Shelter-in-place, self-isolation, stay-at-home, social distancing. These terms are the new vocabulary for the second decade of the 21st century. Add to the list the term “quarantine fatigue,” which most likely captures the prevailing feelings most of us are experiencing as the weather warms and the allure of the ocean beckons those from near and far who wish to avail themselves of the therapeutic qualities it has to offer, and here we are.
As the nation wrestles with the “invisible enemy” that has already cost as many American lives in 12 weeks as the Vietnam War did in 12 years, the battle lines are now drawn over public health versus economic recovery. Not surprisingly, the overwhelming consensus is that health trumps wealth. In the most recent Morning Consult Poll, 75 percent of those interviewed chose health as more important than the economy in determining policy choices, and 81 percent support social distancing, while just 10 percent think we should stop practicing it.
There will be volumes published on the Trump Administration’s response, or lack thereof, to what is the most serious pandemic to strike humans in over a century and I will not spend time discussing the issue here. What is more important in the present context is how we proceed from this point forward.
The ultimate goal, of course, is the development of an effective vaccine, and since that is not likely within the next year or so, we must chart a course that protects as many lives as possible until then. There are more questions than answers at this point. We are essentially learning as we go. One thing that is quite apparent, however, is that social distancing and stay-at-home policies are working. Given the likelihood that a second wave will occur in the fall that will be exacerbated by a concurrent outbreak of the flu, we need to be both cognizant of the impatience and frustration of many Americans yet not succumb to the impulse to overreact.
The absence of a comprehensive nationwide testing regime has been the most glaring failure to date. We simply cannot afford to rely on potentially 50 independent solutions. We are not an agglomeration of 50 republics; rather, we are one republic composed of 50 sub-national governmental entities. There is both a need and a public yearning for a federal response.
Anyone who has wandered into the field of basic economics understands two primary principles: first, supply and demand; and second, economy of scale. Let’s take the latter first—we must combine the vast resources of the national government and the states to lower the costs of needed supplies, personal protective equipment (masks, gowns, goggles and gloves), rather than having individual hospitals or states compete with each other in a bidding war that invites price gouging.
On the former issue, since the American people overwhelming choose health over wealth, prematurely opening the economy begs the question as to whether or not there will be a demand for the services being offered under what will obviously be altered accommodations. Do we really need to put people at risk so they can partake of bowling alleys, gyms, massage parlors, beauty salons and barber shops? Will Americans readily flock to fill restaurants, even if tables and seats adhere to the six-foot rule? Can restaurants absorb the limited capacities and still turn a profit?
We need to listen to our public health professionals, not the politicians. We need to develop a coherent and effective universal testing regime that diagnoses those who have contracted the virus. We can do this by developing testing methodologies that can be done within the privacy of our own homes. Two examples are at-home nasal swabs and at-home saliva testing.
Identification of infected individuals must be followed up with a contact tracing regime that identifies those who have come in contact with an infected person and a program to accommodate isolating the sick. This can be done with either a cadre of individual investigators or through technological innovations using GPS or Bluetooth contained in our cell phones.
Further, we need to explore the potential of antibody testing to determine both levels of immunity and to facilitate the transfer of antibodies to seriously ill patients, known as convalescent plasma therapy.
All of this must be done within the scope of a national disaster priority and, as we progress on a path toward containing the pandemic, we can slowly, carefully, and reasonably restart the economy. Carelessly rushing through a reopening, for whatever reasons—economic, political or sentimental—will further run the risk of spiking a virus relapse that will result in another shutdown of the economy. But the most important ingredient to surviving the pandemic is to level and be honest with the American people. No sugar coating, no cheerleading, no false hopes—just the facts.