Fascinating Discussion on “What’s the Metric” for Reopening the Economy, Getting Back to (New) Normal

See below for an interesting Facebook post by Charlottesville-based journalist Coy Barefoot, which asks the relevant and timely question:

“are we continuing to do all this to prevent the hospitals from being overrun (which, let’s face it, could last forever when there is little to no immunity spread taking place, that is a biological key) OR are we doing this simply to limit the number of people getting infected (which, again, could last forever if THAT is the goal). what’s the metric?”

I’ve added some bolding for emphasis of the parts of Coy Barefoot’s post (see below) that jumped out at me. Personally, I’ve been thinking – and confused about – metrics for reopening since the start of this crisis. My concern is that, without ubiquitous and acccurate testing, there’s no real way to get those metrics…or to solve this problem. What am I missing here?

As for the answers to Coy Barefoot’s questions? Here are some thoughts, from the top-rated responses to his post (again, bolding added by me for emphasis):

• “‘flattening the curve’ means that we spread out infections over a longer period of time, not stop them. If we can limit the impact on our health system, our mortality rate will fall”
• “This. Also buys more time to find effective treatments and learn more about this disease.”
• “It’s both… slow the spread and limit the number of cases. There was an initial lockdown and there will be a next phase, what could rightfully be called the new normal, that will likely last for a year. God help us all if that next phase doesn’t include an election.”
• “The problem now is that there isn’t enough testing available, or fully-tested, effective treatments. Before things start to open up again, there HAVE to be enough tests available for everybody to be tested who is going into a workplace. Any positive cases need to be sent home and quarantined. We don’t have enough tests, not even close. We risk being right back where we were a month ago if people just show up and aren’t tested.”
• “I don’t think the two are mutually exclusive–flattening the curve AND cutting down on the total number of cases. Been reading the article about Fauci in the current New Yorker. Whatever he recommends is what I think we should do. There’s no one better. I think (and hope) that our kids are tougher than we give them credit for.”
• “I think there is a very real chance of civil unrest if 1) opening doesn’t start in any meaningful way in the next 3-6 weeks or 2) government doesn’t step up to help feed and house people who are going to be periously close to losing their homes and not being able to feed their families. Everyone who has responded here so far indicated primarily an annoyance at being ‘cooped up’ – how privileged we are. There are seriously folks who may have no $$ coming in, can’t access unemployment insurance or health care (being sites are down due to heavy traffic), and whose lenders or landlords aren’t willing to postpone rent or mortgage payments. This is the next wave of the crisis.”
• ” IMO Coy, you expressed yourself with crystal clarity and with sensitive respect. As we so often see in public matters, the goal posts keep getting moved and confusion reigns. We will never stop infections and ‘until it is safe’ is an impossible, unattainable goal.”
• “Reopening the economy without a plan, in this chaotic environment, seems a lot like growing cotton in the middle of a civil war. Betting on the casino instead of community. Recipe for failure.”
• “We still have no PPE at the hospitals. Ideally we can hold off for a vaccine. It would also be nice if we could actually find a way to effectively treat it. I’m sure it’s been mentioned in the comments that we need testing, both the PCR tests that show active infection (which are still in short supply) and antibody tests that show evidence of prior infection. That would help us know the prevalence of the disease,which would let us know if/when we could get here immunity. We also need to know how good aquired immunity is. This is off the top of my head. Bottom line, we need time still”
• “You cannot say that the curve is being flattened when nobody’s being tested.”

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SO… just thinking out loud here folks.

1. social distancing combined with closing all but “essential” businesses combined with stay-at-home orders HAS in fact worked (and quite well) to curb the spread of the virus. that’s the remarkably good news.
2. the bad news is that they’re now saying (you know, “they”) that all that is working so well it may actually be DELAYING any modeled nationwide or regional peaks of infection.
3. much of the news chatter NOW seems to be about social distancing for the purposes of limiting ANY spread and infection. at all. full stop.
4. but that’s a new metric isn’t it? I’ve understood for weeks that the actual purpose of these measures was to prevent the hospitals and general healthcare system from being overrun. they were in some places, obviously, but those places are not now nearly as bad as they were (see #1 above), and the situation is just not bad at all in most places (I’m talking specifically about the capability of hospitals to handle spikes of infection- which have not proven to be on the scale as originally modeled, even when those models accounted for preventative measures in place).
5. all of which sets up my current confusion: while I FULLY recognize the value of what we’re doing, it appears that there is some miscommunication as to where that value is now aimed. are we continuing to do all this to prevent the hospitals from being overrun (which, let’s face it, could last forever when there is little to no immunity spread taking place, that is a biological key) OR are we doing this simply to limit the number of people getting infected (which, again, could last forever if THAT is the goal). what’s the metric? And I would point out that these are not the same thing. people can be ill, with plenty of hospital capacity to care for them. are we trying to prevent the hospitals from being so stressed that they can no longer handle the peak load OR are we just trying to limit the number of cases. it’s not the same thing. there, I asked it twice because I’m not sure if I’ve worded this correctly.

I don’t want to sound callous, please, and I so hope that none of this has come across the wrong way. I know for a fact that there are people that I’m connected to on FB who’ve lost loved ones to this horrific illness. I’m so sincerely sorry for that. I’m just thinking out loud here with some thoughts, and wondering if any of you are thinking along these lines. please chime in. I’m honestly interested in what yall think about all this.

Yes, count me among those who is VERY ready for this to be over. what “normal” looks like I don’t know. but I’ll take any semblance of it, frankly. This morning James put his head on my shoulder and said he just wanted to go to the movies and back to “Miss Pat’s School.” (Patricia). He is beside himself with grief. And I know we’re all dealing with our own challenges and situations. Thanks in advance for your thoughts.