Good Morning
Good Morning

In New York, test then trace

Credit: Getty Images/iStockphoto/genkur

We, the people, have been doing what’s been asked of us in this war against the coronavirus. We’re staying home, keeping our distance from others when we’re out and, lately, wearing masks in public.

We’ve done well enough that the numbers charting this awful pandemic — hospitalizations, intubations and deaths — have been declining as we bend downward what had been a distressing upward curve. Now New York, like other states, is evaluating when it will be safe to return to some sense of normalcy. That requires data, and the monumental effort to acquire that information is about to begin.

By now, you’ve probably heard about this campaign — test, trace, isolate. It involves testing as many New Yorkers as possible, tracing the contacts of those who have the virus and testing them, isolating all positive cases, and then retesting. It also includes antibody testing to see who already has had the virus and might be immune. Both are necessary to determine whether, when and how it’s safe to reopen the economy and the schools, while keeping the health care system from again becoming overwhelmed.

It’s a massive effort with many cogs and to be successful they all must work — and that includes each of you, because you have a role to play.

The state government is the prime actor. It will oversee the testing for the virus itself and for the antibodies that signal someone has recovered, as well as the tracking of anyone who came into contact with those who test positive. Former New York City Mayor Michael Bloomberg has agreed to head up the tracking, working with Johns Hopkins University. His philanthropic organization will lend its technical expertise and he will contribute at least $10 million to jump-start it. Bloomberg’s involvement is terrific, we commend him for his leadership, but what does it say about our nation that this initiative must rely so heavily on a private individual?

There is an important role for the federal government. It must assume the reins of the supply chain. There simply are not enough reagents, swabs and vials to conduct the number of tests needed. Leaving procurement to the states would create the same absurd interstate scrum that saw governors bidding against each other and the federal government for ventilators and personal protective equipment. President Donald Trump has promised to undertake this job; he must follow through by using his authority under the Defense Production Act to ramp up production.

And each of us must cooperate. This is not going to be a one-and-done deal. Even if you test negative, you’ll need to be retested later. Testing will benefit the entire community, not just you. It will quickly identify hot spots where the virus reemerges, as it will in the fall. Contact tracing will cut the chains of transmission. So you must be prepared — to willingly accept quarantine if necessary, to divulge your contacts, and to continue to abide by social-distancing and mask-wearing guidelines. And you must understand this is not a short campaign. It will last many months, probably until there is a vaccine. But if you play your part, you will contribute to defeating this virus.

A vigorous public messaging campaign will be needed. Right now there is none. Everyone needs to understand why this is important. If Trump cannot do this, then the National Governors Association will have to take the lead.

Don’t underestimate how difficult this will be. The state is conducting 20,000 tests a day for the virus; Gov. Andrew M. Cuomo said he’s shooting for the maximum of 40,000 a day. That’s a tall order, but experts say even that is not enough. The tests themselves, both for the virus and antibodies, have varying degrees of reliability; the FDA must weed out the bad ones. More technicians to run the analytic machines must be trained.

New York also needs thousands of trackers. Cuomo identified 715 in this largely downstate effort, including 60 in Nassau County and 140 in Suffolk. The governor said the state would tap the 35,000 medical students in the CUNY and SUNY systems, a smart solution.

But the magnitude of the problem can be seen in Suffolk, which smartly created a program for contact tracing in late March and trained 230 workers to make phone calls. Initially, they did all the tracking and have made 45,000 contacts. But they quickly were overwhelmed by mushrooming confirmed cases, now more than 30,000, and are asking people who test positive to reach out to their contacts themselves. Suffolk’s tracking is further along than Nassau’s. Here’s the rub: The state’s baseline antibody testing of 3,000 people, including in Nassau and Suffolk, suggests 250,000 people in Suffolk might have had the virus; if the testing is accurate and representative, that’s eight times larger than the confirmed cases. 

The effort will be expensive. New York got $1.5 billion for testing in the latest federal stimulus bill, a good amount but probably not enough given how long this will have to be maintained. Congress must continue its funding.

None of this will be easy. The scale is immense. Ramping up will be difficult and mistakes will be made. But it must be done. The effort must match the challenge. And that’s up to us. All of us. 

— The editorial board