One pathway out of the lockdown might be to identify people who are COVID-19 negative and antibody positive and deploying them back to the community. This recent study shows that this strategy could substantially reduce the impact of COVID-19 on deaths and the need for beds in intensive care units.
The authors developed a model to estimate how interaction substitution — that is, substituting vulnerable and potentially infected people with recovered people — could reduce epidemic spread. They find that the impact of this intervention (that is, the reduction in deaths) increases with the reproduction number R0 (the number of people that an individual person infects on average), when more susceptible people are replaced with recovered people, and in populations with higher proportions of elderly people. They also find that interaction-substitution protection works synergistically with other public-health interventions such as social distancing.
The study highlights the value of serological testing as part of intervention strategies to reduce the impact of COVID-19; however, as discussed in An accompanying editorial about the study, decision-makers face challenges to widespread implementation of this approach, including the limited accuracy of current serological tests and the uncertainty about the strength and duration of immunity after COVID-19 infection. Further, there are and ethical concerns related to privacy, the potential for perverse incentives (e.g., some people might try to become infected in order to go back to work), and the distribution of benefits and burdens.
