When we begin to reopen, whenever that occurs, we will all need to accept continued personal responsibility for controlling the spread of COVID-19.
Governor Baker faces difficult judgment calls about the pacing of reopening. Without expressing an opinion on the particulars of his judgment calls, he is taking fundamentally the right approach – namely, an incremental and data-driven approach.
For all the reasons that we had to shut down, the potential consequences of re-opening too fast are unacceptable. Given the risk of a catastrophic second surge, the only safe way to proceed is incrementally. We will want to open in phases and evaluate the disease statistics daily for any early indication of an upswing.
As we slowly reopen while the virus is still at large in the community, it will be more important than ever to do the basic things that all the public health professionals tell us will reduce the rate of transmission: Wear masks, don’t touch our faces, wash our hands frequently and especially after making contact with high touch surfaces, stay home when we feel sick, work from home whenever we can, maintain physical distance from each other.
Some businesses and employers will need to change their operations to support more distancing. If the conclusion is that people have to come in, can they come in on some kind of shift system? Does everyone need to come together at the same time?
The Governor bears primary responsibility for pacing the reopening, but it will be on all of us to take the personal precautions that will make the reopening work. People managing the work of others will bear special responsibility for protecting their employees. Customer-facing business managers will bear special responsibility for protecting their customers. The testing, hospitalization and death rate numbers will tell us whether we are all being careful enough to make the governor’s reopening work.
There has been a lot of discussion about the role of testing and contact tracing as a strategy for controlling the epidemic. The state has made huge progress in the expansion of testing. We had lab capacity for only a couple of hundred tests per day at the start of the epidemic. We have built the lab capacity to do over 30,000 tests per day in a few frenetic weeks.
Despite the increased lab capacity, we are tending to test only about 10,000 people per day. The Governor has announced targets of testing 45,000 people per day by the end of July and 75,000 by the end of December.
The further expansion of lab capacity will be relatively easy. Recruiting enough people to get tested will be the challenge that may keep us from achieving Governor’s stated goals. A consortium of consultants and experts has prepared a widely-circulated presentation about strategy for reopening. Although we have already hired 1000 contact tracers, the consortium suggests that our contact tracing operation might have to expand ten fold to trace and test enough contacts to control the epidemic.
The consortium presentation also highlights the importance of the speed of tracing and testing. We have to catch people early in their infection cycle. If we don’t catch them quickly, they may continue to move around and infect others for several days before they become aware of their disease. As we open up, tracing will get harder and harder because infected people will have more known contacts to trace and also more untraceable anonymous contacts.
While the consortium endorses the goal of widespread testing, the take away from their presentation is that it is going to be very difficult to achieve the scale and rapidity of testing that we need to control the epidemic.
We will succeed in rebuilding our economy only through a carefully staged reopening and sustained adherence by all of us to personal practices and lifestyle choices that control transmission of the disease.