Covid-19 after the lockdowns end: We need Contact Tracing to make our world safe again!
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The nation's governors must start immediately on the development of a system to trace the contacts of people who test positive for Covid-19. Then only those who are at risk of being infected need to be quarantined. Medical experts agree that this is instrumental so that the current restrictions can be eased, without allowing the virus to spread uncontrollably again. The current stay-at-home orders and recommendations are re-setting the clock by slowing the spread of the virus. We urge our leaders to use this opportunity and prepare for what comes afterward.
Social Distancing is working, but...
As a nation, we’ve come together to face this pandemic. People all over are Socially Distancing, they are obeying voluntary and mandatory Stay-At-Home orders, and they are wearing face masks when they have to get closer than 6 feet at grocery stores, pharmacies and other ‘essential’ locations. Infections seem to be plateauing, and some governors have even been able to return ventilators to the National Stockpile. Those are the good news, and we are grateful for them.
We also realize that the costs of the lockdowns are tremendous in every way. We really want this to end soon – and not to have it come back.
The End is in Sight?
The nationwide 'Social Distancing,' as well as the lockdowns in Washington, California and other states, are scheduled to end in early May. While we are patient because it is necessary, we also look forward to the day when life will return to normal (or almost).
But we also know that if we just return to business as usual, the virus will rear its ugly head again. Another lockdown will be necessary within a short period of time. Just a reminder: California issued its Stay-At-Home order just six weeks after the first case was detected in the state. Six weeks is a short window – and the second time around, with the virus still widespread, it may be shorter still. It's scary, but fortunately that isn't the only possible scenario.
Lockdowns are not the only answer
What we need is a strategy of how to prevent future lockdowns. Because the lockdown doesn't solve the problem. It only resets the clock. It gives us an opportunity to start over. It allows us to avoid the mistakes we made the first time around.
One thing should be clear: The current lockdowns were not unavoidable. They are the result of a failure to take Covid-19 seriously at first. Sandra Zampa, the Italian health ministry under secretary, summed it up well: Most of the world looked at the example of China, not as a practical warning, but as a “science fiction movie that had nothing to do with us.”
The few countries that did take the virus seriously from the beginning and put in place the right measures – Taiwan and South Korea, among others – have not just avoided the horrific death toll, but also the disruptions of life and economy that have engulfed the West. People there continue their work and lives with relatively few restrictions, yet infections aren't skyrocketing as they are here and in Europe. We don't mention this to point fingers and assess blame. Instead we must work together and use every opportunity to learn and implement real solutions.
So we know that the lockdowns were not unavoidable. And we really want to avoid them in the future. We cringe when we hear predictions that the lockdowns will be eased, only to return when the virus spreads again, through cycle after cycle until a vaccine will be developed, tested and deployed – hopefully – in a year or two. We feel like we're on a rudderless ship being swept about on stormy seas, when we all should be pulling the oars to face the waves head-on and continue our journey. Everybody wants to get back to something resembling normal life, but it won't happen unless we work for it.
How to prevent future flare-ups
Experts are clear on what is needed: Infections need to slow to the point where hospitals are no longer overwhelmed. Manufacture and distribution of test kits and protective gear must catch up. That is the 'easy' part: The lockdowns will achieve those goals. (Let's not talk about the states that haven't even enacted a lockdown yet.)
Experts also agree that we need to contain the virus after we emerge from the lockdown. The virus will still be with us – we need to keep it from spreading out of control again. A lockdown is a blunt tool: We assume everybody is infected, so we quarantine everybody. This works, but the costs are huge in every respect.
Now that we have a chance at a redo, we need a more finely-tailored lockdown: Quarantine only those who are infected, not everybody. More tests will help us figure out who is infected. But testing randomly is not the answer – it's impossible to test the entire population. And you'd have to do it time and again, since somebody who tests negative today may get infected tomorrow.
This is where contact tracing comes in: You deploy the tests strategically. Whenever somebody tests positive, you test everybody who has been in close contact with them: their family members and co-workers, those at their schools, even the cashier who checked them out at the grocery store, and the people who sat near them on the bus or on an airplane. And if any of these 'contacts' test positive, you trace their contacts, too. It's the complement to social distancing – keeping an eye on those who've entered the 6-foot radius of an infected person.
Contact tracing is nothing new: It's standard practice when dealing with outbreaks of diseases. With Covid-19, contact tracing was abandoned in the very early stages of the outbreak in the United States. There simply weren't enough resources to trace the contacts as caseloads were increasing exponentially. In the future, the systems for contact tracing must be beefed up, so that we don't have to resort to quarantining everybody again.
How do you do it? There are different ways, from high-tech surveillance using people's cell phone data to low-tech questionnaires. All require organization – and that has to happen right now, so that the tools are in place (and tested) when we emerge from the lockdown in a few weeks.
For a variety of reasons, the United States is poorly equipped for this public health emergency. Expert after expert has written Op-Eds, there have been articles in the New York Times, on CNN and NPR, outlining the path forward and stressing the need for contact tracing. But their urgent pleas risk being ignored.
The federal government has made it clear: It considers the response to the pandemic a matter the states should handle. And most states only have part-time governments – the Washington State Legislature is not scheduled to meet again until January next year. That will be too late!
Petition to the Governors
Contract tracing is not the only thing we need to do, but it's a essential tool to identify who is at the risk of being infected. And yet the only state working on a program to trace infections and their contacts appears to be Massachusetts. That is encouraging, but all other states need to join that effort. In fact, it may be best if states work together, since infected people may travel across state lines before they develop symptoms and realize that they are infected. However it is implemented, all experts agree that contact tracing is essential if we want to return to normal – and stay normal.
Faced with inaction from those who should lead us, we're launching an extraordinary campaign to petition the National Governors' Association to immediately develop a system to trace the contacts of those found to be infected with Covid-19 and test them, too. (We'll submit the petition to each state's governor as well.)
Please sign our petition. Then let your friends know about it. Thank you!
—Jan & Natsuko
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