This is why we should test everyone for COVID-19

(Credit: Unsplash)

This article is brought to you thanks to the collaboration of The European Sting with the World Economic Forum.

Author: Reda Cherif, Senior Economist, IMF & Fuad Hasanov, Senior Economist, IMF

  • The potential benefits of a universal testing programme far outweigh any downsides.
  • The barriers – such as a lack of expert consensus and the costs involved – can all be overcome.
  • By deploying universal testing, we can avoid a third wave and the devastating consequences that would result.

Many experts have recognized the merits of universal testing for COVID-19, arguing that the benefits outweigh the costs by a huge margin. To cite a few, Paul Romer, a Nobel laureate in economics, Michael Mina, an epidemiologist from Harvard University, the Safra Center for Ethics at Harvard University, our own IMF working paper, and many commentators have argued for a universal testing and isolation policy (TIP) to vanquish the pandemic and reopen economies safely.

It has been shown unambiguously that continuous testing of the population at a relatively high rate – between 10-20% of the population each day – would squash the spread of the virus and prevent any resurgence. A TIP against COVID-19 would help identify infection clusters early and deal with them in a targeted and inexpensive way. This approach would preclude imposing numerous restrictions on economic and social activities, which are extremely costly.

Universal testing would cost about 3% (at $5 per test and 15% population testing rate) of the $3 trillion fiscal support provided by the US in 2020 and less than 1% of the economic and social losses ($16 trillion) incurred during the pandemic. In other words, it would still be worth implementing universal testing even if the chance of success were less than 1%.

A major difficulty in addressing the challenge of universal testing is that it lies at the confluence of many fields of expertise such as epidemiology, medicine, economics, public health and industrial systems. As a result, there is still no consensus among experts. The arguments levelled against universal testing include potential inefficacies due to many false negatives and people skipping quarantine, the infeasibility of producing so many tests, the need for the regulatory approval of non-diagnostic tests, and potential costs resulting from the production and distribution of tests and quarantines based on false positives. Others argue that it would provide a false sense of security by negating other non-pharmaceutical interventions (NPIs) such as mask-wearing and social distancing, or, that if it fails, it would endanger the public’s trust in other NPIs such as lockdowns.

These hurdles could be overcome and must not preclude experimentation with universal testing, given that it is economically worthwhile even with a 1% chance of success. The downsides of false negatives or quarantine avoidance can be compensated for with a higher rate of testing. The recently developed rapid antigen tests are cheap, scalable and precise, resulting in a much smaller number of false negatives and false positives. Even though these tests are less precise than some other tests used to diagnose the disease, universal testing is not about diagnosing patients; rather, it is about identifying the infected – what we call epidemiological testing. In addition, while other NPIs are still important in a transition period, once the curve is squashed, universal testing would allow lifting all other NPIs and help reopen large swathes of the economy while waiting for the vaccine.

Universal testing has reduced infections and deaths from COVID-19 in US care homes
Universal testing has reduced infections and deaths from COVID-19 in US care homes Image: Johns Hopkins Medicine

Breaking this tug-of-war among experts and experimenting with a universal testing strategy as a hedge against the pandemic require Rooseveltian resolve. This implies foregoing a ‘laissez-faire’ approach to production and implementing an industrial policy to ramp up the production of tests quickly. State intervention is required to tackle the market failures stemming from demand uncertainty, capacity constraints, coordination failures, externalities and market power. All the bottlenecks along the way, including regulatory approval and the engagement of the private sector in production, need to be cleared. This challenge looks miniscule compared to the goal president Roosevelt put forth before the nation in 1940 when he announced that the US needed to produce more combat airplanes in the next year than it produced cumulatively since the first flight of the Wright brothers in 1903. Three years later, the US was producing more than 50,000 combat airplanes annually, a 30-fold increase from the 1940 level.

Given the high expected economic return of universal testing, a complete reliance on a vaccine against the virus to end the pandemic represents an ‘incredible certitude‘ and ignores the risk-based approach. It is not certain at all when a safe and effective vaccine will be globally available; even worse, a virus mutation could render the newly developed vaccine obsolete. Even if the world had to wait for just a few more months, it would still be economically justified to experiment with universal testing.

Policy-makers should first acknowledge that experimenting with a hedging solution is necessary while waiting for the vaccine. It is even more paramount in developing countries as vaccines might reach them much later than advanced countries. Moreover, scaling up universal testing should follow experimentation in phases, which are similar to the development of a vaccine. The first phase would run trials on neighbourhoods and small towns and study existing experiences to select a set of testing technologies to scale up. The MIT and Georgetown University campuses in the US have successfully reopened while keeping outbreaks at bay by testing students and staff twice a week. The second phase would involve selected cities learning from others about the logistics of large-scale testing and isolation. Indeed, China has done this in the cities of Wuhan and Qingdao and successfully contained the outbreaks. Slovakia has embarked on testing most of its 4.5 million citizens within a few weeks, while Liverpool is the pilot city for the UK’s Operation Moonshot universal testing strategy. The third phase would scale it up nationally to make testing routine.

We now need some more Rooseveltian resolve to experiment with testing and the eventual scale up to the national and global level as well as international collaboration to share experiences. Policy-makers, together with the private sector, can provide the necessary resources to make universal testing a reality and avoid the next wave of the pandemic with its incalculable consequences.

The 2017 science fiction TV series Counterpart, in which an identical parallel world is stricken by a pandemic, foretells eerily our current situation of social distancing, mask-wearing, and billboards urging citizens to wash their hands. The parallel world’s persistently depressed economy could become our future if we do not fully hedge against this pandemic now.

The views expressed in this blog are those of the authors and do not necessarily represent the views of the IMF, its Executive Board, or IMF management.

the sting Milestones

Featured Stings

Can we feed everyone without unleashing disaster? Read on

These campaigners want to give a quarter of the UK back to nature

How to build a more resilient and inclusive global system

Stopping antimicrobial resistance would cost just USD 2 per person a year

Training for staff in early childhood education and care must promote practices that foster children’s learning, development and well-being

These countries have the most nuclear reactors

Record numbers of people in the UK have applied to study nursing

The British “nonsense”, the relaxed Commissioner and the TTIP “chiaroscuro” at this week’s Council

‘A trusted voice’ for social justice: Guterres celebrates 100 years of the International Labour Organization

Kids who live in the countryside have better motor skills, a study in Finland has found

“No labels for entrepreneurs!”, a young business leader from Italy cries out

Code of Practice on disinformation: Commission welcomes new prospective signatories and calls for strong and timely revision

No way out for Eurozone’s stagnating economy

South Sudan: UN calls for end to inter-communal clashes, attacks against aid workers

Here’s why human-robot collaboration is the future of manufacturing

JADE Spring Meeting 2017– day 1: Excellence awards, panel discussion, keynote speeches

EC v Samsung: A whole year to compile a case

Can medical students be prepared for Global Health ethical issues?

UN rights chief ‘strongly’ condemns ‘shocking’ mass executions in Saudi Arabia

Countries are piling on record amounts of debt amid COVID-19. Here’s what that means

Young activists do the talking as UN marks World Children’s Day

Some endangered languages manage to thrive. Here’s how

Irish Presidency: Not a euro more for EU budgets

European Citizens’ Initiative: Commission decides to register ‘Right to Cure’ initiative

7 ways to break the fast fashion habit – and save the planet

Global warming: our responsibility

COVID-19 has hit Black Americans hardest. Healing this divide would lift the nation

Will COVID-19 usher in a new culture of outdoor living and dining?

From Hangzhou to Rwanda: how Jack Ma brought Chinese e-commerce to Africa

Indonesian tsunami death toll climbs over 400 as Government-led relief efforts are stepped up

The importance of including palliative care in the Universal Health Coverage and how to achieve it

5 Ways Companies Can Progress More Women into Leadership Roles

Health Care Workers’ Safety and Health as Assets in the Fight Against COVID-19

GSMA announces speakers for Mobile 360 Series-West Africa

This is how we make basic income a reality

Revealed: danger and squalor for cleaners who remove human waste by hand

‘Global trust’ declining, ‘our world needs stepped-up global leadership’

UN Envoy ‘confident’ deal can be reached to avert further violence around key Yemeni port city

EU boosts humanitarian aid budget for 2021 as needs rise

The final countdown towards achieving the 2030 Agenda: the contribution of future health(care) professionals

Vaccine nationalism – and how it could affect us all

Investing in health workers yields ‘triple dividend’, WHO chief says in New Year’s message

Palliative care and Universal Health Coverage: how to advocate for the inclusion of palliative care in UHC

Commission (Eurostat) publishes first statistics on short-stay accommodation booked via collaborative economy platforms

Overcoming the paralysis of trust management across a fractured IT landscape

AI can help us unlock the world’s most complex operating system – the human body

Human rights breaches in Eritrea, Nicaragua and Saudi Arabia

Cross-border travel is confusing after COVID – this framework can help borders reopen safely

EU car manufacturers worry about an FTA with Japan

CLIMATE CHANGE FOCUS: Cutting emissions, one bog at a time

Artificial Intelligence in policing: safeguards needed against mass surveillance

World Cancer Day: Here’s how perceptions about the disease differ around the world

Italy’s rescue operation Mare Nostrum shuts down with no real replacement. EU’s Triton instead might put lives at risk

Europe bows to Turkey’s rulers, sends Syrian refugees back to chaos

Global Citizen-Volunteer Internships

Mobile World Congress 2021: Barcelona 08 June-01 July

Darfur peace process at a ‘standstill’ as demonstrations against Sudanese Government continue

Achieving targets on energy helps meet other Global Goals, UN forum told

When Can Everyone Pluck the Grapes?

These vending machines are giving out free short stories to London commuters

Brexit casts a shadow over the LSE – Deutsche Börse merger: a tracer of how or if brexit is to be implemented

There’s a single-use plastic you’ll throw away today without realising

Malaria could be gone by the middle of the century. Here’s how

Impact of high-fats food regimen on immune activity, tumor growth.

More Stings?


  1. Today you test yourself and tomorrow you can be infected

    • yes, that is the point! by testing tomorrow you would know and can isolate vs if you did not test and know you would infect 10s to 100s.

  2. Written by two IMF economists. They should stick to ruining economies the traditional way. Thanks, but no thanks.


  1. […] Muy buen análisis de por qué debemos hacer tests para batir al covid 19: link […]

Speak your Mind Here

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: