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Public health experts are increasingly worried that Americans are underestimating how long the coronavirus pandemic will disrupt everyday life in the country, warning that the Trump administration’s timelines are offering many a false sense of comfort.
Coronavirus cases are expected to peak in mid-April in many parts of the country, but quickly reopening businesses or loosening shelter-in-place rules would inevitably lead to a new surge of infections, they said.
Meanwhile, other parts of the country are only now implementing restrictions and others have not yet ordered the closure of non-essential businesses, creating a patchwork response that will slow progress toward the goal of driving down transmission of the SARS-CoV-2, the virus that causes Covid-19.
“The administration has consistently shown a desire to underplay the severity of whatever is coming. And they’re constantly adjusting that — as it becomes harder to deny the reality will be worse than what they’ve conditioned people for,” said Jeremy Konyndyk, a senior policy fellow at the Center for Global Development.
Konyndyk said he and other experts he’s discussed the matter with believe an “intensive period of social distancing and a national semi-voluntary lockdown” will last for months.
President Trump, after signaling that he may try to restore some sense of normalcy in the country by Easter, has acknowledged that difficult times are ahead and that restrictions should remain in place until the end of April.
But experts say that, even if some restrictions are relaxed, it’s unlikely life as normal will resume in early May.
A former director of the Centers for Disease Control and Prevention, Thomas Frieden, said this week that it’s understandable that people want to know when businesses can reopen and some facets of life can resume. But he said the focus of public discourse now needs to be on the public health response, not the question of when restrictions can be lifted.
“Decisions to reopen society should not be about a date, but about the data,” Frieden, now president and CEO of the global public health initiative Resolve to Save Lives, said during a briefing Wednesday for journalists. “How well and how quickly we do these things will determine how soon and how safely we can reopen.”
He and others have outlined steps that should be taken before restrictions are lifted to ensure new cases do not continue to grow exponentially, collapsing health care systems under their weight. Frieden stressed the importance of expanded testing to know where the virus is transmitting as well as setting up public health
infrastructures to trace the contacts of cases and monitor them in quarantine.
“We need an army of contact tracers in every community in the U.S. to be ready to find every contact and warn them to care for themselves and stop spreading it to others,” he said.
Those resources do not current exist, said Konyndyk, who also noted that hospital capacity across the country needs to be expanded and protective equipment for health workers restocked. There are currently global shortages.
“If we want to be able to — as I think we need to — turn our economy back on in a safe way, we need to be able to do that sort of thing at scale,” Konyndyk said. “And we do not have anywhere close to the public health infrastructure that’s needed to pull that off.”
“That’s fundamental to getting us out of this lockdown phase. And the government’s not talking about it, much less acting on it,” he said.
Public health experts have said the near-term goal is to flatten the epidemic curve of new cases. There are signs that the San Francisco Bay Area and Seattle are starting to see some results in this respect, but progress is not yet apparent in most parts of the country.
Michael Mina, an infectious diseases epidemiologist at Harvard’s T.H. Chan School of Public Health, said the United States squandered a chance to prevent the virus from taking off here and now must do what it takes to beat it back.
“We let things get out of hand,” said Mina, who is also associate medical director of clinical microbiology at Boston’s Brigham and Women’s Hospital. “So now the place that we’re left in is we have to absolutely beat this down with a hammer and get to near zero cases.
“What the means is we have to be patient. By the end of April shouldn’t be anyone’s consideration at this point,” he said. “We have to assume at the very least this is going through May.”
Others suggest it may be longer before stores and restaurants can reopen, before authorities can consider reopening schools and universities.
Philanthropist Bill Gates warned in an appearance on “CBS This Morning” on Thursday that things like lifting bans on mass gatherings — public meetings or concerts — could be quite a way down the road.
Some activities, like reopening schools, might be deemed low risk and of societal benefit, Gates said. But mass gatherings “may be, in a certain sense, more optional.” Until large numbers of people can be vaccinated against the virus “those may not come back at all,” he said.
Though vaccine development is proceeding at a historic pace, in a best-case scenario a product won’t be available for the general public for at least 18 months, and likely longer. Early supplies, which will be limited, would be used to protect health workers.
Konyndyk and others warn that lifting restrictions will need to be done gradually. And the Trump administration has told state governors it will issue county-by-county guidelines on the level of risk, an effort to help local officials decide when to relax restrictions.
Still, experts are worried that if the current measures work, success could have a paradoxical downside: People who are still vulnerable to the virus will see the risk as over, leaving open the possibility of resurgent spread.
“Success is we have a lot of susceptible people left against a disease for which there is still not effective or proven treatment and no vaccine — and won’t be for some time,” Konyndyk said.
Experts say even a return to normal could come with asterisks. Mina noted, for instance, that restaurants may need to put more space between tables. Others have suggested people in high-risk groups — those over 65 or 70 and people with chronic conditions — may need to practice physical distancing even after restrictions have loosened for others, at least until vaccine is ready.
“We’re at the front end of what will be a pretty arduous few years of something. What the something looks like, we don’t fully know,” said Konyndyk. “But I think our best case scenario is we can pull off what South Korea seems to be managing, which is get the curve down. And our job is going to be much bigger than theirs was. … Dramatically bigger.”