Here are two truths. First, we must reopen sometime. And second, nothing has so far changed to make the virus that causes COVID-19 any less contagious or deadly than it was before, when social isolation seemed like such a necessary sacrifice.
The point of sheltering in place was to buy time to build systems to minimize virus spread (or the virus mortality rate). We have bought the time, at great personal and financial cost. But who has built the systems, passed the laws or worked to normalize the new social etiquette to mitigate against the spread of infectious disease?
In fact we have done little to change protocol or immunity for the future. We have little contact tracing, no vaccine (yet), and somewhat less ER equipment than we had before. We don't have herd immunity precisely because social distancing has worked well. We haven’t expanded sick leave or passed laws protecting sick workers who stay home.
So if we do reopen now, why should we think things will be different than they were six weeks ago?
COVID-19 is no less virulent today than it was when it began, and we have changed nothing about our society to suggest that its spread will be attenuated when we go back to normal. Surely a second wave is inevitable under these circumstances.
During the Spanish flu of 1918-1920, the second wave was more deadly than the first.
Here are some key ideas that should be considered by any government hoping to forestall a second, more serious wave of coronavirus infections after society reopens.
1. More testing.
2. Isolation and quarantine support for those who test positive but do not immediately need hospital care. If people test positive, return home and then fail to self-isolate, the tests have made no difference. Supports that would help include two weeks of food, paid for and delivered by the state (to reduce an infected person’s need to go out to get food); mandatory paid sick leave for those who test positive, subsidized by the state; and laws against working after a positive test until cleared by a doctor or until 14 days have passed.
3. Contact tracing. Anybody who tests positive should provide a list of people with whom they have been in close contact in recent days. Those contacts should be called and required to self-isolate for 14 days, also with public support.
4. Continued research into the disease, its treatment, and its prevention.
5. Temporary or permanent hand-washing stations in public spaces. These might make sense on playgrounds after they reopen, in shopping malls, around Temple Square and at public transportation hubs.
6. Staged reopening. Businesses should be opened in two-week tranches, assessing the effect on viral spread at each stage.
7. Low-level social distancing laws that can be implemented rapidly with minimal economic and social impact. The state and individual municipalities should be prepared to temporarily require face masks in all shops, or in all public spaces, the moment COVID-19 cases tick up after reopening. Additional measures along these lines include temporary park closures and six-foot physical distancing requirements in workplaces.
The hope is to keep businesses and social spaces open once they have reopened, but to have an arsenal of simple changes that can be required for the short to medium term if a second wave appears to be building. Leaders should be considering these measures now, and should make the possibilities public.
We must work towards revivifying our economy, our schools, our religious institutions and our social and extended familial lives. But we must do this intelligently and strategically. Simply waiting is no strategy. Nor is opening up rashly.
ShawnaKim Lowey-Ball
ShawnaKim Lowey-Ball is an assistant professor of history at the University of Utah.