Gaps in Data Are Crippling Efforts to Confront COVID-19

My mother used to take great pleasure in pondering the tart-tongued aphorism: "May you live in interesting times." As a child of the Great Depression and a U.S. Army nurse who followed the European campaign through North Africa, to Sicily, and then on to France, she was uniquely qualified to understand what that meant.

I've always taken it to mean that so-called interesting times are best appreciated from a distance, either in time or space (preferably, both). We are all living in interesting times now, of course, thanks to the COVID-19 pandemic. And things are likely to remain quite interesting for some time to come.

The Tension Between Safety and an 'Open' (Humming) Economy

Right now, the biggest problem with handling the pandemic is a lack of the right kinds of data. Politicians, doctors, and public health officials all agree that without fast and widespread testing it's impossible to know how far the virus has spread, and who might be asymptomatic but shedding virus (and infecting others) nonetheless.

In short, we are involved in one of the biggest, high-stakes games of data acquisition that the world in general, and the United States in particular, has probably ever tackled. Given that public health best practice is trace the movements and contacts of infected individuals back to the earliest point in time at which they could have been infecting others, this poses all kinds of technical and even privacy challenges.

If we're to have a hope of learning what we need to know, then a lot of people are going to have to account for their whereabouts and activities over the past 30-to-60 days in excruciating detail.

It's simply not safe to open up the economy until we know who's got the disease, who's been exposed to the disease, who has immunity to the disease, and how long that immunity will last. Each of those is a big problem by itself; combined they're staggering in cost and scope.

According to the excellent Bing COVID-19 Tracker, there are roughly 2.1 million cases worldwide as I write this story, with more than 528,000 recovered cases, and close to 140,000 deaths. The United States has come in for a disproportionate share of that action, with nearly 645,000 confirmed cases, nearly 53,000 recovered cases, and a shocking fatality count rapidly approaching 29,000 (over 30,000 as of this morning according to this story in U.S. News & World Report).

At the same time, The Washington Post reported this morning that 22 million Americans have filed for unemployment in the past four weeks, which parks the national unemployment rate north of 20 percent. The small business bailout fund part of the multi-trillion stimulus authorized so far has already run out of money.

Alas, countless service-oriented small businesses have shut down and may never be able to reopen (hundreds of thousands of operations are closed around the country right now). More and more people are facing destitution, unable to pay for food, shelter, and the basic necessities of life. Indeed, they need to get back to work to stay alive, pandemic or no pandemic.

Interesting times, indeed — readers will agree with me that "too interesting by far" is not an unfair characterization.

Grabbing and Making Sense of the Data ASAP

Tragically, there really isn't much we can do except to continue to work as quickly as possible to offset what we don't know and understand about the virus. We desperately need data to illuminate, isolate, and protect ourselves as best we can.

In the interest of public health — to say nothing of out-and-out survival — case tracking has become a dire necessity. Privacy and personal liberty may suffer in the short term. Thus, we must be prepared to revisit the level of surveillance, scrutiny, and back-tracking that will be necessary to make things safe again until the crisis subsides. Who knows how long that will take?

At the same time, biomedical efforts are focused on more and better tests to identify infection, as well as to detect and characterize the levels of antibodies in those who've contracted and recovered from the virus. And of course, the most important effort is also the one with the longest time to completion: to come up with one or more vaccines that will help the human population to develop herd immunity.

Of course, that also means we need to determine how high that level of immunity needs to be (see the "Mechanics" section of Wikipedia's article on herd immunity to better understand how that level gets determined and calculated).

Most experts seem to agree that the only thing worse than the current situation would be to open the economy too early and suffer another major surge in the caseload, with the attendant rise in hospitalizations. As I see it, the real priority is to get the data.

More than anything else, we need to know what we're dealing with, and what kinds of strategies we can employ to confront that more fully illuminated understanding of things. Until then, we must sit tight, stay in place, and do what we can to keep things going and together. So please: stay safe, and stay well while we get this figured out.