business and philanthropy working together. But it is the type of challenge that the U.S. has
overcome before. It isn’t viable to wait a year or two for a vaccine before getting people back to
work safely. To save lives and prevent a depression, testing on a massive scale is essential.

Mr. Romer is a professor at New York University and a 2018 Nobel laureate in Economics. Dr.
Shah is president of the Rockefeller Foundation and served as administrator of the U.S. Agency
for International Development, 2010-15.

Copyright © 2020 Dow Jones & Company, Inc. All Rights Reserved

This copy is for your personal, non-commercial use only. To order presentation-ready copies for distribution to your colleagues, clients or customers visit
https://www.djreprints.com.

https://www.wsj.com/articles/testing-is-our-way-out-11585869705 3/3