Getting America Back to Work...Safely

What’s the plan?

Without a credible plan, the nation will be in fear and chaos for a long time. COVID-19 infections are peaking in parts of the country, but contrary to President Trump’s assurances that he will open the economy soon, the surgeon general recently declared that many places in the US will not be able to open on May 1. So who decides? What are the criteria? What if infection rates spike again?

The situation begs for a plan to assure all Americans that a strategy exists that makes sense for our economy and our health. It needs to be formulated today, while we are still in this terrible phase of contagion and death, when our country needs a roadmap to normalcy to rally around.

A credible plan must ensure maximum possible safety for every American returning to work as it endeavors to minimize the scale of economic damage done. No plan can be risk-free, but science and evidence must guide decisions to ensure risk is minimized.

One useful example is a recent report  by McKinsey and Company, “How to restart national economies during the coronavirus crisis.” Their study portrays an array of scenarios and their impact on national economic well-being depending on what choices are made. The report does not shy away from the uncomfortable trade-off between saving lives and saving livelihoods, nor the desire and necessity of trying to optimize both.

The framework from the report rests on the critical need for local measures that dictate when and under what conditions specific parts of the economy can be freed from extreme social isolation, region by region.

Foundational: For the duration of the pandemic, the following procedures must be in place:

1. Social distancing must be maintained, with an emphasis on antiseptic cleansing of common surfaces, frequent handwashing and wearing face masks in closed environments.
2. Covid-19 testing must be deployed rapidly throughout the country in order to determine those requiring treatment and who must otherwise be quarantined.  
3. Testing for immunity (anti-bodies) must be rapidly deployed to determine which people are most likely “safe” from reinfection and are no longer contagious.
4. Ongoing research from all sources must inform decisions to adjust, slow or accelerate the end of social distancing, testing and other facets of pandemic control.

Regional staged release:  Rates of contagion and the capacity of the healthcare system must be evaluated at the local level—for example, in the US by county. The rate at which the virus is being spread in the local population compared to the ability of the local healthcare system to accommodate the likely need for hospitalization and related resources (e.g., ventilators) is the key analysis. Only when the rate of new infections has slowed to a pace where local healthcare resources are able to absorb the likely number of new cases can a region ‘graduate’ to ‘stable status’. As the relevant data is collected and independently verified, a particular county would be assigned a color (red, amber, green) to signify whether its infection rate relative to healthcare capacity was unstable, progressing toward stable or stable for the purposes of engaging predetermined economic activity.

This kind of staged approach has a lot of common sense. But, it requires effective leadership at both the national and local level to achieve maximum possible buy-in, collaboration and enforcement. 

The federal government needs to lead by establishing the plan’s criteria and communicate clearly and consistently.  The White House should not announce one date when the country will “re-open,” but rather the framework by which areas of the country can re-open.

Local governments need to mobilize their relevant communities in the business, education, non-profit and political arenas to support the agreed-upon set of evaluation criteria and steps that follow from community progress.  Only then, will reaching commonly recognized and measurable goals enable some normalization of social and economic life.