Here are a few things that might need to be addressed.
April 20, 2020 — 11 a.m. EST
Every day we feel the longing to return to some normalcy more acutely, and every day it becomes clearer that as the pandemic progresses, reopening is a very complicated matter. President Trump’s most recent plan, while sparse on details, declares May 1, 2020 the day we’ll reopen (with some states even sooner). However, experts and officials have been much more hesitant to commit to that date. So, then what needs to happen to make reopening a reality?
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In New York City, still the current epicenter of the pandemic, I went for a run on Easter Sunday, my face hot and wet beneath my homemade mask that made it hard to breathe. I ran back and forth from the street to the sidewalk to avoid people. I didn’t expect to see anyone congregating for the holiday, but was surprised to see multiple groupings, some wearing masks, some with them pulled down around their necks, and some not wearing anything to cover their faces at all. I thought of the more than 30,000 known COVID-19 fatalities in the U.S., and how both my nervous running and their ill-advised gatherings were reactions to the same loss. Everyone’s searching for answers right now. Hopefully this explanation of what needs to come together before we can reopen helps make things a bit more clear. Please note that the following items represent opinions that have come from various experts. These are not set rules that the federal government or state governments are necessarily following, and not all of these may be accomplished before the country reopens.
1. Reduce the Number of Infections
Based on extensive analyses of the previous outbreaks in China, one of the most important, and frankly only, things we can do to overcome the pandemic at this point is reduce the rate of growing infections through limiting avenues by which it can be spread (i.e. flatten the curve). This is why many states, like New York, have extended stay at home orders through May 15 at least.
2. Maintain Current Restrictions Until COVID-19 Spread has Slowed
Yes, this includes all stay-at-home orders, which will likely be required well after May 1 in most areas. A 2020 study published in the medical journal The Lancet looked at the dangers of second wave infections of COVID-19 in several provinces in China. It found that the reproduction number of the virus decreased substantially when control measures were implemented, and that relaxing the interventions when the number was low resulted in an exponential increase in the cumulative case count. According to the American Enterprise Institute (AEI), a state should sustain a reduction in cases of COVID-19 for at least 14 days before any restrictions are lifted — but there’s still no guarantee that this would prevent a second wave.
3. Set National Guidelines
From the outset, states have received little federal guidance, which has left much decision-making up to states and local authorities, creating a patchwork of guidelines. National leadership is desperately needed for everything from face mask usage and procurement and distribution, to COVID-19 testing.
4. Increase and Improve Testing and Reporting
Governors, business leaders, and the federal government are all in agreement that we need to improve the speed and availability of testing. People with symptoms should be tested, diagnosed, treated, and isolated, and cases should be reported by each state quickly. Not only should those who are symptomatic be tested, but also the general population. Antibody testing should be developed in order to determine if previously infected people may be immune.
5. Develop and Implement Contact Tracking System
The success of South Korea’s curve-flattening is due in large part to the use of technology, like cellphone GPS, to trace the location of people who tested positive for COVID-19 in order to alert anyone they came into contact with. According to NBC News, epidemiologists believe that a similar testing/tracing implementation in the U.S. could allow us to lift some of our social distancing requirements. This is controversial in the U.S., due to privacy concerns. Unlike the U.S., South Korea has laws in place that prioritize social security over individual privacy, and many South Koreans may have broadly accepted the loss of privacy as a trade-off for beating the pandemic. But they are beating it — while the U.S. has hundreds dying every day, South Korea hasn't had more than nine in a day (South Korea also has a much smaller population, but the per capita death rate is still lower). However, The Center for American Progress, an independent nonpartisan policy institute, released a plan to end the COVID-19 crisis, and it lays out comprehensive steps in order to implement contact tracing with extensive protections in place for individual privacy.
6. Hospitals Must Be Stable
Health care workers should be protected and their safety and support need to be a top priority. The government needs to provide them with the appropriate personal protective equipment for current and anticipated need. Hospitals must be able to adequately treat and maintain care of patients without going into the crisis mode we’ve seen in places like New York City.
7. Protect the Most Vulnerable
Expand resources for those who are most in danger if they are infected. This should continue if stay-at-home restrictions are lifted, state-by-state.
8. Lift Restrictions State-by-State
Now that it’s been established that state governors, and not the president, are the ones who have the authority over stay-at-home orders, the U.S. can more easily reopen state-by-state. Already, governors across the country are banding together to form concerted regional plans. Experts agree with this approach, as restriction guidelines necessarily vary by region, and say it will be a gradual process.
9. Develop a Vaccine
As the study in The Lancet journal explains, when our restrictions result in a lower reproduction number of the virus and we start lifting restrictions, the adverse health and social/economic effects would also rise again. Simply putting restrictions back in place will not necessarily reduce the burden back to its original baseline, as it might take more effort to do so. Therefore, they posit that for now, we must strike a balance between reopening and keeping the reproduction number low through restrictions, and this is the best strategy until we find a vaccine.
Though it’s undoubtedly a hectic time, it can be somewhat reassuring to remember that governors are working together during this time and stay at home sanctions won’t be lifted unless it’s deemed safe by multiple experts, like the Centers for Disease Control and Prevention (CDC). Therapists are recommending to focus on what you can control in an effort to ease your mind and stress. Try these tips for mental health or work out a small fitness plan that can be done in your living room to have something to focus on and look forward to during quarantine. We’re all in this together.