I'm actually not sure they're "very" different risk profiles, though it isn't unreasonable to assume that before you analyze the situation further. My reason is that contagiousness peaks around 2-3 days before symptoms appear, and the false negative rate for a test is 100% just 4 days before symptoms appear. [1]
Now consider that tests themselves normally take around 3 days to come back. That means if you find out your test results just 1 day before symptoms appear, they'll be based on your viral load from three days prior, where (as mentioned above) the test would've had a ~100% chance of producing a false negative! (Things improve a little for a 2-day turnaround, not that much.) In other news, the only time you can really expect useful results is on (or after) the day of symptoms... at which point you would already be staying home.
I do see 2 places where this argument breaks down:
- For asymptomatic carriers. I don't know what the rates are like, but asymptomatic people won't know to stay home without a test, so tests would seem to have some value there for the purpose of making public gathering safer. However, intuitively, I wouldn't expect it to be a game-changer—I'd only expect it to stretch the runway a little bit (say, get you a few extra days/weeks), but you'd still be back at square 1 having to shut things down afterward.
- For people who aren't cautious and would go out to dine even amidst symptoms, but wouldn't go if they test positive. Which seems ironic because you could say reckless behavior here would (in some sense) seem to create a positive feedback loop justifying more reckless behavior. That not only seems like a questionable way to justify public policy, but it also seems to suffer from the same problem as the last item: it'd only delay the inevitable by a few days/weeks.
- For rapid tests (< 1 day, preferably < 1 hour). I don't expect rapid tests will be available to the masses for everyday activities.
So, at least on my end, with traditional testing that takes 2-3 days to come back, it's entirely plausible (and moreover, likely) to me that testing has low utility for these particular purposes. But I would love to hear an expert's explanation that takes all these factors (and more) into account.
[1] https://medical.mit.edu/covid-19-updates/2020/07/when-should...
Are diners in American restaurants required to register name and contact details before entering? We have that in South Australia (takes a few seconds via QR code), and we currently have no active cases state-wide.
Last time, they showed a list of particular hot spots (bus stops, shopping centres, schools) and asked if we'd been at any of those locations recently. Though I imagine there wouldn't be much of the US right now that isn't some level of hot spot!
Gyms, shops, shopping malls are open. No testing and no limits.
States have a legal and ethical pubic health obligation. They're also on the hook financially via lost sales taxes and medicaid costs. Each covid case is bad for states. But they can't pay businesses to close. And they federal government won't pay even though they could.
A 10 minute spit test would make this allot more doable.
They're in essence, supposed to work in as much of a bubble as they can whereas you cannot say the same about a restaurant. It's an unfortunate situation, but they really are quite different.
The policy goal is to minimize the number of people you meet. You meet your household, if you have to work non-remotely, then you meet some coworkers (preferably a limited amount and always the same, separating a company in teams/"bubbles") and ideally that's it - it makes all sense that places where you'd be eating together with random strangers should be restricted much more than work lunches where outsiders are excluded.