The lockdowns in place around the world to limit the contagion of Covid-19 have been implemented without reliable information on the spread of the disease or the prevalence of the novel coronavirus in the population. We invited our panel to express their views on the role of testing for infections and antibodies to inform decisions about easing measures on social distancing and allowing public activities to restart.
We asked the experts whether they agreed or disagreed with the following statements, and, if so, how strongly and with what degree of confidence:
a) Even if tests for Covid-19 are being rationed, there is an urgent need for some random testing to establish baseline levels of the virus to inform any decisions about ending lockdowns.
b) Required elements for an economic ‘restart’ after lockdowns include a massive increase in testing capacity (for infections and antibodies) along with a coherent strategy for preventing new outbreaks and reintroducing low-risk/no-risk individuals into public activities.
Of our 44 US experts, 42 participated in this survey and the balance of opinion on the two statements are summarized below. More details on the experts’ views come through in the short comments that they are able to make when they participate in the survey. Several provide links to relevant research evidence and commentary, including the web page set up to collect policy proposals for mitigating the economic fallout from COVID-19 written by the network of economists associated with the IGM Forum.
Random testing to establish baseline levels of the virus
On the first statement, weighted by each expert’s confidence in their response, 66% of the panel strongly agree, 27% agree, 3% are uncertain, and 4% disagree. Among the comments of the overwhelming majority who agree on the need for random testing, several experts note the importance of better information.
Christopher Udry at Northwestern warns: ‘The lack of reliable information on the distribution of the virus makes decision-making riskier.’ Larry Samuelson at Yale says: ‘Lockdowns should be ended scientifically rather than blindly; to do so we must know the state of the population, which requires testing.’ Robert Hall at Stanford adds: ‘We need one survey of a few thousand people with repeated testing and clinical observation, to clear up a lot of mysteries.’
William Nordhaus at Yale is emphatic: ‘This is one of the most important holes in current policy. Absolutely critical. Some firms, hospitals can do while waiting for government.’ Aaron Edlin at Berkeley explains: ‘Testing could help us understand prevalence and mortality risk, both overall and by age and condition.
James Stock at Harvard refers to his recent paper on random testing to inform critical policy choices, which concludes: ‘decisions that could save millions of lives or prevent an economic catastrophe with effects that will ripple for decades hinge on the lack of data to estimate a single parameter – how widespread this virus really is.’
Several experts mention testing for antibodies as well as infections: Robert Shimer at Chicago says: ‘Antibody testing on a random sample of the population would also be very useful.’ Bengt Holmstrom at MIT concurs: ‘Foremost we need antibody testing to judge the path of the pandemic.’
Of the small minority of panelists who say they are uncertain or disagree with the need for random testing, David Cutler at Harvard comments: ‘We need to make sure we can test symptomatic people.’ Jose Scheinkman at Columbia says: ‘Not while asymptomatic health workers treating covid-19 patients cannot be tested’, referencing a New York City testing program.
Markus Brunnermeier at Princeton argues: ‘There must be smarter ways to correct for the bias than pure random testing and not using limited resources to people who need it most.’ Angus Deaton at Princeton, who strongly agrees with the statement, adds the caveat: ‘Population testing is the point. We should, ideally, test everyone. Random is not really the point.’
Increased testing capacity to prepare for ending lockdowns
On the second statement about the need for an increase in testing capacity as part of a clear strategy for an economic restart, there is near unanimity. Again weighted by each expert’s confidence in their response, 78% of the panel strongly agree, 21% agree; one panelist is uncertain, and none disagree.
In comments, William Nordhaus says: ‘This is not macro policy, this is good public health policy. Orders of magnitude smaller than stimulus needs.’ Bengt Holmstrom notes: ‘The Asian experience shows this is a viable, hopefully sustainable path. Aiming for herd-immunity always was a much riskier strategy.’ And Larry Samuelson warns: ‘Restarting too early risks a viral resurgence; too late entails extra cost. Careful planning is required to strike the right balance.’
Several experts refer to the need for testing to get people back to work. Austan Goolsbee at Chicago asks: ‘Do you want people to get out of their pajamas and back to work? Then we NEED TO DO MORE TESTS.’ Richard Schmalensee at MIT states: ‘There is clearly a need for testing, not just capacity, as well as a way for low/no risk individuals to credibly identify themselves.’ And Aaron Edlin suggests: ‘Certifying people as recovered would be extremely helpful’, linking to his summary of the idea written with Bryce Nesbitt.
Other panelists provide links on ways to think about getting the economy safely back to work, including a model with testing and conditional quarantine.
Some nuance to the general agreement on this statement comes from James Stock, who says: ‘The only caveat is if we already have a high infection rate (low death rate), then such measures should target the most at risk – for example, the elderly.’ Steven Kaplan at Chicago adds: ‘Would also be very helpful to have treatments that can be administered when symptoms first appear that reduce the odds of becoming critical.’
The one expert who reports being uncertain about the statement, Richard Thaler at Chicago, is not convinced by the suggestion that testing and the other measures are ‘required’: ‘Important yes but would I hold up restart if cases are low but tests are still rationed? No.’ Christopher Udry agrees with the statement but also points out: ‘“Required” may be too strong. A vaccine or treatment could substitute for testing. But most likely, a massive increase in testing needed.’
All comments made by the experts are in the full survey results.
Romesh Vaitilingam
@econromesh
April 2020
