Aldi grocery store in North Versailles, Pa. on March 31, 2020. Photo by Flickr user daveynin.
It was one month ago, on March 16, that governments across the San Francisco Bay area ordered businesses to close and residents to “shelter in place.” America’s COVID-19 pandemic shutdown had unofficially begun.
By April 1, about 95% of the nation’s population was under some sort of government mandate to maintain social distance and “flatten the curve” of critical illness. For businesses deemed nonessential – meaning most that are not involved in delivering food, funds, household goods and medical care – that meant having employees work from home, if possible, or shutting down.
The government reported yesterday that retail sales were down 8.7% last month, despite the rush to buy masks, groceries and paper products. Today's unemployment claims report puts the four-week loss of jobs somewhere north of 20 million, with a bit of distortion for seasonal adjustments (which raise the headline number to 22 million) that probably do not apply in this strange economic season. In Washington, the administration and Congress are negotiating yet another financial support package that will bring total stimulus spending to the vicinity of $3 trillion.
We have never done anything like this in the past: halting most aspects of daily life to fight a disease and save lives. Having never taken such far-ranging measures, we naturally have no experience at how to reverse them.
We are now starting to confront the question of how to reopen the economy. There is near-unanimous agreement among public officials and responsible business leaders that we should not relax anti-pandemic measures too rapidly or broadly. Doing so could trigger or greatly worsen the much-feared “second wave” of the disease. With the possible exception of China, which experienced the pandemic first but whose statistics are questionable, it is too soon to lift or substantially relax social distancing measures anywhere without risking a costly, demoralizing setback.
But it is not too soon to think about when, where and how to relax those measures.
Despite some presidential jawing and backtracking this week about the extent of federal power, a reasonable division of labor has evolved in the pandemic management effort. The White House has controlled the nation’s external borders, shutting down most travel with China in January and travel to much of the rest of the world in early March. Internally, Washington has provided guidance and resources to states. Governors have largely managed the distribution of those resources and the domestic implementation of the social distancing, testing and treatment guidance.
This division of labor will probably continue, with perhaps one significant change: It would not be surprising to see the federal government supersede state restrictions on interstate travel. The White House would be on solid constitutional ground if it asserted such control over interstate commerce. The spectacle of Texas Rangers demanding that incoming travelers quarantine themselves and taking addresses for follow-up checks, or of Florida’s governor singling out travelers from New York and other national hot spots for isolation that he did not require of his own South Florida citizens, may not last long past President Donald Trump’s target date of May 1 for ending his national stay-at-home advisory.
Perhaps in anticipation of this deadline (among other reasons), governors in the Northeast and West Coast states formed consortia to coordinate their states’ return to some semblance of commercial normalcy. Banding together will let them argue for expanded movement within their respective regions. At the same time, it will let them maintain tighter controls against re-importation of the virus from regions of the country that are farther back on the epidemiological curve.
I expect we will see many local and state restrictions lifted in roughly the reverse order in which they were applied. Office workers in “nonessential” industries who do not routinely deal with the general public, and service providers who work in small groups (for example, real estate agents) will probably be permitted to return to work first. They should expect restrictions on the size of meetings and the proximity of work stations, and requirements for wearing face coverings, when they do. Construction, manufacturing, forestry, mining and retail establishments other than bars and restaurants will likely reopen at the same time or soon thereafter under similar strictures.
The biggest challenges will be in restoring normal function in settings where large numbers of people must be close together for long periods of time. We now know how readily individuals who are either pre-symptomatic or asymptomatic can spread the virus through the air. We tragically did not know as much in the pandemic’s first months. This gap in our knowledge allowed the virus to evade our initial efforts to control the spread by staying home when we felt sick and by washing our hands often when we were out and about. Now we know that we can only protect ourselves by avoiding the virus in the first place, or potentially by acquiring immunity through prior exposure, or through vaccination.
Vaccination does not yet exist as a real strategy; the first trial vaccines are only in the early stages of testing. Acquired immunity through exposure is also, at this point, not useful as a guide to when we can resume normal life. We don’t know how many people in a given population have already been exposed but never had their exposure confirmed through testing. Some studies are getting underway that will shed light on this. In one, 10,000 people associated with major league baseball (everyone from players to stadium ushers and vendors) have agreed to undergo anonymous testing for antibodies that show previous exposure to the virus.
Even when we know how many people have been exposed, we will not know the degree or the duration of any immunity that such exposure confers. We can only acquire such knowledge with time. One of the knottier problems in reversing the virus-induced shutdowns is the degree to which we want to assume prior exposure confers immunity.
For most of the United States, the current school year is effectively sunk except for online learning. The bigger question is how to prepare for the school terms that would usually begin in August and September. Should Georgia, which has still not seen its COVID-19 peak, plan to send kindergartners through high schoolers back to classes at the start of August? Will college campuses reopen as usual for their fall terms? Can they even afford to open if foreign students and their vital tuition dollars are not available? Is it safe for students and their instructors to interact when those students, who may not show symptoms, spend evenings together in study groups or recreational activities (surely today’s underage students never go to bars) before returning to shared dormitories, or fraternity and sorority houses?
Before we address these questions, officials must consider what to do about summer camps. Will we allow sleep-away camps to operate as usual, on the theory that bunks of full of youngsters and counselors are at relatively lower risk? Will we make the occupants and camp staffs get tested first? Even if sleep-away camps can operate, what about day camps, which provide important child-care services for working parents when school is out? What about other day care facilities?
Transportation is another problem. Is it feasible to operate airports and airlines at traffic levels that allow for any kind of useful physical distancing? What about subway, commuter rail and bus service? How much can “normal” commercial life resume if such travel if limited? Without transportation, how much can the tourism industry recover and salvage its summer business?
The early stages of any reopening are likely to emphasize testing, isolation and contact tracing. This is much easier said than done. Even if we test someone for the virus once and the test comes back negative, it will not tell us anything about whether the individual will contract the virus tomorrow or next week. We can’t test everyone every day. Even if we could, there will be a certain percentage of false negative results. This virus’s ability to spread from asymptomatic hosts is what makes it so difficult to stop without a vaccine.
We will have to prepare to live with a certain level of illness until a vaccine comes along. There is no way around that fact. We can save lives by trying to focus that illness on the less vulnerable young and healthy populations. This means, sadly, that restrictions on visits to nursing homes are likely to be among those to stay in place the longest. It also means that businesses and employers will be under pressure to keep older and health-compromised workers away from their colleagues as much as possible.
And finally, what about the events that bring us physically together as a community – assembling for worship, gathering to root for our favorite team, marching in parades and watching those marchers, or attending concerts, county fairs, conventions and corporate retreats? Will we see a World Series played before an empty stadium? Or a Super Bowl?
I don’t know. Nobody does, for now. But I will predict that we will have a World Series with fans in attendance in 2021, and a full Super Bowl stadium in 2022. It will be a slower and longer road back to our old lives than we would wish, but we will get there – or to something close – in due course. We just need to work out the route before we start the journey.