Here’s a thought experiment for our pandemic times: What if all of us — every single one of us — defied our individual impulses in favor of the greater good, heeded the advice of our government, hunkered down for 14 days and halted all human interaction? Could we turn the tide of the COVID-19 outbreak and emerge, after two weeks in isolation, battered but victorious against a disease that now threatens to overwhelm our hospitals and decimate our economy?
The answer is yes, as reporter Donald G. McNeil Jr. wrote in a now-viral story for the New York Times, but only in theory. McNeil likened the necessary circumstances to “waving a magic wand.”
“In theory, if we were all to sit far enough apart that we couldn’t and we didn’t interact with anyone, sure, that would break the chains of transmission here,” said Crystal Watson, a senior scholar at the Johns Hopkins Center for Health Security. “It wouldn’t mean we would be out of the woods immediately because those people who have already gotten [infected] and haven’t shown symptoms yet are still going to get sick, and a portion of them are going to go to the hospital, and a portion of them are going to die."
Epidemiologists are cautioning against conflating theoretical possibilities with real-world solutions, especially as some business and political leaders, including the president, have hinted at their desire to quickly return to business as usual and lift the recent social distancing measures that have shuttered large segments of the economy.
Here’s why that’s a bad idea:
Two weeks is not nearly long enough.
“One of the problems with the 14-day narrative is basically that’s what China did. They said everybody has to stay inside. But it wasn’t 14 days, it was more like two months before things really started to come back to normal,” said Samuel Scarpino, an assistant professor at Northeastern University’s Network Science Institute, who is studying the pandemic using mathematical and computational modeling.
In late January, the Chinese government imposed harsh travel restrictions to control the coronavirus outbreak in the province of Hubei, where the pandemic began, suspending all outbound travel and confining people to their homes. Now that the outbreak there has slowed, China is finally easing its lockdown measures. On April 8, public transportation will start running again in Wuhan, the original epicenter of the pandemic.
But the United States doesn’t need to adopt China’s extreme measures to flatten the epidemic curve of its outbreak, Scarpino said, if Americans take social distancing very seriously — and for several more weeks — and we test much more widely for COVID-19.
“The point of imposing these measures is to bring the outbreak under control to a level where we can control it with the kind of testing and isolation strategy that we see in South Korea, Singapore, Hong Kong and Taiwan,” he said. “So I think what we need to do is take the steps that we’re taking now and understand that for them to work it’s going be more like four or five or six weeks.”
And keep in mind infected people can carry the virus for several days before showing any signs of illness. Research indicates the incubation period for COVID-19 is between two and 14 days after exposure. Say you were infected right before your mandated 14-day period of isolation. If your symptoms arrived on day 10, you would still be contagious even after emerging from your temporary solitude.
“As soon as you impose those restrictions on people, it’s not really that it’s 14 days, it’s 14 days until everybody that was already exposed could become sick,” Scarpino explained. “So it’s really more like a month or more you would have to physically lock everybody down in order to have this go away. And the situation is, we already are having a lot of of trouble maintaining the social and political will to implement the measures we’ve done in the US.”
If we relax social distancing measures too early, we’ll undo whatever progress we’ve made.
Now in the second week of his administration’s “15 Days to Slow the Spread” social distancing initiative, President Trump has signaled his desire to reopen the economy and send Americans back to work by Easter, April 12. At a Fox News virtual town hall Tuesday, Trump said he will assess the impact of the 15-day effort next Monday and decide whether to “give it some more time if we need a little more time, but we need to open this country up.”
But there are huge risks of relaxing social distancing measures too early, said Watson.
“Now [would be] the worst possible time to let up on those measures because we are in this exponential growth period still,” she said. And the multitude of sacrifices many of us have already made, including job loss and social isolation, “could be for nothing."
“Most of the people in our societies are still vulnerable to this. This disease hasn’t spread widely among most people," Watson said. “It will be totally uncontrolled. We’ll have hospitals completely overwhelmed, so not only will COVID patients not be able to get care, but everyone else who’s having heart attacks, having babies... . So we would see the death rates skyrocket.”
The economic consequences would be even worse.
“The options aren’t social distance or life is completely normal," said Ellie Murray, an assistant professor of epidemiology at Boston University School of Public Health. "It’s social distance or we have a huge number of cases, an overwhelmed medical system, people dying from COVID, people dying from other diseases where they can no longer get the care they need, and ... the [economic] impact is almost certainly going to be greater than the current impact of social distancing.”
While early data from the Centers for Disease Control and Prevention show 53 percent of intensive care unit admissions and 80 percent of deaths linked to COVID-19 in the United States were among adults over the age of 65, younger adults can still suffer severe outcomes from the disease. According to the CDC, working-age adults, between 20 and 44 years old, made up 20 percent of COVID-19 hospitalizations.
“We will have an economic problem if we have a large proportion of our workforce who are sick at any one time, and we’ll have a lot more deaths if we let up on this prematurely,” Watson said. “So it’s not this dichotomous choice.”