In order to safely reopen our schools, we may need to hit the brakes on our phased reopening of the economy in Massachusetts. The latest numbers are telling us that we may need to reclose some businesses or find other ways to reduce infection.
As we manage the reopening of the economy, we need to think more clearly about the trade-offs we are making and the consequences we are willing to accept. The decision to open optional services like casinos, movie theaters, and health clubs may make it impossible for us to safely reopen our schools.
There is some guesswork in estimating how each specific business closure or infection control measure will affect the average rate at which people with COVID-19 transmit it to others. That transmission rate is referred to by the letter R. It is not possible to reliably estimate the R that will result from a particular level of economic opening.
But there is no guesswork in the consequences of different R values. If R is greater than one, then the epidemic will expand. If it is less than one the epidemic will wane. When COVID-19 was initially expanding, R was between two and three and the positive test count was doubling every few days. By late April, the shut down had spread people out and reduced transmission opportunities, driving R below one. As a consequence, the daily new case count began to drop and is now a tenth of what it was at the peak.
Yet, about a month ago, as a result of additional social transmission from reopening, R rose back to roughly 1. Each infected person is now infecting roughly one other person. We know this because the new case count has stopped dropping. Over the last month, it has been fluctuating in the low hundreds (well above the levels in early March when alarms first went off). Most recently, the new case count appears to be drifting up, even though the volume of testing has remained steady.
The fact that case counts are not dropping suggests that what we are doing now is just barely keeping a lid on the epidemic and that if we open up much more, R will rise above one and the epidemic will start growing again. For all the imprecision about particular measures, the leveling off of the case count is sending a clear message: We open further at our peril.
Yet we plan to open further. We plan to receive thousands of college students back into the state, especially in the Boston and Northampton areas. And we hope to at least partially reopen our elementary and secondary schools. While safety precautions will help control transmission, it seems a stretch to imagine that transmission among students and from students into the community will not push our infection rate up substantially.
Ideally, as we prepare for the fall and the added transmission that school opening (and generally increased contacts indoors as the weather changes) will bring, we would still be seeing falling case rates suggesting that our R value was below one. That would tell us that we might have the capacity to add some additional social contacts without pushing our R above one. But that is not where we are. Currently we are embarking on the third phase of the Governor’s four phase reopening plan and R is already creeping above one.
Moving back from Phase III to Phase II would mean closing casinos, fitness centers, health clubs, movie theaters, and museums. It would also mean delaying the arrival of college and university students on campus. Alternatively, maybe we should revisit elements of Phase II that may be contributing more to infection than some elements of Phase III.
Our elementary and secondary schools should be a high priority — for children and for working parents. We should demonstrate that we can get them functioning without driving our total transmission rate above one and then we should open less essential businesses and bring students back to our universities.
Massachusetts has done a good job in shutting down the economy to bend the rapidly rising COVID-19 curve, building up the health care system to avoid care shortages, and defining clear safety rules for each kind of business and institution as they reopen. But the numbers are now sending a message: We may be setting ourselves up for trouble in the fall. We could be on the cusp of making the same mistake that other states have made.
Each choice to reopen a category of business adds to the transmission rate. Let’s face up now to the fact that our transmission rate is creeping above one and reassess our plans. We need to make choices about what businesses and institutions should stay open in a way that reflects community priorities and acknowledges that there are trade-offs — we can only reopen so much of the economy without risking catastrophic resurgence of the disease.
- 91-DIVOC — COVID Visualizations
- NY Times compilation of Massachusetts statistics
- County level R estimates — COVID Act Now
- Governor’s Phase III opening order
- Massachusetts COVID-19 Dashboard
- Krugman Op-Ed: America Drank Away Its Children’s Future
- COVID-19 Social Distancing (willbrownsberger.com)
- COVID-19 Recession Relief (willbrownsberger.com)
- COVID-19 Community Resources (willbrownsberger.com)