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 Milestone

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

This is the environmental catastrophe you’ve probably never heard of

Electronic cigarettes, a better alternative or a well-advertised product

Parmesan cheese on shelves in Italy (Copyright: European Union, 2014 / Source: EC - Audiovisual Service / Photo: Daniela Giusti)

CETA at risk again: Italy says it won’t ratify EU-Canada trade deal over product protection fears

ECB’s unconventional monetary measures give first tangible results

Cleaner Air in 2020: 0.5% sulphur cap for ships enters into force worldwide

Antimicrobial resistance: how can an intersectoral approach between society and healthcare professionals be developed and applied?

6th Edition of India m2m + iot Forum to open its door on 14th January, in association with The European Sting

Why press freedom should be at the top of everyone’s agenda

UN chief saddened at news of death of former US President George H.W. Bush

Cum-ex tax fraud scandal: MEPs call for inquiry, justice, and stronger tax authorities

Davos on Climate Change: citizens demanding more actions while CEOs tried to balance profit with sustainability

Mobility package: Parliament adopts position on overhaul of road transport rules

This top-10 of business risks misses the biggest of them all: climate change

Nepal faces a crisis as COVID-19 stems the flow of remittances

Fairness in the Food Supply Chain: Commission welcomes Member States’ support for greater price transparency

Can we automate our way out of the savings crisis?

Climate action: 4 shifts the UN chief encourages Governments to make

Around 23 million boys have married before reaching 15; ‘we can end this violation’ says UNICEF chief

The multidisciplinary team facing the multidrug resistant form of Tuberculosis in the state of Amazonas (Brazil)

EU and U.S. castigate Facebook on Cambridge Analytica scandal as citizens’ data privacy goes down the drain again

Humans have caused this environmental crisis. It’s time to change how we think about risk

What is hydroponics – and is it the future of farming?

Mental health in medical students: the deciphered quandary

UN chief condemns air strike that hit school bus in northern Yemen, killing scores of children

The European Parliament double-checks the EU 2014-2020 budget

What you need to know about the Sustainable Development Impact Summit

How to help an ageing population stay wealthy for longer

One million facing food shortages, nutrition crisis after Mozambique cyclones: UNICEF

UNICEF chief hopes 2020 will be ‘a year of peace’ for Syria’s children

Polluted lungs: health in the center of environment discussion

MEPs want the EU to play a stronger role in improving public health

Can we put a price on clean air? Yes, we can

Commission introduces surveillance of imports of bioethanol, and remains open to examining requests from other sectors

The European Brain Drain: a truth or a myth?

In this Tokyo cafe, the waiters are robots operated remotely by people with disabilities

How can we produce enough protein to feed 10 billion people?

Reforms in a few countries drive a decline in average OECD labour taxes

Western Sahara: a ‘peaceful solution’ to conflict is possible, says UN envoy

The first new university in the UK for 40 years is taking a very different approach to education

This is what a Green New Deal for Europe could look like

How UN cultural treasures helped set the stage for Game of Thrones

Parliament boosts consumer rights online and offline

Militias force nearly 2,000 to leave Libyan capital’s largest shelter for internally-displaced: UNHCR

Key quotes from China’s Premier Li on COVID-19, the economy and US relations

EU Citizenship: New survey shows EU citizens are more aware of their rights

FROM THE FIELD: South Sudan’s green shoots, highlight environmental recovery from war

UN chief hails victory of ‘political will’ in historic Republic of North Macedonia accord

We have a space debris problem. Here’s how to solve it

Hiring more female leaders is good for profits. Here’s the evidence

Why we need to solve our quantum security challenges

70 years on, landmark UN human rights document as important as ever

Righting a wrong: UN Fund helps thousands of sex abuse survivors rebuild their lives

What the future holds for the EU – China relations?

As human genome editing moves from the lab to the clinic, the ethical debate is no longer hypothetical

Companies have a new skill to master – innovation

Why 2020 will see the birth of the ‘trust economy’

The Italian crisis may act as a catalyst for less austerity

Foreign direct investments the success secrete of Eurozone

What makes America the world’s most competitive economy?

Climate Change and Human Health: Two Faces of The Same Coin

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