Planning right now is a little like being in a car with a GPS system whose satellite connections have gotten screwy–you making an endless series of turns while the GPS reroutes and re-reroutes again. It’s probably better to just pull over for a few minutes to let it get its bearings than to keep driving in circles. Strategies based on information we’ll learn in the next two or three weeks will be a lot more solid than what is possible now, and an argument can be made to take a few days of vacation to rest up to better navigate the coming obstacle course when you can actually see the obstacle course.
That said, we are beginning to get glimpses of what Phase II (loosening restrictions) might look like after Phase I (flattening the curve) is over. Western Europe is a few days ahead of the US in the spread of the disease, and Arkansas is a few days behind hot spots in the US, which means we might get glimpses of what works and doesn’t work. Various policy makers, think tanks, scholars and others are beginning to issue Phase II plans, and a few European countries are preparing to ease lockdowns. Austria, for instance, is set to begin opening some shops next week.
In our reading, we’ve come across a few recurring themes, many of which are likely to be features of Arkansas’s near future:
- How Phase I Will End
- The general theme here is to identify criteria that indicate when it is safe to begin loosening restrictions. An American Enterprise Institute report, for instance, suggests a region must meet four criteria before beginning to loosen restrictions:
- “A sustained reduction in cases for at least 14 days,
- Hospitals in the state are safely able to treat all patients requiring hospitalization without resorting to crisis standards of care
- The state is able to test all people with COVID-19 symptoms, and
- The state is able to conduct active monitoring of confirmed cases and their contacts.”
- On criteria 1 and 2, we still don’t know precisely when we will begin to see sustained reduction of cases and how stressed our health care systems will be, but early indications for Arkansas are promising. Nonetheless, it’s hard to say with certainty because rural areas are lagging in infectious spread. (Stay tuned.)
- Criteria 3 and 4 both depend on adequate testing capabilities, and the US is at a minimum several weeks away from this. (Better testing is the answer to at least half the questions you likely have.) If Arkansas maintains its status as a non-hot spot, we’ll likely be down the queue in getting widespread access to tests.
- The general theme here is to identify criteria that indicate when it is safe to begin loosening restrictions. An American Enterprise Institute report, for instance, suggests a region must meet four criteria before beginning to loosen restrictions:
- How Phase II Will Roll Out
- Opinions vary on the sequence and timing, but a recurring theme is that when it is safe to start loosening restrictions, it should be done in stages.
- All of the plans we have seen continue to stress the necessity of maintaining rigorous hygiene and physical distancing strategies until we get to Phase III (vaccine or effective treatment). We’ll be washing our hands, disinfecting surfaces, wearing masks, and maintaining 6’ boundaries for the foreseeable future. And all emphasize isolating vulnerable populations for the duration, especially older populations and those with comorbidities like COPD, hypertension, diabetes, and asthma.
- As far as we know, there is not yet a definitive plan on how Phase II staging will be ordered. The German ifo Institute’s “Risk-Adapted Strategy” provides a good example of how experts are thinking. It advocates:
- Differentiating by regions. Regions with lower overall infection rates, low potential for rapid spread (e.g., low density), and sufficient health care capacity can begin to loosen restrictions sooner. Again, Arkansas may emerge from Phase I in relatively good shape on this dimension.
- Differentiating by vulnerable populations. Schools and universities are frequently mentioned for early stage reductions because their populations are generally more resilient to COVID-19. Businesses and organizations with target audiences skewing older than 60 are in for a more difficult path.
- Maintaining social distancing restrictions on sectors whose work can be digitized and conducted remotely. Those who can accomplish their jobs in front of a computer at home should anticipate being required to do so throughout Phase II. It is also possible that work life will become an in-home and in-the-office hybrid. Any reduction in the time spent in the presence of others will reduce the risk of community spread.
- Easing restrictions on high economic value added sectors (sectors that are critical for local economies) and their complements, including supply chains, along with highly automated industries are also likely to see early reductions in restrictions.
- Being especially careful in easing restrictions in the hospitality sector due to the importance of physical distancing. Given the importance of this sector to local economies and labor forces, this is likely to be the most difficult sector to get right. It is unlikely we will be seeing massive gatherings like sports events during Phase II, which are custom made to transmit infections quickly and broadly across wide geographic regions.
- Adapting Along the Way—Pulse Strategies
- Another emerging theme is the possibility that communities should prepare for cycles of targeted loosening and tightening of social distancing policies throughout Phase II.
- Each reduction is essentially an experiment, some of which will work better than others. If infectious spread accelerates—identified through widespread testing—community leaders should be prepared to reinforce some targeted restrictions. This means that managers must also be prepared for periodic pull-backs.
- Ideally, over time we will develop sufficiently widespread testing capabilities to have less blunt instruments at our disposal. State-of-the-art epidemiological controls involve testing, contact tracing, and isolating infected and exposed individuals rather than wholesale shutdowns.
The pandemic has, of course, affected everyone, universities included. University of Arkansas classes will be taught remotely during both summer terms, and in the fall, we will ask faculty in our department to be prepared to transition in-person classes to on-line, and back again, at any point in the semester. We are exploring offering simultaneous in-person and video delivery of lectures for students in vulnerable populations. Depending on the state of world, we may very well ask faculty to work from home except when teaching classes and conducting other necessary in-person meetings. By then, I imagine we’ll have become quite good at teleconferences. Etc.
It’s going to be an educated guessing game for everyone for awhile.