Expect Redistancing if Health Systems Are Overwhelmed

For the past hundred days, all across the country, people have questioned how long the current COVID-19 pandemic will last and when life will return to normal. Our society’s eagerness to be free of our homes combined with economic turmoil have led to many states and cities easing restrictions and physical distancing measures. Communities are asking when everything can fully open, from gyms to bars to churches. Children are asking when they can see their friends, and grandparents are asking when they can see their grandchildren.

My analysis shows that in most states, while we have only had a ripple so far, a tsunami could come if we are not vigilant. Distancing policies have been effective at slowing the spread of the virus, giving communities time to prepare their health systems for the predicted onslaught. We now know that we need to avoid breathing each other’s air, even if someone has no symptoms.

We are already seeing signs of this looming wave in states, like Florida and Texas, that began easing restrictions weeks ago. Florida has recently seen its largest daily increase in COVID cases since the start of the pandemic. This surge of new cases has renewed fear that premature reopenings could lead to a second round of closures.

In response to the uptick in cases, city, county and state governments have begun reversing the hundreds of reopening plans – each with varying phases and rules. This patchwork of restrictions and constantly changing policies has forced people into an unfortunate limbo. Now fending for themselves, communities and households should continue to take precautions to slow the spread of the virus, while finding ways to adapt to a new normal that will likely last months.

For a pandemic in a country to stop, one of three things needs to happen: First, a country could effectively stop the pandemic with a rigorous testing and contact tracing scheme, as has been done by Germany, New Zealand and others. However, we are past that point in the United States, and it is difficult with our large geography and global connectivity.

The second option is a safe and effective vaccine that can be reproduced and distributed en masse. We are all hoping for this, but in the best case, it might be available by 2021.

The third way is for communities to have “herd immunity” where enough people have had the disease and recovered from it so that the virus is not able to spread effectively in a population. For the SARS-CoV-2 virus that causes COVID-19, herd immunity may require 50 percent to 80 percent of the population to be protected from the disease to slow the virus, or lower if the transmissions can be reduced.

So what immunity might we have so far? My calculations show that the majority of the states are far below the threshold needed. As of June 13, in the state with the best immunity case, New York may have 35 percent recovered, while states like Texas have likely had less than 2 percent of their population exposed to COVID-19 and recovered so far.

To try to reach herd immunity of 60 percent as quickly as possible could result in millions of deaths and completely overwhelm our health system. We need to slow the disease by not breathing each other’s air. We need to keep physical distancing where we can and wear face coverings to slow the spread and protect the vulnerable. This could also allow us to break the pandemic with a lower level of herd immunity, given that these interventions lower the infectivity rate.

Remember the epidemic curve that looks like a mountain? We are not even at the Base Camp of Mount Everest. So settle in and get used to the new normal. Determine your own vulnerabilities and risks, what you need in life, and which risks you are willing to take. Use interventions available to you such as face coverings, which are increasingly being shown as effective. Expect that some communities will need to redistance if the system becomes overwhelmed. We have a long road ahead of us, and communities across the United States should be prepared to stay vigilant for the health of themselves and those around them.

Julie Swann is department head and the A. Doug Allison Distinguished Professor in the Edward P. Fitts Department of Industrial and Systems Engineering at North Carolina State University; in 2009, she was on loan as a senior science adviser for the H1N1 pandemic response at the Centers for Disease Control and Prevention.

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