Source: Harvard University

Massive Scale Testing, Tracing, and Supported Isolation (TTSI) as the Path to Pandemic Resilience for a Free Society

roadmaptopandemicresilience_updated_4.20.20.jpg, Apr 2020


COVID-19 IS A PROFOUND THREAT TO OUR DEMOCRACY, COMPARABLE TO THE GREAT DEPRESSION AND WORLD WAR II. As ever, the greatest bulwark of democracy is us. What we do together—for one another and, even more, with one another—to fight this terrible disease, protect human life, secure our institutions, and prevent the destruction of our economy will determine whether free societies will prove resilient in the face of existential emergency.

What we need to do is much bigger than most people realize. We need to massively scale-up testing, contact tracing, isolation, and quarantine—together with providing the resources to make these possible for all individuals.

Broad and rapid access to testing is vital for disease monitoring, rapid public health response, and disease control.

We need to deliver 5 million tests per day by early June to deliver a safe social reopening. This number will need to increase over time (ideally by late July) to 20 million a day to fully remobilize the economy. We acknowledge that even this number may not be high enough to protect public health. In that considerably less likely eventuality, we will need to scale-up testing much further. By the time we know if we need to do that, we should be in a better position to know how to do it. In any situation, achieving these numbers depends on testing innovation.

<<Between now and August, we should phase in economic mobilization in sync with growth in our capacity to provide sustainable testing programs for mobilized sectors of the workforce.>>

The great value of this approach is that it will prevent cycles of opening up and shutting down. It allows us to steadily reopen the parts of the economy that have been shut down, protect our frontline workers, and contain the virus to levels where it can be effectively managed and treated until we can find a vaccine.

We can have bottom-up innovation and participation and top-down direction and protection at the same time; that is what our federal system is designed for.

This policy roadmap lays out how massive testing plus contact tracing plus social isolation with strong social supports, or TTSI, can rebuild trust in our personal safety and the safety of those we love. This will in turn support a renewal of mobility and mobilization of the economy. This paper is designed to educate the American public about what is emerging as a consensus national strategy. The work has been produced in partnership with The Rockefeller Foundation and builds on important work already released by Johns Hopkins Center for Health Security, the Duke Margolis Center for Public Health Policy, Center for American Progress, and the American Enterprise Institute.


1. The level of testing and supported isolation we need depends on how effectively we can trace people’s contacts, warn those contacts about their exposure and need for a test, test them, and isolate those who are COVID-positive.

2. To succeed, isolation must be supported with job protections, resource support, and health care.

3. Testing and public health response—in programs established by states and administered by local health authorities—can and should be fully aligned with civil liberties, due process, non-discrimination, data and health privacy protections, and health



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