BAR HARBOR — There have been over 970,000 confirmed COVID-19 cases in our nation, resulting in nearly 55,000 deaths. Between March 15 and April 1, the number of new cases emerging daily in the U.S. grew 26-fold. Undeniably, this pandemic is also triggering the worst recession in living memory, dragging down the global GDP potentially by over 3 percent.
The good news is that the social distancing policies most states enacted are “flattening the curve,” as the number of new cases identified per day has not increased significantly since April 1. This means control of the pandemic is in sight. Already every state is making plans to relax social distancing restrictions to get the economy going again. But unlike the 2008 economic crash, this virus follows only the laws of biology, so any successful economic solution must take into account scientific realities and engage medical interventions.
So, what do we do? First, we must understand that our top two goals – saving lives and restarting the economy – need not be mutually exclusive. We will have to “thread the needle” between the two options. Second, no single intervention will restore the economy safely. Many actions must be simultaneously applied to have the greatest effect. Third, we should acknowledge that we will make mistakes along the way. The key is to test solutions incrementally and quickly change course if we have to. Lastly, there are scientific realities that cannot be ignored and upon which our decisions must be made. Science must have priority over politics.
If we accept these premises, then operationally, this is what we must do: All employees coming back to work, regardless of symptoms, need to be tested, and those who are actively shedding the virus must be on isolation until they are clear of COVID-19. This is perhaps the most important action to ensure a safe economic recovery. During that time, isolated employees would be eligible for paid leave and benefits under the Families First Coronavirus Response Act and the CARES Act and from state funding. In the recent past, only significantly ill patients could access COVID-19 testing and only at medical sites. This has to change.
Viral testing should be freely available and be collected at convenient nonmedical sites such as pharmacies and workplaces. It is now known that many asymptomatic carriers in the population can inadvertently infect others. By quarantining such individuals, we block this spread without locking down the economy. Antibody tests had been discussed as a substitute for viral PCR tests. However, antibody assays have not yet been validated, and therefore, cannot at this time be used as the basis for a return-to-work plan.
After testing, individuals who are virus-free should be certified to re-enter their workplace. All this can be done using modern application-based approaches, since such extensive population screening cannot possibly be accomplished manually. Individuals would use an app to register for the COVID-19 test and then be certified for their COVID-19 status online. Employees will control their test information, and sharing it would be a consenting transaction between the employee and employer. This is especially important for some essential services.
Along with testing, self-monitoring and modulated social distancing should still be practiced. With a little creativity, restaurants can reopen with different seating arrangements, varied seating times and COVID-free certified staff.
Finally, there should be an orderly and staged return-to-work process that is transparent to the public and calibrated to community risks. We should open in increments, with each increment triggered by objective data. Is this going to be expensive? Yes, but the CARES Act mandates cost-free COVID-19 testing, and these costs pale in comparison to the $2.1 trillion that the U.S. is estimated to have lost in this pandemic.
In time, this will pass, but like the changes that occurred post-9/11, the world will not be the same. 9/11 triggered a “new normal” with the establishment of the Transportation Security Administration and airport screening. There will now be a new normal for public health, since pandemics will become a more common threat. Going forward, we will need organizational structures designed to meet such future health-security challenges as a necessary function of an effective state.
Maine has many advantages in this crisis: Our population is small, our leadership is competent and, in the matter of the health of Mainers, they are completely unified. Let’s take advantage of who we are.
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