From my computer science days before I embraced the healthcare industry , it was always the case that version 1.0 of any software was buggy and required updates to become mature , stable and more intelligent. I can see a very interesting analogy between initial software releases and early covid-19 responses , testing methods that were common in most countries of the world .

Today RT-PCR is still the golden standard for testing moreover, this “clinical” testing needs to be taken to a different level, which we can call “surveillance testing” . In surveillance testing , you can mass test people for infectiousness rather than flagging people positive for just carrying the virus as they might not be shedding it. I will outline below the main reasons behind the need for a paradigm shift :

1) The world economy needs to fire-up again

2) Countries cannot sustain the closure measures anymore

3) Financial resources needed to keep up the economies alive during lockdowns are drying up

4) The number of people that needs to be scanned for the virus is exponentially growing bypassing the RT-PCR time constrained capacities.

5) Wave 2 seems to be more challenging than the initial spread .

If you remember in early 2020, when economies went into a total stall, afterwards most countries needed to open back by the end of the first half . Look at us now, we are struggling again with far more number of cases. Wave 2 surely looks more aggressive as a lot of countries are going back to lockdowns to avoid further virus spreads .In Covid-19 2.0 , the concept of positive / negative RT-PCR testing should be augmented with a new paradigm where by a person can be classified as being “infectious” (+) or “non-infectious” (-) is more helpful to achieve what experts call “Intelligent Lockdown” . In this approach , you quarantine the infectious people (not necessarily for 14 days , but rather until they become non-infectious) and return the non-infectious virus carriers to society in order to keep the world moving.

The tools needed for “Intelligent Lockdown” are available in the market today waiting for the world to understand the need for a new way for working. They are much faster than RT-PCR and can mass scan people for infectiousness thus promoting faster reporting, swift virus spread control measures, and higher frequency of testing per day.

Interestingly enough the Pareto rule applies to Covid-19 infections were “80% of the new transmissions come from 20% of the carriers” mainly asymptomatic and super spreaders. So unless we start shifting gears with the number of tests per day , we might always be lagging behind in our fight against the virus .

In covid-19 version 1.0 , the world took actions that falls under the same version as well . There was panic, the healthcare system was under severe strain, fire fighting infections here and there. The learnings from all of this started shaping the world in order to pave the path forward . RT-PCR emerged as the golden standard in order to uncover those who are carrying the virus , for isolation and treatment. Even China flexed its muscles by building a hospital in a historical record time to take care of its positively identified Corona virus carriers .The need to know if a person carried the virus or not was very key , but one problem was hindering the progress of this way of working . RT-PCR takes a long time (at least 4 hours initially , now this has been optimized) to be processed and with the huge number of tests , suspected virus carriers would only get their results after 24-48 hours which is long enough for a person to get infected or infect others while waiting for the results to be communicated.

Finally though vaccines are starting to emerge here and there, yet several questions remain unanswered: Will a vaccinated person transmit the virus? How long do the antibodies last? How reliable is the messenger RNA method? What are the medium to long term effects? Whatever the answers to the above questions are , the need to test people more efficiently will be there for sometime and the world should move to version 2.0 that promotes intelligent lockdowns .

*https://www.technologyreview.com/2020/06/15/1003576/whats-a-coronavirus-superspreader/