Will the US need to expand testing before lifting lockdowns?

Romesh Vaitilingam | Apr 08, 2020

Sections Public Policy

Collections COVID-19 Crisis IGM Poll

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. Chicago Booth’s Initiative on Global Markets (IGM) invited its US panel of economic experts 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.

In the short comments that they are able to make when they participate in the survey, some of the panelists provided links to relevant research evidence and commentary, including the web page set up by IGM to collect policy proposals for mitigating the economic fallout from COVID-19.

Random testing to establish baseline levels of the virus

Among the comments of the overwhelming majority who agreed on the need for random testing, several experts noted the importance of better information.

Christopher Udry of Northwestern warned, “The lack of reliable information on the distribution of the virus makes decision-making riskier.” Larry Samuelson of Yale said, “Lockdowns should be ended scientifically rather than blindly; to do so we must know the state of the population, which requires testing.” Robert Hall of Stanford added, “We need one survey of a few thousand people with repeated testing and clinical observation, to clear up a lot of mysteries.”

William Nordhaus of Yale was 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 of Berkeley explained, “Testing could help us understand prevalence and mortality risk, both overall and by age and condition.”

James Stock of Harvard referred to his recent paper on random testing to inform critical policy choices, which concluded, “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 of the University of Chicago said, “Antibody testing on a random sample of the population would also be very useful.” Bengt Holmstrom of MIT concurred: “Foremost we need antibody testing to judge the path of the pandemic.”

Of the small minority of panelists who said they were uncertain or disagreed with the need for random testing, David Cutler of Harvard commented, “We need to make sure we can test symptomatic people.” Jose Scheinkman of Columbia said, “Not while asymptomatic health workers treating COVID-19 patients cannot be tested,” referencing a New York City testing program.

Markus Brunnermeier of Princeton argued, “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 of Princeton, who strongly agreed with the statement, added 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 was near unanimity. 

In comments, William Nordhaus said, “This is not macro policy, this is good public health policy. Orders of magnitude smaller than stimulus needs.” Bengt Holmstrom noted: “The Asian experience shows this is a viable, hopefully sustainable path. Aiming for herd-immunity always was a much riskier strategy.” And Larry Samuelson warned, “Restarting too early risks a viral resurgence; too late entails extra cost. Careful planning is required to strike the right balance.”

Several experts referred to the need for testing to get people back to work. Chicago Booth’s Austan Goolsbee asked, “Do you want people to get out of their pajamas and back to work? Then we NEED TO DO MORE TESTS.” Richard Schmalensee of MIT stated, “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 suggested, “Certifying people as recovered would be extremely helpful,” linking to his summary of the idea written with NextBus cofounder Bryce Nesbitt.

Other panelists provided 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 came from James Stock, who said, “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.” Chicago Booth’s Steve Kaplan added, “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 reported being uncertain about the statement, Richard Thaler of Chicago Booth, was 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 agreed with the statement but also pointed 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.