As several states make plans for reopening their communities during the coronavirus pandemic, a group of top public health experts cautioned Tuesday against reopening society before testing capacity expands significantly.
Different parts of the country are in different stages of the epidemic, with New York well into the first wave and other places just beginning to see the impact of the disease. This matters, said Dr. Caroline Buckee, Harvard associate professor of epidemiology and the associate director of the university’s Center for Communicable Disease Dynamics.
Knowing the location of the virus is key to relaxing social distancing and returning to normalcy, Buckee told a symposium sponsored by Harvard’s T.H. Chan School of Public Health and the New England Journal of Medicine.
The lack of testing capacity is a big problem because the disease has “a very broad clinical spread,” Buckee said. So even when people show up at the hospital and get tested there are many more cases in the community, including mild and asymptomatic cases. “And those are the people that are spreading the disease,” she said.
It’s important to learn whether people who have recovered can still spread the disease, noted NEJM editor Dr. Eric Rubin.
“What we really need is some epidemiological data to tell us, 'Are people who have left the hospital going on to transmit the disease?'” Rubin said. “That’s kind of the shoe leather epidemiology, contact tracing, following what happens to the context of those patients, which takes some manpower.
Buckee added that without knowing the answers, the nation could reopen too soon and risk a deadly second pandemic wave.
“Right now, we don’t have good estimates for where we are on the epidemic curve in different places. So, discussions of relaxation of physical distance, which do seem to be having an effect, curbing some of the worst impacts of the outbreak, need to be based on the capacity to test people so we know where we are,” she said.