The sixteenth white paper in our ongoing COVID series is, “Mitigate/Suppress/Maintain: Local Targets for Victory Over COVID,” by Divya Siddarth, Marie-Laurie Charpignon, Dean Foster, Kazumi Hoshino, Sham Kakade, John C. Langford, Nicolás Della Penna, Rajiv Sethi, Sema K. Sgaier, Peter Smittenaar, Nicholas Stewart, and E. Glen Weyl.
There is growing consensus around a strategy centered on testing, tracing, and supported isolation (TTSI) to suppress COVID, save lives, and safely reopen the economy. Given the high prevalence the disease has reached in many OECD countries, this requires the expansion of TTSI inputs to scales and with a speed that have little precedent (Siddarth and Weyl, 2020). As scarcity of testing supplies is expected to remain during the build-up to a surge, authorities will need to allocate these tests within and across localities to minimize loss of life. This paper documents a preliminary framework that aims to provide such guidance to multiscale geographies, in conjunction with our previous recommendations. Given unfortunate limits in current testing capacity, we describe a testing and tracing regime in which orders of magnitude fewer resources can be used to suppress the disease. Such suppression should be rapidly scaled in low-prevalence areas (within and across regions) to the extent that those areas can be insulated from other areas. In particular, if travel restrictions are used to allow asynchronous suppression, and if logistics permit the use of mobile resources, a smaller number of tests per day may be required. At the same time, vulnerable communities and essential workforces must be protected across regions, as prescribed in Phase I of the Roadmap to Pandemic Resilience (Allen et al., 2020).