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We’ve been delivering some better news in the last week, with case growth starting to flatten in Michigan and in hot spots around the country.
We’re still not there yet, but I’ve started thinking about what easing up on lockdown measures and getting back to work would really look like in the U.S. The likely scenarios for restarting the economic engine all include one big factor -- being able to manage COVID-19 without a vaccine ready.
Dr. Anthony Fauci, the government’s top infectious disease expert, said Tuesday the U.S. does not yet have the critical testing and tracing procedures needed to begin reopening the nation’s economy, adding a dose of caution to increasingly optimistic projections from the White House.
“We have to have something in place that is efficient and that we can rely on, and we’re not there yet,” Fauci said in an interview with The Associated Press.
In Italy, Spain and other places around Europe where infections and deaths have begun stabilizing, the process was already underway, with certain businesses and industries allowed to reopen in a calibrated effort by politicians to balance public health against their countries’ economic well-being.
California Gov. Gavin Newsom released his six-goal plan for restarting the state’s economy on Tuesday, and it includes ongoing distancing measures, retooling of hospitals, and the reimplementation of restrictions, if needed. Newsom said that when the economy does reopen, daily activities will be different. Restaurants will open with fewer tables, waiters will likely wear gloves and masks, and face coverings will be common in public, he said.
Pandemics often come in waves. H1N1 had two waves. Heck, the bubonic plague had 15 waves over 300 years. So a resurgence of the virus after measures are lifted is not only possible - it’s almost inevitable.
So how do you send people back to work and open businesses without a vaccine for the virus? Here are some of the scenarios that people smarter than me have thought up -- you’re not going to love them.
Mass surveillance and data
A plan released by the National Center for American Progress earlier this month laid out a list of items the U.S. would need to take action on to reopen the economy. Here are some of the key elements:
- Ramping up testing to South Korean levels so that every individual who has a fever, and every member of a household of a positive case, has access to a test;
- Isolation of individuals who test positive for COVID-19, individuals who have a fever, and front-line health care workers;
- Restrictions of mass transit;
- Robust surveillance testing of representative samples of every county, including counties that are not reporting any cases;
- Instantaneous contact tracing and isolation of individuals who were in close proximity to a positive case.
Obviously, the surveillance part could be very controversial in the U.S. More on this from NCAP:
“In South Korea and Singapore—two nations that have suppressed transmission—the use of technology to conduct instantaneous contact tracing has been pivotal to their success. These nations use mobile phone apps or mobile telecommunications infrastructure to notify individuals on their mobile phone through notifications or text messages if they have been in close proximity to an individual who has tested positive for COVID-19. These methods use GPS, Bluetooth, cell tower, and Wi-Fi network data to identify whether the user’s phone pinged the same signals as the phone of a COVID-19-positive individual during the same time period. In South Korea, mobile alerts and public maps inform the general public of the locations of COVID-19 cases.”
Last Friday, Apple and Google announced a system for tracking the spread of the coronavirus, allowing users to share data through Bluetooth Low Energy (BLE) transmissions and approved apps from health organizations.
NCAP says “the entity that hosts the data must be a trusted, nonprofit organization—not private technology companies or the federal government.” That’s a tricky one. Read more of the NCAP plan here.
Massive scale testing
Nobel Prize-winning economist Paul Romer’s plan is more focused on massive testing, instead of mass surveillance.
While it appears to be the best-case scenario for sustained economic viability, it calls for 22 million tests per day — so that the entire country is being tested every 14 days, and anyone who tests positive can be quickly quarantined.
Even if it were realistic to ramp up testing to this level, the question of who administers these tests, manages results, and keeps supplies (swabs, kits, etc) flowing is an entirely separate issue.
For reference, as of Tuesday afternoon, the U.S. had tested just under 3 million -- total.
This may seem grim, and honestly, it is. The bottom line is -- we need a vaccine to really move on with our lives. And that doesn’t seem imminent, even with multiple clinical trials underway. Harvard researchers published a study this week, suggesting distancing may carry into 2022. “Under current critical care capacities, however, the overall duration of the SARS-CoV-2 epidemic could last into 2022, requiring social distancing measures to be in place between 25% and 75% of that time.”
So you can bet on a few things until then:
- Social distancing is here to stay for a while -- even if some businesses reopen. Big group events are probably not happening any time soon. Masks are also sticking around.
- We need more testing -- like, way more testing -- to really manage this thing.
- Even if things start to re-open, it will be nothing like “normal,” and a resurgence of the virus -- and of distancing measures -- is likely.
The good news is, we can control how the disease spreads by staying home, washing hands and following distancing measures. I hope this was more informative than scary.
This article first appeared in the Morning Report Newsletter. Sign up for it right here to get it right to your inbox.