The first step in solving any problem is to define the problem. You need to quantify the shape, size, and scope of the problem so you can measure the effectiveness of any potential solution. That’s why testing and tracing is so important. You cannot know what you do not test.

We didn’t do that with Covid-19. Because we didn’t do that, we don’t know how many people are infected. We don’t know how many have been infected by symptomatic vs asymptomatic transmission. We don’t know how long immunity lasts after infection. And we don’t even know if, and to what degree, a vaccinated person can be a carrier. We don’t know these things because we never prioritized testing and tracing. And you cannot solve a problem without first quantifying the problem. 

Let’s say I’ve been vaccinated. 

I wish. The vaccine rollout here in Navada has been slow and problematic so I don’t expect to be vaccinated before summer. But I know people in other states who have been vaccinated so let’s just say, hypothetically, that I’ve had both shots and I’ve waited a month and I’m good to go. Because that’s what people think happens. 

So, vaccinated Me now wants to go to a restaurant and sit inside and have a nice meal. (sigh)

Who else in that restaurant has been vaccinated? But I’m protected, why should I care? Remember, we don’t know if vaccinated people can be carriers. We don’t know how many asymptomatic people can be carriers. So I could potentially come home and infect others without even knowing it. In fact, other vaccinated people in the restaurant could be spreading the virus. 

We just don’t know. 

Why don’t we know this stuff?

You cannot know what you do not test.

The past year could have provided valuable information about the breadth and scope of the spread of the virus. Data from countries where testing and tracing has been prioritized give us some glimpses into the picture. Data from Taiwan suggests that roughly 50% of community spread is via asymptomatic hosts. Data from a study in Spain suggests that immunity lasts roughly 3 to 6 months after infection (a small meta study, alas). Bits of data from other countries are being used to inform policy here in the US because we don’t have our own data. 

The reality is, those countries who have prioritized testing and tracing (e.g., South Korea, Taiwan, New Zealand) have had far greater success combating the virus than countries who have not. Unfortunately, few countries have done so. 

But we have the vaccine now! 

Yes, we have the vaccine now. Several, in fact. And that is a very good thing indeed. But it is not a panacea. Because we have not been testing and tracing, we don’t know the scope of protection provided by the vaccine. 

Here’s a brief list of things we don’t know: Does the vaccine prevent asymptomatic transmission? How much of the population needs to be vaccinated before we can feel safe going out? How long does the vaccine last? How often will we need boosters? Will we need one or two boosters? At what age can we vaccinate children? When can we start vaccinating children? (25% of the US population is under 18 and they are especially efficient spreaders.)

These are all vital questions that need to be answered. We should have answers to these questions. And we could have, if we had prioritized testing and tracing earlier. And the only way we will answer them going forward is to implement a comprehensive testing and tracing program. Now.