Peter Embi & Shaun Grannis: Here’s what to consider when reopening the economy

DEBATE Q

When will it be time to lift restrictions on the economy?

In the three months since COVID-19 hit our shores, those of us working at the intersection of health care, public health and data science have been studying, tracking and predicting the course of the pandemic. Unfortunately, the numbers here, as around the globe, tell a clear story: COVID-19 will get worse before it gets better, and only if we take the appropriate actions can we minimize its harmful impacts.

To slow disease spread and reduce demand on our finite medical resources, our leaders implemented difficult but necessary community-mitigation measures called “nonpharmaceutical interventions” or NPIs (e.g., social distancing, sheltering at home, and temporary closure of nonessential businesses). While these measures work and are absolutely critical right now, they also come at a very real cost.

Given both the inevitable impact of prolonged NPIs on our economy and the certainty that the worst will eventually improve, we must begin to think about strategies for responsibly returning to a new normal. While the exact timeline for easing NPIs might not be crystal clear, some of the prerequisites for doing so are.

Principles for adjusting NPI. First, we cannot begin to ease NPIs until we are well past the peak of the infection, and spread has diminished significantly. Second, once we do begin, we must continue measures that protect the most vulnerable, at highest risk. Third, we must do so in a way that avoids spreading the disease anew.

Tracking and testing. We are fortunate in Indiana to have a robust, interconnected health information infrastructure that allows us to collect, analyze and track COVID-19. Still, to ease NPIs, we must enhance our testing and tracking abilities, not only to keep screening for new cases, but also to determine those previously infected, who might have recovered and now are immune. Protocols for whom and how often to test those re-entering the workforce will be important, as will maintaining an early-warning system to detect new outbreaks.

Understanding the disease. As new data are collected, we must continue to learn about the virus’s behavior, how it is spread, risk factors for severe disease, and the clinical course of those with COVID-19.

Treatment. We still don’t know how to treat this disease. Continued expansion of clinical trials to test treatments and vaccines will be critical. In fact, the availability of an effective vaccine is the ultimate solution to our current crisis.

Learning from others’ experiences. As we consider relaxing the current NPIs, we must also look to other countries dealing with COVID-19 that have slowed the infection and started to ease NPIs for approaches that could work here.

Beating this pandemic will take time. It will not be easy, but we can and will succeed. Unfortunately, there are no shortcuts, only tempting detours that risk prolonging this painful journey. To arrive safely, we will need good data-driven decision making, continued collaboration and steadfast determination.

By working together, we can develop a rational strategy for gradually easing NPIs and begin the slow return to a healthy and prosperous life.•

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