Wednesday, March 25, 2020

A 40-Day Plan to Start Recovery

by Calculated Risk on 3/25/2020 11:31:00 AM

Based on the experiences of other countries, it appears the number of cases per day (and deaths per day) will peak about 2 to 3 weeks after well observed shelter-in-place orders are issued (some areas are reporting less than 2 weeks - that would be great).

In some areas of the United States, shelter-in-place orders were issued a week or more ago. In some states and communities, orders have still not been issued.

Based on the experience in China, it appears the recovery can start in about 40 days after a national shelter-in-place - if certain rules are in place.

So here is a suggested 40-day plan to start recovery:

Today:

1. The Federal Government should ask all states to order Shelter-in-place (except for essential workers and businesses).  This starts the clock across the country.

2. Use the Defense Production Act to increase supply of Personal Protection Equipment (PPE).   We must protect our healthcare workers.  This includes masks, gowns, face shields, and other protective equipment - and also medical equipment, primarily ventilators and ICU beds.

3. Sign Disaster relief fiscal policy into law.   This will help Americans impacted by this national disaster.

4. Name a head of a national Test-and-Trace-and-Quarantine task force.   Start putting in place the necessary manpower and tools to conduct test-and-trace when testing capacity (and sufficient PPE) allows for testing all contacts of anyone who has tested positive.   We can't do this surveillance testing today due to lack of testing capacity and insufficient PPE (the priority for PPE is our healthcare workers and first responders) - but we should be able to do test-and-trace a couple of weeks after the cases-per-day peak.  We must be ready!   We will need people in the field, and software to track contacts, and also software (and manpower) to call those in quarantine twice a day until they test negative twice.

Every day:
1. Remind people about shelter-in-place, hygiene, and minimizing contact with others.  

2. Ask people to keep a record of where they go, and the people they have contact with.   This will be important once test-and-trace starts.

After Cases-per-day peak:
1. Continue to manufacture PPE, especially surgical masks - there will be another need for these masks.

2. Start test-and-trace and quarantine program as soon as possible after cases-per-day peak.   This will identify asymptomatic people that will need to self-quarantine.

About 40 days from now (maybe sooner in some areas).  Note: This will require an operational test-and-trace program, and sufficient masks for anyone who needs one.
1. Start easing shelter-in-place rules.

2. Require anyone in close contact with others to wear a mask (this is why surgical mask production must continue at high levels, even after the number of cases slows0.  People need to wear masks, not to protect themselves, but to protect other people.  This will help slow the spread.

3. Remind everyone daily about hygiene and minimizing contacts and staying home when sick (even as restrictions ease).

4. Anyone with even mild symptoms should be tested.   Wide spread testing - and following up with test-and-trace will keep the spread minimal.

The crisis will not end completely until a vaccine and effective treatments are available, but the economic recovery could start in 40 days (or less time in some areas), if the Federal government takes action today.