Public health officials, clinicians, and healthcare administrators around the Commonwealth are working around the clock to care for those who are sick and plan for the coming weeks and months. Rightly, they are not committing to when or how this state will reopen for business.
On this Patriots Day, at about the time I had planned to be at the starting line of the Boston Marathon, here’s my prediction about when and how we resume.
When:
Governor Andrew Cuomo of New York extended the stay-at-home order for that state through May 15, which is about five weeks after cases there peaked on about April 10, and a month after deaths peaked, according to the New York Times’ tracker. Massachusetts cases may have peaked yesterday (nine days after NY), and it looks like deaths haven’t yet peaked here, so the epidemic here is about 10 days delayed compared to New York. I’m using deaths as an imperfect proxy for hospitalizations, because those data are delayed and difficult to obtain. The difference between New York and Massachusetts is that due to great planning, we won’t exceed our hospital capacity (including the overflow beds at newly opened facilities). This gives Massachusetts a buffer to step into the unknown of reopening. Massachusetts is also ramping up testing (both viral and antibody), and standing up a public health corps to track contacts, which will be a critical tool to prevent a resurgence of the pandemic. I think we will begin to reopen on May 15.
What will reopen:
Non-essential businesses will reopen if they can go back to work and maintain 6-feet separation between employees, and between employees and customers. Schools will reopen in communities that aren’t hard-hit, but not in communities with high prevalence of the virus. Restaurants will reopen if they can position tables with six feet between them. Bars, conference venues, gyms, theaters, and other places where crowds congregate will not reopen any time soon.
What will life in public be like:
Masks will be required in all public places, including businesses and schools. The effectiveness of masking is controversial, but they are a reminder that we are not yet safe. Businesses that can function remotely will be required to continue remote work, at least through June. Groups and meetings larger than 4-6 people will be banned. Look for a social etiquette of subtle and overt shaming to influence gatherings and individual behavior.
What about those at high risk?
High-risk individuals - the elderly and those with chronic diseases - will be encouraged to remain isolated, although desperation and boredom may drive many of them out of their homes. I hope we’ll see a spirit of communal care, with those who are healthy and low-risk supporting and shopping for those who really can’t get sick.
Will there be a resurgence?
Contact tracing will allow for quarantining to occur on an individual or even neighborhood basis. Anticipate rolling community lockdowns and school and business closures, as micro-outbreaks recur and are addressed by testing, contact tracing, and quarantines.
What will be the impact of antibody testing:
As flawed as these tests are, presumed viral immunity will be the ticket to freedom. Some of those who think they are immune will fall ill, but the tantalizing promise of release from lockdown will overwhelm those fears.
When will life and business return to normal:
When there’s a vaccine. Not before.
It’s Patriot’s Day. How about some inspiration:
Here’s Des Linden, 2018 Boston Marathon Champion, from her commentary on WBUR: “That’s OK for now. Running rewards consistency and resilience. So does life. Keep your heads up. Lend a hand to the people around you. If we act like champions, we will all win.”