For now, social distancing is the best America can do to contain the Covid-19 pandemic. But if the U.S. truly mobilizes, it can soon deploy better weapons—advanced tests—that will allow the country to shift gradually to a protocol less disruptive and more effective than a lockdown.
Instead of ricocheting between an unsustainable shutdown and a dangerous, uncertain return to normalcy, the U.S. could mount a sustainable strategy with better tests and maintain a stable course for as long as it takes to develop a vaccine or cure. The country will once more be able to plan for the future, get back to work safely and avoid an economic depression. This will require massive investment to ramp up production and coordinate the construction of test centers. But the alternatives are even more costly.
Two types of testing will be essential. The first test, which relies on a technology known as the polymerase chain reaction, or PCR, can detect the virus even before a person has symptoms. It is the best way to identify who is infected. The second test looks not for the virus but for the antibodies that the immune system produces to fight it. This test isn’t so effective during the early stages of an infection, but since antibodies remain even after the virus is gone, it reveals who has been infected in the past.
Together, these two tests will give policy makers the data to make smarter decisions about who needs to be isolated and where resources need to be deployed. Instead of firing blindly, this data will let the country target its efforts.
Here’s a simple illustration of how test data can save lives. Every day millions of health-care professionals go to work without knowing whether they are infectious and might spread the virus to their colleagues. We both have close relatives on the front lines. As soon as one of them developed a cough, she pulled herself out of service. But at that point she may have been infectious for several critical days. If she and her colleagues had all been tested every day, her infection would have been caught earlier and she would have isolated herself sooner.
To be used as a screening mechanism at the beginning of a shift, the test would need to be able to give a result within minutes. Developers are making progress on speeding up these PCR tests—so much so that the aforementioned physician received the results from her second test, conducted five days after the first, before those from the first test. Abbott and Roche, two pharmaceutical companies, are moving forward with tests that can decrease reporting times from days or hours to minutes. Now that the doctor has recovered, an antibody test could help determine when she can return to the frontlines of patient care.
As testing capacity expands, the same tests could be offered to all essential workers, such as police officers and emergency technicians, and then to other overlooked but critical workers—pharmacists, grocery clerks, sanitation staff. The next step would be to test people throughout the country at random to get up-to-date information about who is infected now and who has ever been infected.
For those who are currently infected, governments can provide immediate assistance to make sure they don’t infect anyone else, especially family members. Those infected before who now have antibodies may be less susceptible to reinfection. If that is proved in the weeks to come, they could also return to work.
Putting this system in place will take resources, creativity and hard work. Test developers will have to increase the production rate of kits by an order of magnitude. In his work fighting Ebola in West Africa, Dr. Shah saw how a virus can cause a 30% reduction in economic output. Mr. Romer’s back-of-the-envelope calculation is that the recession caused by the coronavirus pandemic has already caused a 20% reduction in U.S. output, which means the country is losing about $350 billion in production each month. If a $100 billion investment in a crash program to make antibody and PCR tests ubiquitous brought a recovery one month sooner, it would more than pay for itself.
Building this testing system would be complicated and require the best of American science, business and philanthropy working together. But it is the type of challenge that the U.S. has overcome before. It isn’t viable to wait a year or two for a vaccine before getting people back to work safely. To save lives and prevent a depression, testing on a massive scale is essential.
Mr. Romer is a professor at New York University and a 2018 Nobel laureate in Economics. Dr. Shah is president of the Rockefeller Foundation and served as administrator of the U.S. Agency for International Development, 2010-15.
I have some friends who have children with autism. This article is for them. Very encouraging to me- yes, even though it feels like a lot of work.
BY CLARE ANSBERRY
CHRIS TIDMARSH CO-OWNS Green Bridge Growers, a commercial greenhouse in north central Indiana that provides herbs, lettuces and nasturtiums to local restaurants, and sunflowers and cosmos to florists.
He has degrees in chemistry, environmental studies and French. He has a passion for agriculture. He also fits a very rare profile for an entrepreneur. He has autism.
The 30-year-old created the company in 2013 with his mother—and co-owner—Jan Pilarski, after a promising job as an environmental researcher ended abruptly because he had difficulties communicating. That left him with the choice of either trying to find a more suitable job or, with the help of his family, creating a business that would capitalize on his skills.
They chose the latter. “My mom does most of the administration,” says Mr. Tidmarsh, including accounting, marketing and sales. He perfects the spacing between rows of kale and spinach, and keeps close tabs on water chemistry and soil acidity. He spends hours researching natural and effective pesticides to deal with aphids. The solution: 4,500 ladybugs.
Ms. Pilarski often explains how they created and run the business to groups of parents whose children have autism, to show that it is possible. “There is a deep, deep need for hope and jobs,” she says.
A network of support
In many ways, Mr. Tidmarsh’s path to entrepreneurship resembles that of others starting their own business. He has a wide breadth of knowledge and a vision of what he wants to accomplish. He is a mentor to those working alongside him. The results are promising. Green Bridge is projecting revenue of $80,000 and profit of $30,000 in fiscal year 2018. In fiscal 2020, when an expansion is complete, it expects to reach $220,000 in revenue and $72,000 in profit.
In other ways, though, his journey is very different. Other entrepreneurs may know what they can’t handle and delegate those tasks to others. But they know how to execute their vision. That is difficult for Mr. Tidmarsh. He has a dream but leans on his mother and a network of supporters to plot and fulfill it.
It is a story shared by many other entrepreneurs with autism spectrum disorder, a condition affecting about one in 68 children and 1% to 2% of the overall population in the U.S. Starting a successful business is no small task for anyone, but those on the autism spectrum face challenges that others don’t. Many have difficulties with executive functioning—the ability to follow multiple steps to complete a task. They may also have a limited ability to follow rules of social interaction— like maintaining eye contact or shaking hands—or to read facial expressions to let them know what someone might be feeling or thinking. Sometimes they can type what is in their head, but are unable to say it.
They know how to work, explains Danny Raede, chief executive of the Asperger Experts online community, who was diagnosed with Asperger Syndrome, an autism-spectrum disorder, at age 12. But “their brains won’t let them.”
So, jobs are few for people on the spectrum, and adults with the condition have an estimated 80% to 90% unemployment rate. “One of the ways people choose to address this is by creating a business that allows them to be selfemployed,” says Angela Geiger, CEO of Autism Speaks, an advocacy and support organization, which has a business- accelerator program.
By launching their own companies, people on the spectrum can create a work environment that fits their comfort level and doesn’t force them to navigate the traditional, heavily social office setting. Very often, though, their key to success is not to try for independence, but to build up a network of supporters who will help them with the business.
“It’s how interdependent can you get,” says Mr. Raede. “Try to get as many people you can rely on, not one. I want to have 10,000 people I know and can rely on.” His online community is built on that concept, offering support groups and online courses to facilitate learning on a mass scale.
One of the best ways those supporters can help someone on the spectrum become self employed is to identify and build on their skills instead
of trying to change behavior or have them do something they can’t, says Cary Griffin, co-founder of Griffin-Hammis Associates, a Florence, Mont., consulting firm that specializes in developing self-employment opportunities for people with disabilities. If a person can’t manage bookkeeping or marketing, for instance, others can.
Often, it’s a parent or sibling. When Matt Cottle, 28, of Phoenix learned that he couldn’t be a Marine like his father and brother because he was on the spectrum, he took culi- nary classes and began working with a pastry chef. Many people on the spectrum, in fact, are chefs, along with craftsmen, locksmiths and candle makers.
Mr. Cottle found his vocation in baking and started Stuttering King Bakery, which supplies muffins and scones to local coffee shops, corporate events and farmers markets. He is licensed and works out of a large kitchen in the home he shares with his parents. His mother, Peg, handles orders and marketing.
“For someone on the spectrum to be able to make it, they really have to have someone else who has a real high investment in their success, and usually that is going to be family,” says Ms. Cottle.
Approaching the puzzle
Mr. Tidmarsh, the oldest of four children, was diagnosed with autism as a preschooler, when a caregiver noted that he seemed in his own world and uninterested in family members coming and leaving the house. Since he was their first child, Ms. Pilarski says that she and her husband, Jay, likely missed the significance of behavior that might have concerned more-experienced parents.
For most of his childhood and teen years, the couple focused on the most immediate next step—elementary school, middle school, high school and college—while also raising their other three children and working. Jay Tidmarsh teaches law at the University of Notre Dame, and Jan ran a social-justice program at St. Mary’s College.
Chris Tidmarsh received his three degrees from Hope College, a small liberal-arts school in Holland, Mich. After graduating in 2010, he got a job as an environmental researcher. But it didn’t last.
“I was doing a lot of office work and behind the computer. I’m not the best with that style. They generally communicate verbally, and I’m more of a visual learner,” says Mr. Tidmarsh, who struggles at times to find and say the right word. He’s better at following directions when they are written in emails and texts. It is harder when they are spoken.
After three months, he was let go. “I felt disappointed, and I guess I felt kind of sad that it didn’t work out, but I was looking forward to finding a job that I might enjoy more,” Mr. Tidmarsh says.
Back at home, his parents saw him surrounded by peers with degrees and on the spectrum, and likewise unemployed. The reality of the obstacles facing their son and his limited options loomed large.
It wasn’t so much the idea of his son earning money that concerned Jay Tidmarsh. “I wasn’t stressed that way,” he says. “It was hard for us to have this young man with a lot of ability unable to use it. That was really concerning. I really believe in the importance of work. It’s a part of who you are.”
Over many meals, Chris Tidmarsh and his family talked about what he loved doing most. He interned at an organic farm, became a master gardener and took a class designed to help people become farmers.
“I’ve been really interested in the environment and Earth for a long time,” Mr. Tidmarsh says. “I decided I wanted to do something related to that.”
He and his mother, who grew up on a farm, began researching options. They visited a software business set up by the family of a young man on the spectrum, and talked at length about how they made it viable. They also visited several farms, including one that used an aquaponics process, where fish’s waste is used to fertilize plants that grow in water, while the plants clean the water to cycle it back to the fish tank.
That process, heavily dependent on chemistry and environmentally friendly, captured Mr. Tidmarsh’s attention. “It requires a bit of knowledge of chemistry,” he says. “It is very sustainable. It uses 90% less water than growing in the soil.”
The plan emerges
From there, mother and son began working together to figure out how to get the business off the ground. Ms. Pilarski left her job in 2012 and applied to a program through her alma mater, Notre Dame, designed to help startup social enterprises. Part of the class involved creating a plan that could be entered into a business-plan competition at Notre Dame’s Mendoza Business School.
She and Mr. Tidmarsh laid out their strategy with the help of four graduate students. Among other crucial choices, they decided to set up the business as a 501(c)(3) nonprofit, and have a key component of its mission be training others with autism.
When the group presented the plan to the competition judges, Mr. Tidmarsh spoke about unemployment problems faced by people on the autism spectrum and described his own experience.
They won the social-impact prize, which provided $15,000 as well as legitimacy. “It really took us to a different place and acknowledged the viability of what we were doing,” says Ms. Pilarski.
The team met with area farm-to-table restaurant owners and a local Whole Foods Market to determine market potential and realized that it was huge: Indiana trucks in 90% of its food, they discovered. They researched profit margins and decided to focus on those products that have the highest ones, like basil, which sells for $16 a pound retail and $10.50 wholesale.
In 2013, the partners built a prototype for their business, located on a site in South Bend, Ind., that housed an agency serving people with disabilities. As they produced their first crops—along with basil, they grew cilantro, red Russian kale, lettuce, mint and parsley— they learned the ins and outs of the growing process.
Mr. Tidmarsh focused on monitoring the details of the fish tanks and the level of nutrients the plants were getting.
The next step in their plan was expansion. Guided by the board they had set up for the nonprofit, they raised money through donors and a crowdfunding campaign, which they added to a $10,000 entrepreneur- of-the-year award won by Mr. Tidmarsh.
Finding land that met zoning regulations and offered access to water and electricity, and room for growth, was more difficult than they envisioned.
“It took a tremendous amount of time,” says Mr. Tidmarsh.
After more than a year, in December 2014, they found a farm with 5 acres, a house and barn, and bought it for $70,000. Ms. Pilarski scouted for other funding sources to cover the cost, landing grants from a utility and the U.S. Agriculture Department.
All was progressing until March 2016— when Ms. Pilarski was diagnosed with cancer. It wasn’t only a personal blow, but also a tremendous setback for the business. She was the one calling contractors, pricing materials and looking for the best suppliers.
She did as much as she could for as long as she could, but “it was difficult to keep the momentum going,” she says.
Mr. Tidmarsh struggled with the disruption. He says little but nods in agreement as Ms. Pilarski tells her story and concludes, “I’m back and healthy.”
In the midst of those difficult times, their support network helped keep the business moving forward. Board members pitched in when and how they could, as did Jay Tidmarsh. While caregiver to his wife during her 10-month treatment, he and volunteers started building two now-complete greenhouses on the new property. Once the growing facilities are fully operational, the family expects to harvest about 45,000 pounds of produce a year.
Having both parents involved in the business, says Chris Tidmarsh, “brought us closer.”
The way forward
The business has provided a path forward for Mr. Tidmarsh and his family. He says that he has become more comfortable conducting tours of the greenhouse. He has also addressed large audiences, speaking in front of advocacy groups and gatherings at Notre Dame and St. Mary’s, including graduate speech-pathology classes. The goal is to help them understand the difficulties that those on the autism spectrum have communicating.
Until recently, Mr. Tidmarsh lived with his parents. Now he has moved into a house with a friend who is also on the spectrum. His parents pay for his housing, but he hopes that will change. “My goal is to be self-sufficient,” he says, as well as help to employ others on the spectrum.
Toward that end, he is mentoring workers at Green Bridge. Matt Coleman, Mr. Tidmarsh’s longtime friend and now his roommate, works alongside him, planting and harvesting, and monitoring water levels. Adam Rousculp, who is also on the spectrum, feeds the fish and cleans the tank. Photos and explanations hang throughout the pilot greenhouse to explain the process to visitors and help workers, who better absorb information visually.
The changes in Mr. Tidmarsh are striking to Ms. Pilarski. “I’ve seen him grow in such a lovely way,” she says.
On a recent afternoon, Mr. Tidmarsh checks nutrient levels in tanks that hold koi at the pilot greenhouse. Afterward, he creates holes 1/8th-inch deep and drops seeds into trays of soil. Later, at the site of Green Bridge’s two new greenhouses, he describes his plan to plant perennial rye in an open field on the property to restore microbes in the soil and prevent erosion.
He’s optimistic about the future of Green Bridge. “It does provide hope not just for me, but others on the autism spectrum to find and keep jobs,” he says. “I think I can see myself doing this for the rest of my life.”
Ms. Ansberry writes The Wall Street Journal’s Turning Points column. Email firstname.lastname@example.org .
DAVID KASNIC FOR THE WALL STREET JOURNAL (2)
Top photo: Chris Tidmarsh working with floating hydroponic raft beds. Bottom photo: Mr. Tidmarsh at a greenhouse containing lettuce and herbs, and trays of seeds for the company’s larger greenhouses.