cases anywhere within its borders otherwise the first unmistakable sign that something is wrong will be the wail of sirens as oxygenstarved patients are taken to a local emergency roomby then it may be too late to stop a flood of patients over the next week that will overwhelm that hospitalin rural america even in relatively wealthy states like texas financially struggling hospitals often have few ventilators and ambulances must drive long distancesimagecreditterray sylvestergetty imageswhen hospitals run short on supplies or ambulances fail to promptly reach victims of pneumonia heart attacks strokes or car accidents many lives may be lost as happened in new yorknew york has tested more citizens than any other state has more than twice as many per capita as california and more than three times as many as texas to spot outbreaks early the harvard model advocates scaling up to 20 million tests a day nationwideadm brett p giroir the coronavirus task forces chief of testing strategy recently said there was absolutely no way on earth that goal could be reached and that eight million tests a month or about 270000 a day might be possible by junepaul m romer a nobel prizewinning economist at new york university has called for daily rapid tests for every worker in contact with others meaning 20 to 30 million tests a dayat 10 a test he has conceded such an undertaking would cost at least 15 billion a week but even that is far cheaper he argued than the damage now being done by keeping the country locked downfor now the lofty goal of tracing and testing the contacts of every infected person remains unthinkable epidemiological models in the united states and data from china suggest that each case generates about 50 contacts so the 25000 new daily cases in the united states generate another 13 million contacts to find each dayeven under ideal circumstances a team of five tracers takes about three days to find 50 contacts so if the number of trained contact tracers were increased to 100000 from 3000 the most recent tally the daily case count would still have to drop below 5000 just to stay even assuming the tracers worked fiveday weeksbut the daily load is barely dropping below 25000digitally automating the job has been proposed but for bluetooth and gps apps like those used in south korea to work in the united states and find a useful percentage of a victims contacts about 80 percent calculated tomas pueyo author of an article titled coronavirus how to do testing and contact tracing apple and google would have to update their smartphone operating systems with builtin tracking apps that all cellphone owners would by law have to use also neither location data nor bluetooth could be turned offamericans are unlikely to accept that mr pueyo concededwe fear 1984 he wrote we want to avoid an aidriven world where the government knows our every movement rates us according to our behavior and soon tells us