Ice storms and the ensuing power outages require an immediate response by electric utilities, their regulators and state governments. Responding to the COVID-19 pandemic via diagnostic testing raises a different and more complicated set of issues, but the common denominator is the need for information on what needs to be done.

Knowing what to do to restore electricity is one thing, but dealing with COVID-19 may require diagnostic testing scaled up to levels previously unknown. But it could – and must – be done quickly. Policymakers are rapidly getting up to speed on this issue, but the scale of it is daunting, and a lot has to happen soon. States must start preparing to massively scale up COVID-19 diagnostic testing ASAP.

The U.S. response to COVID-19 began with a regulatory failure, which was eventually solved by the Food and Drug Administration via a deregulatory approach that opened entry into the market by companies with new ways to test for COVID-19 and that also opened the door for states to find their own ways through the COVID-19 crisis. Much more needs to be done – and soon.

German scientists had a COVID-19 diagnostic test up and running Jan. 21; it was then adopted and distributed by the World Health Organization. Germany had an abundant set of private labs to implement testing and has already tested over 1 million people. South Korea was also quick to address COVID-19 diagnostic testing – having learned a lesson from their slow response to MERS in 2015. Another example is Iceland, which aims to “test everyone.”

In the U.S., the Centers for Disease Control and Prevention issued its diagnostic test Jan. 24 and received regulatory approval to distribute it to state labs for verification Feb. 5. Many state labs, however, were unable to verify that the test worked correctly. This verification problem became a regulatory bottleneck with the federal CDC test the only game in town.

The regulatory bottleneck was broken when the FDA issued immediately-in-effect guidance Feb. 29 that opened up entry by companies into the COVID-19 diagnostic testing market and gave the Wadsworth lab in New York greater regulatory flexibility. Subsequently, a Presidential Memorandum, issued March 13, expanded the federal government’s commitment to facilitating state requests for greater regulatory flexibility. Thus, states now have an important role to play in dealing with the COVID-19 pandemic. To ensure they have the flexibility they need as they scale up diagnostic testing, the 50 states must work with the federal CDC and FDA.

Having failed to quickly respond to the COVID-19 pandemic via mass screening, testing, contact tracing and selective quarantines where needed, lockdown via self-isolation in place became necessary in most U.S. states. Now, state and federal policymakers are beginning to think carefully about what happens next.

Economist Paul Romer’s proposal is to “test everyone, every two weeks” in order to safely and quickly respond to the COVID-19 pandemic. This ambitious proposal would require a “man on the moon” level of commitment over the next few months by state and federal governments, industry, and households.

Romer’s proposal is to test essential workers every day and to test the rest of us every two weeks or so. Those who test positive would be expected to self-isolate in place for 14 days. Romer, a 2018 Nobel economics laureate, says that if you do the math, you will find that millions of people will need to be tested every day. It won’t be cheap, but he argues that if $100 billion is spent on testing, compared to the roughly $350 billion or so of monthly economic losses that he estimates results from lockdowns, then it is money well spent. He shows via a series of simulations that even if the diagnostic tests have a high false-negative rate, the retesting is sufficient to contain the virus, thereby allowing the U.S. to return to normal quickly.

Much of the work of actually implementing a testing program of this scale and scope would be the responsibility of state and local governments. Drive-through diagnostic testing on this scale may be doable, but a lot of logistical hurdles would have to be overcome to make it work smoothly. In order to save lives and reduce economic damage, Maine should start thinking and planning for this next phase of the COVID-19 crisis immediately.

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