04-12-2020, 04:07 PM
As it seems like we are at or close to the peak (hopefully) of coronavirus activity and the rate of new infections starts to decline, it is probably a good time to start planning for what reopening looks like. The administration has set a goal of May 1, which I think is aspirational. But regardless of when the date is, it is worth starting to think of how to relax restrictions so that the economy can start to come back without triggering a new outbreak. I think there's a tendency to think of reopening the economy as an event (as witnessed by setting a date for it), but it's more like a process. And Teejers post about people pursuing various low risk activities got me thinking that really there are three or four dimensions on which you can judge activities.
1) How essential is it? We dichotomize activities into "essential" and "non essential" but in reality there are gradations involved, from critical (healthcare services) to completely non-critical (leisure activities) with a whole host of things in between. Public transport, for example, might not be critical per se, but if that's how a doctor or nurse normally gets to the hospital, it's critical. School is not immediately essential, but it is very important (forget for a moment that it probably also carries a high risk for transmission, I'm trying to rank it in terms of how essential it is).
2) How risky is it? Some critical activities are very risky because they bring together lots of people, some who may be sick, in an enclosed area (hospitals are a good example); others are very low risk (Teejers example of socially distant golf, for example). So, note that you can have high-risk essential services and low-risk leisure activities.
3) What is the individual risk? By this I don't just mean the individual risk of getting sick, but also the individual risk of having or spreading infection. A worker in a high contact essential occupation (grocery store clerks, hospital personnel), even if they are young and otherwise low risk themselves would have a high risk of passing the virus along and therefore should minimize exposures, even if relatively low risk exposures. On the other hand, individuals who have recovered from the virus are probably low risk (assuming they can get immunity) and can probably do what they want without putting themselves or others at risk. Kids themselves are probably fairly low risk, but higher risk if they live in a multigenerational family with their grandparents.
4) What is the local prevalence of disease? Tightening or relaxing of restrictions has to be dependent on how many cases are out there. There are probably many parts of rural California that are very low risk and for which local shutdowns may not have been necessary. Even as much of the rest of the country opens up, there will be local hotspots that won't be able to.
5) What kind of risk mitigation measures are possible. These might include things like limiting occupancy to allow effective social distancing (I'm thinking for example of the Dish, which was closed because too many people went). The Dish probably could be reopened, but only if there are guards allowing one person in for every person who goes out and has hand sanitizer at the entrance and hikers are willing to take risk reduction steps such as using masks.
And of course all of this is predicated on having testing and contact tracing.
So what does "reopening" look like? It probably means starting important but not essential lower risk activities with some risk mitigation measures in place, and then if the infection rate remains low, allowing higher risk important activities and lower risk non-important activities until, hopefully, by the end you are able to allow even high risk leisure activities (like large sports gatherings). As I said, a process, not an event.
BC
1) How essential is it? We dichotomize activities into "essential" and "non essential" but in reality there are gradations involved, from critical (healthcare services) to completely non-critical (leisure activities) with a whole host of things in between. Public transport, for example, might not be critical per se, but if that's how a doctor or nurse normally gets to the hospital, it's critical. School is not immediately essential, but it is very important (forget for a moment that it probably also carries a high risk for transmission, I'm trying to rank it in terms of how essential it is).
2) How risky is it? Some critical activities are very risky because they bring together lots of people, some who may be sick, in an enclosed area (hospitals are a good example); others are very low risk (Teejers example of socially distant golf, for example). So, note that you can have high-risk essential services and low-risk leisure activities.
3) What is the individual risk? By this I don't just mean the individual risk of getting sick, but also the individual risk of having or spreading infection. A worker in a high contact essential occupation (grocery store clerks, hospital personnel), even if they are young and otherwise low risk themselves would have a high risk of passing the virus along and therefore should minimize exposures, even if relatively low risk exposures. On the other hand, individuals who have recovered from the virus are probably low risk (assuming they can get immunity) and can probably do what they want without putting themselves or others at risk. Kids themselves are probably fairly low risk, but higher risk if they live in a multigenerational family with their grandparents.
4) What is the local prevalence of disease? Tightening or relaxing of restrictions has to be dependent on how many cases are out there. There are probably many parts of rural California that are very low risk and for which local shutdowns may not have been necessary. Even as much of the rest of the country opens up, there will be local hotspots that won't be able to.
5) What kind of risk mitigation measures are possible. These might include things like limiting occupancy to allow effective social distancing (I'm thinking for example of the Dish, which was closed because too many people went). The Dish probably could be reopened, but only if there are guards allowing one person in for every person who goes out and has hand sanitizer at the entrance and hikers are willing to take risk reduction steps such as using masks.
And of course all of this is predicated on having testing and contact tracing.
So what does "reopening" look like? It probably means starting important but not essential lower risk activities with some risk mitigation measures in place, and then if the infection rate remains low, allowing higher risk important activities and lower risk non-important activities until, hopefully, by the end you are able to allow even high risk leisure activities (like large sports gatherings). As I said, a process, not an event.
BC


