We cannot stay closed forever. We cannot reopen without risk. How do we make our way forward?
Bottom Line: This pandemic is a health crisis. The only way to solve it is to focus on safety. Once people trust that it is safe to come out, they will.
As always the key is:
THINK = Theory
KNOW = Experience
PROVE = Data
We KNOW the state of play for COVID19 (https://bit.ly/2zGET16). We can PROVE that it is highly infectious by measuring the R0 (“R-naught”). This number shows how many people will get infected by one sick person if nothing is done. For COVID19, that number is 5.7, and we can PROVE how just one person can lead to many others getting sick or dying (https://bit.ly/2AneVA6). We can PROVE that only by taking steps to get R0 below 1 will an outbreak slow down and eventually come to an end.
We KNOW that we have two ways to reduce R0 and stop an outbreak: a “Hammer” and a “Scalpel.”
The “Scalpel” is simply keeping sick people away from the healthy ones. It’s a 4-part strategy where we test for the disease, isolate the sick, track down all their contacts, and then quarantine the exposed people (https://bit.ly/2Z4AMXy). Contact tracing is done by interviewing the sick person and asking where they’ve been and who they’ve been around for the last 2 weeks. Next, someone calls all those people, interviews them, and asks them to self-isolate. It's a labor-intensive approach. Maricopa County Public Health, for example, had 25 contact tracers before COVID19. This approach is narrow and targeted, but we KNOW it’s useless if the disease is widespread.
When that’s the case, the only option we have is the “Hammer,” where we shut down the economy, keep everyone inside, and break the chains of transmission (https://bit.ly/3cwTZVK). This approach is a blunt tool, a “break glass in case of emergency” option only. We used the “Hammer” in March. We KNOW it flattened the curve. We can PROVE that it reduced R0, (https://bit.ly/3btwfAh) which protected hospitals from being overrun (https://bit.ly/2LuE9yW) . We can PROVE this saved lives by slowing the spread and reducing case numbers (https://bit.ly/2LtkMGr).
We also KNOW that it caused great economic harm. We can PROVE a lot of people are out of work (https://bit.ly/3fSLAxG). We KNOW that the impact was widespread and deep (https://bit.ly/2Ltb07f). We also KNOW the impact wasn’t felt equally with people of color and women bearing the brunt of the job loss (https://bit.ly/2WBRkoh). That being said, we KNOW this is a tough time for many (https://bit.ly/3cAMJIh) and that numbers don’t tell the whole story. We KNOW that hospitals (https://bit.ly/3czFvV4) and the healthcare (https://bit.ly/2LraQgL) sector got hit too. That’s not even counting the budget problems states and cities will face soon due to loss of tax revenues (https://brook.gs/2T3am4w) or the probable closure of department stores (https://nyti.ms/3fOQ6xp)and rural hospitals (https://ampr.gs/3cu6T6N). Because of these economic effects, the “Hammer” is a short-term option only.
We KNOW we have to restart the economy, but we THINK (https://bit.ly/3bESoMo) that reopening will lead to more infections (https://bit.ly/3cADIyP). Social distancing needs to be maintained, or we’ll be at risk for starting a “second wave” (https://bit.ly/2zzAz3P). The risk comes because we KNOW most jobs require people to leave their homes (https://bit.ly/3cAOXHD). Because of the fear of contracting COVID19, we KNOW people are worried about going back to work (https://bit.ly/3fE0isv).
However, it's not just the workers. We can PROVE that consumer spending makes up 67.5% of the US economy (https://bit.ly/2LmXkuC). One survey found 64% of consumers were worried about their health while shopping (https://accntu.re/3fFDVTv). People over age 65 are at greater risk for COVID19 and they make up 22% of the US consumers (https://bit.ly/2YWpLaC). Consumers stuck at home spent less overall, but spent much more online (https://bit.ly/2WKaZ49). This change in behavior could remain even after COVID19 ends (https://go.ey.com/2WFzsY4). What consumers do will have a huge impact on the economy.
As the "Hammer" is lifted, we THINK people will resume some activity, how much remains to be seen. We KNOW that people can protect themselves and others by wearing a mask, washing their hands often, and being socially distant. Also, we KNOW that we can control the spread of COVID19 by employing the "Scalpel" well. We do that by expanding testing, hiring many more contact tracers, and having people who get sick self-isolate at home. Maricopa County, for example, is hiring up from 25 contract tracers to 250. We hope this will keep us from having to use the "Hammer" again.
Still, we THINK that as long as people feel their health is at risk, they will prefer to do their business online and from home. This is key for us to understand. COVID19 is a health crisis first. As long as this pandemic continues, we KNOW everyone will be at risk, although some more than others (https://bit.ly/2yF3Hqt). That risk will remain until we get a vaccine or we get to herd immunity. Experts are predicting that both of these could take until 2021 (https://bit.ly/2WPDEEH) (https://bit.ly/2SZIG0y). It’s important to understand that much of our "modern" economy is based on trust and faith that the future will be better than the present or the past. If a large enough group stops believing that our economy will change (https://bit.ly/3fHey3K). This pandemic can shift an entire generation's understanding of risk (https://bit.ly/3bp5H3g).
Reopening the economy has sometimes been presented as a choice between safety and jobs. That is not the case. Instead, we THINK both are important, and they go hand in hand. We KNOW that the health and safety of people must come first as we reopen the economy.
Comments