Adm. Brett Giroir, the assistant secretary for health has outlines the plans to develop a broad-based infrastructure consisting of testing, and contact tracing to control the spread of Coronavirus once the President reopens the country.

“Let me put it into context: All of the testing that we’ve done thus far is testing for the virus in your nose or nasopharynx, meaning you’re actively infected with the virus,” Giroir said when asked about the testing scaling up especially on the serological side. “The antibody test will get us an idea of if you have been infected in the past and are presumably—not 100 percent certain but probably by all known medical computation—that you would be immune to getting the virus again at least in the intermediate term. It is an important component, but it is not really the whole foundation of where we’re going. I call it a component because it will tell us who had the virus and give us a good sort of understanding of what happened, but we still expect only a minority of people will have had the virus and have recovered from it. The outer estimates—and again we don’t know—maybe it’s as much as five or ten percent in some places, and that’s going to be very important to know who those five or ten percent of people are both for themselves and others, but it’s not the total solution.

“To get everyone back together, and I’m sorry to be geeky; it’s very important to have a number of things in place,” Giroir said. “Number one, surveillance. So is this virus circulating in the country? Right now, I think we had 22,000 new cases yesterday. But as it gets lower, sort of is it circulating and where is it circulating? This is apparent from both testing and what the CDC says would be syndromic surveillance, like if you come in with a cough and a fever and influenza-like illness. This is a very good system to understand. In the summer, if you see people like that, it’s not flu—it’s going to be COVID-19. The second component is actively testing people with symptoms. That’s what we’re doing now. But we need it on a sort of generally available sort of scale. It depends on how many cases there are. If there’s 20,000 cases, or let’s say there’s 10,000 cases a day in the U.S., then you need 10,000 tests and you probably need to oversample. For every positive test, you want five to ten negative tests. So, then for every positive person you’re going to contact trace four to five people. So that’s kind of the milieu of what happens—surveillance, testing, and contact tracing is really defining it, plus the antibody on the other side. As I said last week, we are going to have for a test—we’re going to be in the range of the number of tests that we need to do this in a very short period of time, just a few weeks.”

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