Friday, April 10, 2020

Reopening: Milestones, Not Dates

by Calculated Risk on 4/10/2020 03:12:00 PM

It appears the US is close to peak cases per day. Social distancing, hand washing and shelter-in-place orders are workings.

This means we need to redouble our efforts over the next several weeks. Minimize our contacts (social distancing), wash our hands, and wear a mask or face cover whenever we are in public.

We need to shift the reopening discussion away from being date specific to milestone specific. I believe there are two clear milestones that we need to achieve before reopening (these are my suggestions, and I'll defer to the experts on the milestones).

First, Impact on Hospitals and First Responders:

a) We need to return to standard levels of care. Dr. Gottlieb, et. al. described this as "Hospitals in the state are safely able to treat all patients requiring hospitalization without resorting to crisis standards of care"

b) We need to have adequate PPE for all healthcare workers and first responders. We must do everything possible to prevent further deaths of healthcare workers.

c) Healthcare workers and first responders should be able to be tested on demand.

Second, we need a robust Test-and-Trace program:

a) Apple and Google announced today software that can help with contact tracing.

b) We need to increase testing capabilities to several hundred thousand per day (maybe close to a million per day).

c) We need a well trained team to follow-up on tracing, and also to regularly contact all people in self-quarantine.

d) This requires naming someone to head the test-and-trace taskforce with extensive logistics and medical experience (maybe co-chairs). Perhaps the states should name someone.

With clear milestones we can progress toward slowly reopening the economy.

We will need clear guidelines in advance of reopening (mask wearing, minimize groups, etc) and consistent messaging.  We can do this.