March 29, 2020

TOUGH LOVE:

We Can Safely Restart the Economy in June. Here's How.: Get tough now. Test widely to isolate those infected, and slowly revive businesses with workers and customers who have developed immunity. (Ezekiel J. Emanuel, March 28, 2020, NY Times)

I've helped make the case before that a strong, fast, federal effort to speed the distribution of testing, protective gear, intensive care equipment and training, and to coordinate a national response, could sharply limit the spread of Covid-19.

The federal government has done little, but if it acts now a similarly strong national response may allow America to open up sooner -- in June, not by Easter -- and do it more safely. Here's how:

Stop the virus. A nationwide shelter-in-place or quarantine should take place for the next eight to 10 weeks. According to Chinese data, this would mean the number of Covid-19 cases would peak in four weeks or so and then decline over the next four to six weeks. So, as hard as it would be, everybody but essential workers would have to remain inside until roughly June 1st.

Make reasonable exceptions. In counties with few cases of Covid-19 and the ability to test and trace infected people's contacts, normal life could go on as long as people believed to be infected are quarantined and those who are known to be infected are rapidly isolated.

Mobilize public health resources. During the eight weeks of shelter-in-place, the federal government needs to produce and distribute enough tests so state and local health officials can check as many people as possible, even those without symptoms, and determine the true extent of infections. We should also push the Food and Drug Administration for rapid approval of blood tests to determine who has antibodies to coronavirus, and is thus immune, and then distribute millions of them.

State and local health department then need to deploy thousands of teams to trace contacts of all new Covid-19 cases using cellphone data, social media data, and data from thermometer tests and the like. We also need to get infected people to inform their own contacts. It would be easier to lift the national quarantine if we isolate new cases, find and test all their contacts, and isolate any of them who may be infected.

The national quarantine would give hospitals time to stock up on supplies and equipment, find more beds and room to treat people, get better organized and give clinical staff a respite to recuperate for the next onslaught of Covid-19 care. Without these measures, any Covid-19 resurgence would be far harsher, and economically damaging.

Begin a mass education program. While many Americans have been more careful about washing their hands, keeping six feet away from other people, and staying indoors as much as possible, these new behaviors have not been adopted in every part of the country. We need a stronger campaign to educate Americans about these habits so that the average number of people any infected person might spread the virus to would drop below one, from about 2.4 today.

Create a Covid-19 certification system. States should use blood tests to certify people who have had Covid-19, are immune and are no longer contagious. These people could then work in hospitals or other areas where being risk-free would be a benefit.

Slowly open the economy and social activities. If these steps are taken, we should slowly open up parts of the economy in June, while requiring those 70 and older, or others at high risk, to continue to shelter in place, perhaps in isolation. Lifting restrictions could start with children and young adults, who are far less likely to get seriously ill and die. We might open up summer school, on a voluntary basis, and camps. Parents should be allowed to assess the risk that their children could become infected with the coronavirus and bring it home. Teachers and administrators would also have to be able to opt in, knowing they could acquire Covid-19. Colleges and universities might open up for summer sessions, with faculty and staff opting in, or not, with knowledge of the risks they are taking. Following South Korea and Taiwan, America should deploy testing and contact tracing aggressively during this opening to limit any potential outbreak.

Open the economy more fully. If the initial opening works, we should allow people in offices to go back to work in places where Covid-19 infections have died down. 

Posted by at March 29, 2020 12:19 PM

  

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