Using "Test and Trace" to Fight COVID-19 in Massachusetts

After the first, convulsive phase of the COVID-19 crisis has passed, states like Massachusetts will determine how to gradually restart the economy and safely reopen parts of social life. That means new strategies for disease containment and new rules of social interaction — at least until an effective treatment can be found. For this policy report, the Center for State Policy Analysis has synthesized the best evidence around test and trace: the known, the unknown, and the key decision-points facing policy-makers.

We find:

• Testing capacity in Massachusetts likely needs to increase from the current mark of 5,000-8,000 tests per day to 10,500-17,000 per day.
• Even modestly successful contact-tracing programs in other countries often involve invasive government activity, which may not be compatible with U.S. law, the established norms of American life, or modern partisanship.
• The fact that asymptomatic people can spread COVID-19 complicates the work of contact tracing — and puts a premium on speed. Using cell phone data could help quicken the process, but it raises serious concerns about privacy and surveillance.
• Coordination and centralization could be a challenge in Massachusetts, as contact tracing is typically handled by the 351 cities and towns.
• Choosing between voluntary and mandatory measures is fraught, as voluntary approaches may weaken compliance while mandatory moves can stoke resistance.
• Massachusetts also needs to prepare for potential failure, which means specifying triggers for when to return to lockdown. Even under a strict contact-tracing regime, living with COVID may involve periods of relative openness followed by semi-regular shutdowns.