Washington State Lacks a Rational Coronavirus Testing Approach: Can We Follow Oregon's Lead?

Washington State is in trouble.

Testing of coronavirus has stagnated and our current testing is being done in an uninformative, unscientific, reactive way.

We need not only to increase our COVID-19 testing, but importantly to begin random sampling of our population.  Embarrassingly, such science-based, rational testing is exactly what Oregon is about to start.

As stated by Oregon governor Kate Brown:
“This program is a game changer,” Brown said. “It will give us a more accurate understanding of the true rate of infections in Oregon and to have ongoing precision monitoring of any new outbreaks.”

Oregon is not alone.  Other states, such as Ohio and Indiana, are also doing randomized testing to understand the true state of the infection.  But not Washington.

Random sampling is the scientific way to deal with the COVID-19 crisis

Today, Washington State is dealing with the coronavirus pandemic in ignorance.  We are only testing those that have symptoms and ask for a test.  We do not know what percentage of the population is currently infected.  We don't know what percentage has been infected and thus might be immune.  We have no way to identify infected, but asymptomatic, people that need to be quarantined.

We are driving blind...and our state leadership doesn't seem to understand what needs to be done.

Scientists of all types (yes including atmospheric scientists) are well aware of the importance of random sampling to understand a population or system we are studying.  Pollsters use random sampling  for every election cycle.    But we are not even talking about doing it in Washington State when it comes to a fatal disease with vast economic implications. Why?

Our state leadership is throwing away a tremendous opportunity to defeat the virus.  If appears that random testing of a population is a powerful tool for keeping diseases like COVID-19 in check.  Several papers have shown exactly how this can be done.  One samples a few tenths of a percent of the population each day.  Such testing provide a good idea of the trend in infection.  But even more important, you can catch asymptomatically infectious folks and take them out of circulation.  If you have the resources, you can trace their contacts and test them as well.  Slowly, but surely you defeat the virus by quarantining the infected.

This approach, plus wearing masks in crowded indoor spaces and reasonable social distancing, might well allow us to reopen society much more quickly and extensively....and do so safely.

Not only is Washington State testing in an ineffective, unscientific way, but the number of tests is essentially stagnated, something evident from the statistics on the Washington State Department of Health website (below).  No increase in May.  Not good.  Massive increases in testing is needed, the lack of which is a failure on both the state and Federal levels.

This is a lot of talk about us being involved in a "war" with the coronavirus.  In that spirit, let's consider the military analog.

Consider two approaches for dealing with an enemy that is attacking and marauding the population of a nation.

One approach is to tell your population to hide in their homes and lock the doors, with the hope that the enemy will keep away.   Only when the enemy attacks does the military react by capturing and imprisoning the enemy. 

There is never an attempt to determine the strength of the enemy with surveillance  or to weaken the enemy by proactive raids.  The enemy, unmolested, retains their strength and the war drags out.  With folks stuck inside, the economy flounders.  This is how Washington State is fighting our war with Covid-19.

Another nation has a different approach. They start comprehensive surveillance of the enemy with armed scouting parties and overflights. They know exactly the strength of the enemy and where it is surging in strength. When they find the enemy preparing an incursion, they attack and take the enemy off the field.

Citizens are not told to lock themselves in their homes, but to go about their normal productive lives, but with care and watching for any trouble. They can do so, because they have confidence they will be warned if a threat looms. Slowly but surely the raids on the enemy weaken it and eventually they give up the fight. The nation's economy remains strong.

This is what Oregon, Ohio, and Indiana, among others, is going to do. What many municipalities and states are talking about doing. What Washington State should do. And yes, what the whole country should be doing.

But it is worse than that. Not only is our state missing the boat on testing, but there have been a number o unproductive steps that are not based on science, such as closing parks, restricting the use of outdoor spaces, and promoting excessive lockdowns of the economy. 

As the economic toll becomes catastrophic, society will have no other option but slowly reopening. Random testing offers an approach to do so safely.

Here we have a state with unequaled scientific capabilities and knowledge, deep experience in data science and medicine, and unparalleled economic clout and we fail to follow an obvious, science-based path to opening our economy and loosening restrictions on our population. 

 
When considering anything dealing with conflict, it is often valuable to consider some of the wisdom of the Chinese military genius, Sun Tzu:

If you know the enemy and know yourself, you need not fear the result of a hundred battles. If you know yourself but not the enemy, for every victory gained you will also suffer a defeat. 

Time to know our enemy.