Coronavirus DK: Testing as a way of life

The debate over testing will never end. In a detailed opinion piece, Kenneth Jensen, head doctor specializing in anesthesiology and intensive therapy at Næstved Hospital, questions whether the Health Authority has the capacity to carry out its planned testing strategy (DK). A key problem for testing, he says, is that the number of asymptomatic infected people is three to ten times larger than the number who become ill and they are not being tested. Of those tested recently, only 5-7 percent have been found positive, so number of tests has relatively little value. In addition, the treatment of those who test positive is the same as for anyone else with mild symptoms – self-quarantine at home. The Health Authority’s new policy is that people who test positive must trace their recent contacts, who must all be tested.

Double the testing

Jensen calculates the number of tests required to implement the policy and points out a number of problems, for example the difficulty of identifying all relevant contacts and a seven-day wait for results. He estimates that at least 25,000 must be tested daily, whereas the maximum level thus far has been around 13,000. Jensen also says that spot checks must be made in order to find asymptomatic carriers, that healthcare staff must be tested regularly, and that results must be available within 48 hours. He concludes that because the number of infected persons is now low, more aggressive testing and tracing could reduce the spread of the virus while lockdown restrictions are further relaxed, but the window of opportunity will not be open for long.

No, 30x the testing

That advice is similar to recommendations that the Ministry of Health recently received from an unexpected quarter. On May 1, the Danish Broadcasting Corporation’s Detektor program interviewed Paul Romer, Professor of Economics at New York University and Nobel Prize winner. Romer has been advocating an even more aggressive test-trace-and-isolate policy in the United States in order to allow the economy to reopen quickly. His proposal is that 7 percent of the population should be tested per day until a vaccine is developed; that is, everyone should be tested every two weeks. That will give people the confidence to return to work without much danger of getting infected. In Denmark, this plan would require some 400,000 tests per day. Romer’s argument is that the cost of such extensive testing is much lower than the cost of idling the economy and the concomitant rescue packages, only about DKK 1,800 ($250) per person for a year.

Betting on free-market incentives

When questioned about the feasibility of the plan, Romer goes as far as to propose a bet to Minister of Health Magnus Heunicke: If Denmark offers a prize of, say, DKK 1.4 billion, to the first lab that can produce 1 million tests per day, he believes a lab will achieve this within six months. When asked whether such mass testing is really necessary, he cautions that there was an earlier, milder version of the corona virus and there may be an even more dangerous version in the future. So every country should invest heavily in testing capacity in order to be ready for the next pandemic.

Danish researchers do not think such a drastic suppression policy and extensive testing are necessary in order to continue the lockdown exit since the number of infections remains low and people have been able to adapt to social distancing and stricter hygienic habits. Heunicke didn’t respond to the wager. Instead, the Health Ministry made a referral to its press release about increasing the testing capacity as quickly as possible.

Not so bad after all

On Monday, the government released a chart showing that Denmark ranked second among selected countries in the number of tests it has conducted per million inhabitants. At 42,262, it was 3,500 behind Israel and nearly 8,000 ahead of the third-highest country, Ireland. The chart included the major European countries as well as some countries that have been most successful in stopping the virus – South Korea, Hong Kong, Singapore and New Zealand.

(NB: Coronavirus DK will take tomorrow off and return on Friday.)