If we want to beat the virus, we’re going to have to act like one.

I don’t mean people should infect each other with the coronavirus to develop herd immunity. I mean our public health system must counter the virus in the way it behaves, not in a manner that comports with wishful thinking or past practices.

Specifically, we need, as medical professionals, to cultivate a far more flexible and resilient testing system that can overcome the political, financial and industrial hurdles that have kept the United States from leveraging its vast economy and deep pool of expertise to test for the coronavirus early, often, easily and reliably.

Testing, in other words, needs to go viral.

A test for testing
The U.S. is working hard to manufacture sufficient tests to identify and trace individuals suffering from the coronavirus, including unwitting asymptomatic carriers, in order to stop the spread. That’s a logistical problem we as citizens can help solve by making our demands for more testing clear to our elected officials and community leaders.

As researchers, however, we must immediately devote our attention to the next critical task of developing antibody tests that determine whether someone has contracted and beaten the virus, a necessary measure if people are to return to work, school and other activities that we all wistfully recall as normal life. It’s no surprise that a global race to develop better antibody tests is now underway.

It’s more than having a test
As the race continues, we can’t let the kinds of problems that bedeviled the rollout of coronavirus testing hamper the deployment of antibody tests. We’re going to have to accept new strategies, new models and new mindsets if we’re going to empower our communities to emerge safely and stronger after lockdown.

Adapting to the complexity of our environment – political, social, economic and ecological, for the coronavirus pandemic is, at base, an ecological crisis – is the challenge we confront. The coronavirus has proven a formidable adversary to our public health system in its current state. Allowing change is necessary, and that change requires approaching the coming months and potentially years with a new mindset that reflects the reality and gravity of the days ahead.

First, testing has to be convenient. Most people understandably dislike the prospect of a clinician in a hazmat suit swabbing their nose or throat. Coronavirus antibody tests should resemble routine blood or pregnancy tests if they want to catch on as the thing to do.

Second, we need to make our tests in the United States. At present, many companies use reagents and other materials from abroad, especially China, where the quality of those inputs has reportedly been suspect. What’s more, the production of American tests in the US is a matter of national security that should garner significant buy-in from across the political spectrum.

Third and most importantly, we need to make testing more open source, to borrow a phrase from Silicon Valley. Americans are lucky to live in a country where top-notch healthcare companies have the capacity to fund science and mass produce medical devices, pharmaceuticals and other products. But big companies are often necessarily slow to adapt. They rely on rigid and closed systems.

Getting to the frontlines
We need tests that any medical professional can perform, hopefully, with the equipment they already own or can purchase easily, without long-term contracts and other encumbrances. As is the case with open-source software, medical professionals should be able to fit the tests into their current lab capabilities instead of having to make major investments that hamper diagnostic progress in the name of profit-seeking.

The coronavirus has managed to inculcate itself into every nook and cranny of our lives. We need a testing regime that is equally pervasive, repeatable and unrelenting. The only difference I’d highlight is that where the virus is unaccountable, we be the opposite. We can answer for taking back our lives.



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