Summary: America, due it its limited testing supplies and contact tracing capacity, does not have the ability to contain the coronavirus in the entire country. Thus we are presented with two difficult choices, a national lockdown with devastating economic consequences or reopening the country and releasing the pandemic.
Consider a third choice, let states with high levels of coronavirus lockdown and impose self-isolation mandates. This will allow the virus naturally die off due to lack of hosts. At the same time, quarantine the states (and counties and towns) that have low coronavirus counts and focus most of our virus testing and contact tracing in those areas in order to prevent seeding the virus there. This will allow a large portion of our country to go back to work. As the lockdown chokes out the virus and our testing capabilities increase, we can reopen the rest of the country.
“Lockdown!”
“Death toll rising!”
“We’re killing the economy!”
We hear these cries daily. Are we living in a movie?
It’s clear that until our country develops a massive increase in testing ability and effective medicinal tools, the only way to stop the spread of the coronavirus is by stopping social contact. Effectively, lockdowns are required and after a few weeks or months, the virus will eat through the nearby hosts and burnout.
But this approach brings with it tremendous pain. Telling people they can’t work means they can’t feed their families, pay their mortgages or rent and pay for basic expenses. Small businesses will close for good. The government stimulus is not enough to cover necessities for most people. The bailout and easy money provided supports massive corporations. It gives them free cash, cash that can be used to buyout small businesses that are struggling to survive (see Matt Stoller and Nassim Nicholas Taleb on this). The longer the lockdowns last, the more people are out of work and the greater the economic and societal distortions will become.
A second serious concern is the inflationary and hyperinflationary abyss. Inflation happens when you have more money and less goods. Each dollar buys less. Our nation is out of work and therefore producing less goods. The bailout is flooding money into the system. Once inflation is triggered it’s difficult to get under control. Imagine rapidly rising prices in the midst of a lockdown.
A third serious concern is the food supply. Thus far our food supply has not been seriously affected. But what happens if farmers start to get ill. We need to stop the spread of disease to those rural (and so far, mostly unaffected) areas that feed us. Keep the breadbasket safe.
President Trump floated the idea of quarantining New York, New Jersey and part of Connecticut, areas which have most of the coronavirus cases in America. This action would help contain the spread to other regions of the country. Trump backed down after pushback from Governor Coumo and others. This quarantine would have been helpful, but now we need another plan.
I propose that we can get large parts of the economy up and roaring again and simultaneously contain the coronavirus spread. Instead of continuing the national lockdown, we can take two extreme and opposite actions: lockdown the sick and quarantine the healthy. Paradoxically, this will end the pandemic more quickly. Consider the following idea:
Instead of quarantining the states with coronavirus, quarantine the states (and counties and towns) without the virus. As you read on, you’ll see this makes a lot of sense. Imagine a town without a case of coronavirus (and over a third of counties in America still do not have cases). No one is allowed to enter without testing negative. Trucks drivers delivering food and picking up food can be tested or use appropriate social distancing. Since the town is free from exposure, everyone can go back to work. The citizens don’t need to walk around in fear of catching the virus.
One particular benefit of this approach—less medical resources required. If you want to stop the coronavirus in New York City, you may need millions of testing kits and massive amounts of contact tracing. Conversely, if a town quarantines, it only needs to test the traveling truck drivers. If a citizen develops symptoms, they can be isolated immediately and their contacts traced relatively easily. This only works for the first few cases. After that, the system becomes overloaded and the virus spreads rapidly.
A second benefit is that it is much easier to keep people out then to keep people in. When President Trump tried to quarantine New York, the residents there did not like it. Who wants to be jailed? But empower a healthy county to keep a deadly disease out of their borders you will get enthusiastic support. Allowing them to continue to function and produce the goods the country needs will create the bedrock we need to get through this crisis.
This approach of quarantining the healthy has been tried in the past. As documented in an Integrated Disease Management study and beautifully illustrated by WOK the city of Ferrara in Italy quarantined itself during the Black Death for two years. The people worked and the city continued trading goods. The people who developed symptoms were quickly isolated. The town emerged from the black death healthy and unscathed.
Stopping the coronavirus in New York requires a lockdown. More testing right now will not significantly help. The disease needs time to burn out. Throwing testing and tracing resources at an infected hotspot will confirm what we already know. These people need to stay home.
On the other hand, if we use our resources to stop the virus entering and spreading in the quarantined healthy areas then each test will count for more. Many Americans can go back to living normal lives.
Here is an example. The governor of Virginia has issued a stay-at-home order. The entire state cannot go to work. At the same time, twenty eight counties have 0 reported cases. If these counties close their borders and we give them the resources to test, trace and isolate any positive or suspected case, then these counties to go back to work. Testing and tracing in “hotspots” is largely ineffective and takes away resources badly needed elsewhere.
Consider what happens if we don’t take this action. If America dilutes its resources and doesn’t protect the “healthy zones” then the healthy zones will get infected as well. Raging spread in these newly infected areas will drag the country down even further.
Conclusion
I’m currently locked down in an area with a significant number of coronavirus cases. I know that it is important for my zone to remain in lockdown. But I want our country to succeed and for this I need the healthy parts of the country to return to life as normal. As locking down infected areas chokes the virus, we can take back the America town by town, county by county, state by state. Let’s heal our country. We can start by quarantining the healthy.
