[Goose]

The only thing that makes sense is ramping up the RNA detection tests that identify current infections, making them yield results ASAP, and to stop farting around with testing only suspected positive people. We need to use the testing capacity we do have to do random population sampling so we can build models around what we project is happening in the entire population, infected to not. The more localized the better.

OF, with respect, I think you are wrong. First of all, when you say "The more localized the better", what do you mean? If you test some locales different than others, it isn't random. Second, the worst hit county (percentage wise) in the bay area is San Francisco. They have a current measured infection rate of 0.15% Let's assume that is low by a factor of 10. If you test the entire 883,395 people in San Francisco instantaneously and simultaneously you would expect to find about 13,000 infected people. But, even under the most optimistic scenario, you can't do 883,395 people in an instant. Look at Iceland, the country who has done the most "random" testing. They have been testing their population of 364,000 since January and got through 10% of it on April 19th. Since most of the "mild" cases of the disease come and go in three weeks or so, several generations of the disease would have come and gone while they tested 10% of the population. Some of that testing is "randomly" selected, but most is not. The incidence of this disease is small enough that gathering co-temporal statistics about it by random sampling is basically impossible, and what you do find will of necessity be retrospective.

The contact tracing and tracking approach OTOH involves deploying your testing capability among the people that are most likely to benefit from it. Those are people with a significantly higher probability of disease. Surveillance testing is also targeted at "suspicious" or probable outbreaks. The data derived from these tests will be timely enough to take targeted steps (quarantine) that will (hopefully) control the disease. That is a big reason this approach is the goal of just about everyone. Korea, HK and Taiwan are making it work pretty well. Singapore is have problems right now but still hasn't been forced to completely "shut down" like we have.

To be clear, I understand you aren't recommending testing everybody. However, to "know" the actual infection rate is 0.16% instead of 0.15% with any degree of confidence, you are going to have test a whole lot of people, 99.8% who will be negative. If it takes you three weeks to do so, the infection rate at the end of three weeks could now be a lot higher or lower than what it was when you started because it changes (in theory) exponentially. So what have you actually accomplished?

[Goose]

The only thing that makes sense is ramping up the RNA detection tests that identify current infections, making them yield results ASAP, and to stop farting around with testing only suspected positive people. We need to use the testing capacity we do have to do random population sampling so we can build models around what we project is happening in the entire population, infected to not. The more localized the better.

OF, with respect, I think you are wrong. First of all, when you say "The more localized the better", what do you mean? If you test some locales different than others, it isn't random. Second, the worst hit county (percentage wise) in the bay area is San Francisco. They have a current measured infection rate of 0.15% Let's assume that is low by a factor of 10. If you test the entire 883,395 people in San Francisco instantaneously and simultaneously you would expect to find about 13,000 infected people. But, even under the most optimistic scenario, you can't do 883,395 people in an instant. Look at Iceland, the country who has done the most "random" testing. They have been testing their population of 364,000 since January and got through 10% of it on April 19th. Since most of the "mild" cases of the disease come and go in three weeks or so, several generations of the disease would have come and gone while they tested 10% of the population. Some of that testing is "randomly" selected, but most is not. The incidence of this disease is small enough that gathering co-temporal statistics about it by random sampling is basically impossible, and what you do find will of necessity be retrospective.

The contact tracing and tracking approach OTOH involves deploying your testing capability among the people that are most likely to benefit from it. Those are people with a significantly higher probability of disease. Surveillance testing is also targeted at "suspicious" or probable outbreaks. The data derived from these tests will be timely enough to take targeted steps (quarantine) that will (hopefully) control the disease. That is a big reason this approach is the goal of just about everyone. Korea, HK and Taiwan are making it work pretty well. Singapore is have problems right now but still hasn't been forced to completely "shut down" like we have.

To be clear, I understand you aren't recommending testing everybody. However, to "know" the actual infection rate is 0.16% instead of 0.15% with any degree of confidence, you are going to have test a whole lot of people, 99.8% who will be negative. If it takes you three weeks to do so, the infection rate at the end of three weeks could now be a lot higher or lower than what it was when you started because it changes (in theory) exponentially. So what have you actually accomplished?