Over the last week, a debate about when to reopen our country has begun in earnest. If we reopen too soon, we’ll lose the progress we’ve gained by social distancing, see a new spike in cases that overwhelms our hospital system, and inject even more uncertainty into an economy that’s buckling under the weight of the worst pandemic in a century. If we wait too long, we’ll cause more economic harm than necessary to combat the virus and more Americans will die from that fallout as well; death rates always go up due to prolonged economic hardship.
Many have referred to this as a war, and to win it, our political leaders must listen to scientists. Scientists understand numbers, and much of determining the best path forward comes down to math. But as in war, the stakes couldn’t be higher because each number is a human life.
I’ve had the good fortune throughout this crisis to receive the advice of a kitchen cabinet of experts that includes Partners in Health founder Dr. Paul Farmer; North Shore family practitioner Dr. Alain A. Chaoui, who stood up one of the first drive through testing centers in my state of Massachusetts; Georgetown virologist Dr. Erin Sorrell whose expertise focuses on pandemics that originate in animals; and James Ellard, CEO of New England Biolabs Inc, a biotech company that discovers and produces enzymes for molecular biology applications, including reagents that enable researchers working to develop better diagnostic tests and vaccines for the COVID-19 virus.
We also have the help of an emergency room doctor from New York City who has helped lead her hospital through this crisis in its epicenter, and like another Gotham superhero prefers anonymity.
When it comes to reopening, these experts and all of the others are saying the same thing: to safely reopen we need six things, four Ts and two Ps: testing, tracing, time, treatments, protection and proof.
We won’t turn the tide of this war until we can test every American for the virus’ current or past presence. We must saturate hospitals, nursing homes, schools and workplaces with enough tests for Americans to get them frequently, time and again. We also need to mass produce blood tests so people like me who had all the symptoms of COVID-19 but could not get tested can tell if we actually had the virus and what that might mean in terms of future immunity. This will help us understand more of what we don’t know, which includes whether having COVID-19 once means you can’t get it again.
Testing is key because if we identify the sick, we can aggressively trace their contacts with other people and isolate those who were exposed. This is called contact tracing. Thanks to Dr. Farmer and Partners in Health’s partnership with the commonwealth, Massachusetts is leading the way on this. But contact tracing will only be as good as your willingness to isolate if you’ve come into contact with a friend or stranger who has had COVID-19. This will require some patriotic selflessness. If you get sick, you can save the lives of Americans you’ve never met by telling contact tracers where you’ve been.
We also need effective treatments for the coronavirus. Right now, we can only rely on our own immune systems to fight it off. We know that’s a different fight for everyone, but one that you’re more likely to lose if you’re older, a person of color, or have pre-existing conditions. A treatment isn’t necessarily a cure, but if we break social distancing without more effective treatments, there’s little hospitals will be able to do should infections spike again.
Until we get effective treatments and a vaccine, time is the best way to knock this virus down. The more time we spend in isolation, the sooner the virus dies out because it can’t infect new victims. Likewise, to trust that the virus has been effectively curtailed before we re-open, we have to see infection rates — measured by far more widespread testing — not just tick down for a week but stay down over time.
Finally, we need the two Ps: PPE and proof. We are sending the Americans fighting this war into combat without armor, a mistake we should have learned from Iraq. Health care workers, grocery store workers like Vitalina Williams, bus drivers, train conductors, service members, tow truck drivers and everyone else working right now deserve protective equipment and still cannot get it. And if the rest of the economy is to open up, every one of us going back on the job needs the basic gear to keep us safe in this new pandemic reality. The president can solve this problem by fully invoking the Defense Production Act instead of telling people to drink bleach. Americans should demand, at the very least, protective equipment while they’re working.
The last point is proof. There are still too many unknowns about this truly novel virus. What kind of immunity do you have if you’ve been infected and how long will it last? How many Americans have had the virus already to begin with? Will the summer heat reduce transmission or not? Science should guide our policy, but for scientists to get their equations correct, we need better proof for their best estimates. We will never know everything, but we need better answers for some pretty basic questions before we can know how reopening will go.
The longer Americans stay home, the higher the unemployment rate rises, the more people will be hurting from economic pressure, and the higher the pressure will be on political leaders to make a decisive move. Reopening is the right decision when we can test for and treat this virus, when all of us have the protective equipment we need, and we have reasonable proof that we understand enough about the pandemic to prevent a second wave.
In almost every war in history, scientists have supported our troops on the front lines. We need their support in this war more than ever, and we need to heed their advice.
Seth Moulton, D-Salem, is the congressman for the Sixth District of Massachusetts.