Photo by Fusion Medical Animation on Unsplash

Many have asked, “When will social distancing end?”

A better ask: “What needs to happen so we can return to normal life?”

Oh, I’m so glad you’ve asked! The Road Map to Reopening outlines a plan and strategy moving forward with COVID-19 that answers this question. Please keep in mind the evolving nature of this situation as plans may change and new evidence may provide more information.

Plan trigger:

When people begin testing positive for the virus with no travel history and this appears in multiple locations, Phase One should begin. The earlier Phase One begins, the more lives saved.

Phase One: Slow the Spread.

This phase aims to decrease the number of people who catch the virus from each infected person and should include actions like:

The number of tests and the speed at which we carry them out must increase before relaxing any measures.

Should we wear masks?

Emerging research indicates that masks can help reduce the spread of SARS-CoV-2. The general public should at least consider wearing fabric masks in Phase One.

Fabric masks in the general public may work as prevention because presymptomatic people can spread the virus before they know they are sick, but Americans should not be wearing surgical or N95 masks. I discuss this in more detail here. Newsweek summarized a wealth of expert opinions including WHO, CDC, and Johns Hopkins.

The CDC is currently considering recommending face coverings in public.

CAUTION: Fabric masks can increase risk if not washed or touched frequently by wearers. If the mask leads people to touch their faces, then it could do more harm than good.

Our situation is less than ideal, so consider all evidence, your circumstances, and continually update yourself as new research publishes every day.

When can Phase One end?

States can transition to Phase Two when:

Photo by CDC on Unsplash

Phase Two: Reopen, State by State.

Relaxing and lifting the strictest social measures should begin in Phase Two. The vast majority of businesses and schools should re-open. Notably, we must continue to maintain the distancing and hygienic measures where possible. Those aged 60 years or older and high-risk individuals should continue to distance or self-isolate.

Phase Two may lead back to Phase One, so states should take care not to give the impression that there is no need for preventative measures anymore.

Strategic recommendation: Those who are immune (methods to identify those with immunity exist but have yet to scale-up) could serve in high-risk roles, especially those involving the care of elderly people.

When can Phase Two end?

Once a state has a strong system with funding and staff capable of detecting and testing cases, contact-tracing, quarantining and isolating

AND one of two options develops:

  1. treatment that decreases the risk of severe symptoms/death or
  2. a vaccine has been developed with demonstrated safety and efficacy

then, Phase Two may end.

Phase Three: Establish Protection Then Lift-All Restrictions.

Phase Three aims to prevent spread, treat serious cases to prevent death, build population immunity to reduce death and slow the spread, and to allow all physical distancing to end.

Behind the scenes: Blood testing to understand immunity, vaccines and treatment prioritize toward groups most at risk for hospitalization or death, and planning for mass vaccination (where will they be offered and by whom?).

Then, comes the most important part.
Phase Four: Preparing for the Next Pandemic

As we saw with COVID-19, public health infrastructure and quick action make the difference. The US started Phase One nearly two months after confirmed community spread cases appeared.

Prevention is significantly cheaper than attempting to plan and use a response at the same time. Planning makes us safer and less panicked.

Imagine a world where you had known about social distancing, curve flattening, and the steps, outlined here?

It’s the reason we do fire drills — we know during a fire is not the time to teach people how to safely navigate the situation. We must regard pandemic preparedness as we do fire safety. Support politicians who fund public health measures like health security and pandemic preparedness. These save lives and money — universal appeal.

“Everything we do before a pandemic will seem alarmist. Everything we do after a pandemic will seem inadequate. This is the dilemma we face, but it should not stop us from doing what we can to prepare. We need to reach out to everyone with words that inform, but not inflame. We need to encourage everyone to prepare, but not panic.”

Michael O. Leavitt, 2007

Key reference:

Gottlieb, S., Rivers, C., McClellan, M. B., Silvis, L., & Watson, C. (2020). National Coronavirus Response. American Enterprise Institute.

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