Seattle-King County Public Health had this in a portion of an email -- which I think lays out some of the challenges and what needs to be in place before loosening the ties that currently bind us to home. You can be glad that you personally don't need to make the decisions that are coming.
There seems to be a local historical lesson from the influenza pandemic in 1918. What happened then and what can we learn from it?
During that influenza pandemic, the health officer and the mayor of Seattle put some pretty strong social distancing measures in place, and the city fared much better than other cities at the beginning. But when victory was declared in World War One, people emerged out of their homes in celebration, and then all the closures and prohibitions against mass gatherings ended. Shortly thereafter, there was a serious second wave of illness that lasted for several months. It’s a sobering lesson about the danger of prematurely relaxing social distancing.At the same time, we need to consider the hardship that a prolonged Stay Home order could have on those who are struggling to get by. So we’ll be continually evaluating what aspects of social distancing need to stay in place, and what could be scaled back.
What needs to happen before social distancing measures could scale back?
When it appears safe, we will need to consider the gradual relaxing of one or more of our social distancing measures and carefully resume our normal “pre-COVID-19” activities. These measures include the Governor’s Stay at Home order and school closures, cancellation of gatherings, and directive to stay six feet apart. During this time we will need to carefully monitor COVID-19 illnesses and deaths and our health-care system’s ability to cope so that we can adjust course quickly if things head in a dangerous direction.Some key indicators we’ll look closely at include:
How many people are getting sick from COVID-19:
We would want to see a steady decrease in the number of people getting sick and needing hospitalization for at least 2 weeks before we do anything that may make those numbers go up.
Health-care system readiness:
When social distancing measures loosen, we should expect to see an increase in cases. We need to make sure our health-care system has what it needs in terms of staff, bed space, medical supplies, and equipment to take care of the sick people in our community before we discontinue social distancing measures.
Testing:
Our ability to keep COVID-19 cases at a manageable level after relaxing social distancing measures requires widespread availability of rapid testing and reporting of results so that people who are infected can take quick action to prevent the spread of COVID-19. That is not yet available.
Testing is necessary to have the most accurate picture of the extent and spread of the outbreak to inform strategies for relaxing social distancing. Widespread testing is also necessary for public health disease investigation to decrease community spread of infection.
Public health readiness:
Public health agencies will need capacity to do a large number of thorough case and contact investigations in order to identify people who are infected and their close contacts. This would be necessary so that these people are quickly isolated or quarantined in order to limit spread to others. This is the main thing that needs to happen to allow us to start resuming normal activities safely while avoiding a dangerous increase in new illnesses. People will need to understand the critical importance of isolating themselves when ill and rapidly helping inform their close contacts so they can quarantine themselves away from others and be tested if necessary based on guidance from public health.
To be successful, this work will need to occur at an unprecedented scale and speed, many times beyond what public health departments across the country can do currently. It requires a massive and rapid infusion of resources including disease investigators and information management tools.
Availability of proven treatments:
There are multiple therapies currently under evaluation to treat people with COVID-19, and the availability of these therapies will also be considered in our calculus of when to ease up on the mitigation measures.
How do we consider the threat of a rebound of COVID-19 along with the needs of the community?
We must continue to advocate for and provide support to those who are suffering from unintended economic and social impacts of this necessary disease control strategy.If people cannot practice social distancing or stay in isolation and quarantine because they fear losing their jobs, or because there is no one to help them get the food or medication they need, not only will they be at increased risk for infection, but it will prolong and worsen the outbreak for all of us. The degree to which we can provide support for all of our residents so that they can make safe choices will have benefit to the entire community. This includes access to wage and employment security, food security, child care, sustainable rent assistance and evictions protections, and paid sick leave. It also includes strong support for seniors and people with disabilities.
Small businesses should have access to grants and loans to keep business open should they need to close due to lack of staffing for a period of time while employees are recovering.
Keep in mind that we may be able to relax some measures while retaining others so that we can take a more measured approach. For example, it’s possible that the Stay Home order or school closures could be lifted while the directive to stay six feet apart will stay in place. It will depend on what the key indicators tell us about the safety of relaxing the measures.
