Getting Down to Planning the Next Year and the Interim New Normal | Talking Points Memo - 0 views
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Put simply, we won’t be able to get back to even a semi-normal social and economic life until we have a system in place that will prevent us from rapidly falling right back into a cycle of more outbreaks, lockdowns, deaths in the tens of thousands and economic shocks.
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We will need a system of mass surveillance testing to give us real time visibility into the current prevalence of the disease and keep numbers low enough to make contact tracing at a vast scale possible.
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Without this kind of data and early warning system our society will be like a plane flying in a cloud bank with all the instruments on the blink.
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First is the initial outbreak which we hope we’re getting some handle on. But there won’t be a return to a real normal until there’s a widely available vaccine or very effective treatments for COVID-19
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in the best case scenario we face what I’ll call Phase Two of the crisis – a lengthy period after the initial outbreak in which the challenge will be to get back to an Interim New Normal until vaccines or treatments come online
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The third phase will be the arrival of an effective vaccine that can finally in some sense end at least the epidemiological crisis.
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So Phase One: Initial Outbreak. Phase Two: Sustaining an Interim New Normal. Phase Three: Vaccines and/or robust Treatments arrive and the crisis ends.
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Another key concept: Testing isn’t all the same. One form of testing is diagnostic, tests you give to a particular person to guide their treatment.
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You can’t go back to even a semblance of normal economic and social life until you have an integrated, national system of surveillance testing in place that will give us a good shot at avoiding a rolling series of outbreaks and lockdowns for another year.
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some building blocks are clear. The first is building a robust and vast system of testing across the country, both testing for infection and testing for antibodies
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You also need a system of data collection and analysis that allows all those tests to be analyzed to granularly measure the prevalence and possible spread of the disease, both nationally and on the local level
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You also need to keep the scale of infection low enough that contact tracing of new infections is at all possible.
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Conventional contact tracing alone with armies of disease detectives probably isn’t up to the challenge, at least not on its own. That is why there’s already extensive discussions of using big data and geolocation tracking on cell phones to do some of this work at scale
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A lot of that discussion has focused on taking something China did with mobile applications and adapting it to our social mores and laws. Put simply, you download an app. You say you’re healthy. If you get sick and test positive you tell the app. The app has recorded your movements over the last two weeks and a lot of other peoples. Once I test positive, the people who’ve been in close proximity to me get alerted and told they should get tested.
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This is a very blunt instrument version of contact tracing. But unlike conventional contact tracing which operates with disease detectives, phone calls and interviews it can potentially be done at scale and almost instantaneously.
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Ezra Klein published a look at a number of the proposed plans for this Phase Two/Interim New Normal and he found all of them almost totally unworkable. They all involve levels of technical capacity, privacy intrusion and political will that seem almost fantastical
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we’ll either do one of these plans or all stay in our houses for a year or engage in the truly fantastical approach of going about life as usual while hundreds of thousands of Americans are dying and our national health care system collapsing around us.
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The reality is that we’ll likely get some mix of all three. But knowing the alternatives helps focus our attention not on the seeming impossibility of these strategies but the fact that we need to get down to the business of planning and implementing them.
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Phase Two is much more complicated. It is what everyone involved in any sort of public policy needs to be focusing on right now. Unfortunately the federal government has shown very, very little ability to mount any kind of coherent, national response.