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For this question, we will define surveillance as large scale random Covid-19 testing.

It is my understanding that:

  • surveillance enables the sorting of asymptomatic patients to be immediately isolated when infected (and reducing further infections).
  • the USA does is not applying said strategy
  • said strategy was successfully engaged in Korea

HBR indicates:

“Testing is the biggest problem that we’re facing,” Peter Slavin, president of Massachusetts General Hospital, said recently in a roundtable on Covid-19 at Harvard Medical School. While South Korea had tested about 4,000 people per million of its population at the time, the United States had just run five tests per million — despite the fact that they both reported their first cases at essentially the same time (on January 21 and 20). The discrepancy was surprising because the genome of the virus had been available since January and scientists had figured out the diagnostics shortly thereafter, using proven molecular methods first discovered in the 1970s."

South Korea has a population of ~ 51M and the USA population is ~330M.

This article indicates Jacksonville drive-in testing is limited to 250 tests per day.

  1. Why is surveillance not implemented at scale in the USA?
  2. If the USA does not have testing at scale, why is this the case?

    • Unwilling (culture / etc.)
    • Unable (knowledge / materials / preparation / etc.)
    • Regulatory hurdles?
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  • South Korea isn't doing random testing, it's doing targeted testing of people who may have had contact with COVID-19 patients, and it has sufficient capacity to test all of them.
    – Mark
    Mar 31 '20 at 21:43
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Why is surveillance not implemented at scale in the USA?

Not enough test kits.

If the USA does not have testing at scale, why is this the case?

Didn't go through MERS and SARS, unlike South Korea. E.g see https://www.theguardian.com/world/2020/mar/15/experience-of-sars-key-factor-in-response-to-coronavirus

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