Determining When Vermont Should Re-Open: Random Testing Needed

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It seems sensible to test sick people instead of healthy ones for Coronavirus. But that sensibility goes out the window when trying to assess when Vermont (or other states) should take steps to “return to normal” -- whatever that will look like after this massive shock to our economy. That’s because normalcy will be attained based not on how many people get sick or die -- it will depend on how many people have recovered from the virus.

Lacking a cure for COVID-19, the best we can hope for is to manage health through preventive measures -- but at some point we must also consider preventive measures against the threats to human health of a drastic economic contraction. Already many in Vermont are threatened with a reduction in food security -- they can’t get healthy food. Virtually impossible to quantify, the adverse health effects of a deteriorating economy are also impossible to deny.

Governor Scott says he will “take the blame” for putting the brakes on our economy too sharply, and that “.... as soon as the data shows a downward turn or trend we will open the spigot just one quarter of a turn at a time to get folks back to work in a measured way that's responsible and safe…. unfortunately, while it appears we're leveling off, which is good news, we don't have enough evidence at this point in time to show that the virus won't spike.”

But the only way to gain that evidence is by random testing, which Vermont is not doing. Many of the infected population are asymptomatic, and so they go untested. Vermont has now received more testing kits from the federal government, and surely there is a process which can be created to learn what number of Vermonters have overcome the virus -- this will help better than any other indicator to determine how fast that spigot can be turned open.

Governor Scott has been tight-fisted with that spigot of his. Unemployment claims weren’t flowing at all for weeks; farmers markets were closed down; firearms sellers still have not been provided clear guidance. And while the State of Vermont has refused to provide details of COVID-19 cases by town, it scurried to investigate whether there are racial disparities in suffering from COVID-19 (apparently not). Perhaps now it can assess random testing.

In order to safely return to work, Vermonters need to know how many people are walking around who have been exposed but are immune. This information is also necessary to determine the mortality rate of the illness -- presently, even that is uncertain. Serological testing is becoming available, and it is estimated that as few as 1,000 random tests nationally would likely provide enormous data. There are logistical hurdles, but Vermont can and should implement a random testing effort ASAP!

Finland is implementing a random test. As long as Vermont tests only sick people (and avoids testing healthcare workers), we will be flipping a coin as to when, and how much, that magic economy spigot turns. As one writer notes, “Identifying what proportion of the population has already been infected is key to making the right decisions about containment.”

Governor Scott insists hundreds of lives have been saved by his measures. But with that rationale, the spigot will stay closed until he is certain that no one will die from COVID-19 -- and we will never be certain of how many lives are lost due to economic decline. Surely if the Governor left all businesses open and people began to die, he could not argue that “by allowing people to get sick with COVID-19, we have saved hundreds of people’s lives who would have died from economic decline.” Both risks must be carefully assessed -- hindsight is useless.

Randomized testing data would demonstrate whether or not the virus has truly declined, and this information is crucial to determine when to reopen Vermont. Our state has been truly fortunate to have avoided widespread illness, but many businesses will be irrevocably destroyed by the Governor’s shutdown, and the longer this goes on the more casualties there will be. Food, housing, heat, and security are “social determinants of health” that are being threatened for all Vermonters.

Governor Scott must turn the testing spigot wide open, so that Vermont can resume its way of life as soon as humanly possible.