The Waffle House Test: Randomized Controlled Chaos

One of the hardest things — the hardest thing? — in medical research is to conduct an objective research study on a deadly disease. This is because you can’t ethically infect someone with a disease that can kill them, to then try to test a possible cure. And if someone already has the disease, you can’t ethically compare a prospective treatment to a placebo (a make-pretend medicine), lest you risk depriving someone of a life-saving treatment. We are faced with exactly this challenge with coronavirus.

But we have a researcher’s dream-come-true in America. At this very moment, millions of Americans are “dying” to congregate again— can I say that? — in the close confines of their favorite restaurant or bar. And they don’t expect to be invited to participate in a randomized, controlled trial (the gold standard of scientific experiments) to do so; they simply want the restaurant or bar to throw its doors open and they’ll run in.

So we have in front of us the perfect — and perfectly ethical — solution to this otherwise usually unethical dead end. All we have to do is put a truck outside some restaurants in locales that have loosened their restrictions, and solicit research participants from it. I’d make it look like one of those soft-serve ice-cream trucks and play the Mr. Softee jingle.

Ask customers who come out of the restaurant if they’d allow us to check on their health for two weeks, and inquire on the health of those they’ve come in contact with for another two weeks. We could even offer them some money, or an ice cream cone, whichever they choose, but I think we all know what any normal person would choose if they just came out of the Waffle House. Duh.

And I sincerely believe that the majority of people who will go to a restaurant right now would be delighted to help prove that it is safe… that the odds of infection are low. I mean them no malice other than a few bad medical puns or double entendres, nor do I believe they are any less sharing, or selfless, or conscientious than any average person. They simply want to go to a restaurant — as do I and every one of us — but they feel their circumstances warrant the risk as it’s been apprised and appraised. Most people are good, so many would gladly want to be part of proving that things are safe… or they wouldn’t be there in the first place.

And speaking of the Waffle House, we should have trucks set up at both closely-packed restaurants such as Waffle House and at the open prairie-like spaces of your basic Denny’s with its cushy booths and airport runway aisles. If the Waffle House customers ‘win’ in the coronavirus transmissivity contest, then we have solid confirmation of the Bromage Protocol, which posits that proximity is a key determinant in the transmission of the disease.

We are missing a desperately needed opportunity if we do not do this. If we find danger, we save thousands of lives; if we find none, we save the financial and mental health of millions. I’m dead serious.