For both economic and ethical reasons, it is imperative that the United States prioritize defeating the virus over other concerns. Now that we are finally making that a priority, we're starting to see the full consequences of that necessary decision. Our economy is screeching to a halt, and the government is consumed with ad hoc efforts to prop up existing economic arrangements and prevent a total collapse. It's enough to give anyone pause. The psychological and physiological consequences of long-term separation and enforced idleness are not to be minimized either. Critics even warn that they could dwarf the ultimate harm caused by the virus itself.
We've barely begun to fight, and yet it's already clear we can't keep this up forever. How long will it have to last? If extreme social distancing is about buying time, what are we buying time for?
Ultimately, we're buying time for a vaccine and/or cure, both of which are being worked on furiously, with the first human trials for a vaccine already begun. But vaccine development and deployment is not a quick process. An 18-month timeline is already breakneck speed for bringing a vaccine for a novel virus on line; the world economy can't be held at a standstill that long. And while a number of anti-viral strategies are already being tested, and could prove effective much more quickly, it's impossible to know when or if any of them will succeed.
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So it's important to realize we're buying time for many things short of a vaccine or an effective treatment, milestones that we have far more control over.
First, extreme social distancing buys time to ramp up testing, so that we can shift from keeping most of the population away from work and from each other, and focus on quarantining those who are actually infected. That's been South Korea's approach from the start, and while it hasn't been perfectly effective, South Korea has performed far better than most Western countries, and their economy and society have continued to function.
If the United States had a comparable testing infrastructure, tools for tracking contacts of people who prove to be infected, and protocols to prevent infected people from slipping through the cracks, then we likely wouldn't have had to go the route of mass closures and lockdowns. What going that route now does is — at great expense — slow the progress of the disease sufficiently to give us time to put that infrastructure in place. Once we know the pace of infection has slowed dramatically, we test to find out where the disease is widespread and where it is rare. We can then methodically relax restrictions except in hot spots and for individuals in non-hot spots who are infected, knowing that with an adequate system for testing for and tracking infection, we could quickly confine a renewed outbreak without having to shut the whole economy down again.
Second, we're buying time until warmer weather. We still don't really know whether the coronavirus, like the flu, will subside as spring advances toward summer. The lack of serious outbreaks in tropical countries suggests it might, as does one study of different rates of spread in different Chinese cities. If it does subside, then restrictions might be substantially relaxed as the weather warms. By the same token, though, we'd have to expect the virus to return in force once the weather cools in the fall. So ramping up testing and tracking infrastructure remain absolutely essential.
Third, we're buying time for the virus to evolve. This may seem counterintuitive, because the evolution of the virus is part of what makes vaccination difficult (and initial evidence suggests it is not evolving any faster than the flu). But evolution can work in our favor once we are effectively isolating the sick and infected. If some people do slip through the net, they will likely be asymptomatic, which is more likely if they are infected with a less-deadly strain of the virus. Over time, that should mean the milder strains displace the fiercer strains, and the virus gets less dangerous. But again: This only works if we are effectively isolating the contagious before they infect others, which means extensive testing.
To a considerable extent, social distancing is just waiting. Psychologically, it's vital for people to understand what they are waiting for, and to avoid catastrophic projection of our current situation into the indefinite future. We have to adapt, but we also have to be able to plan for the future — and to do that we need some sense of what the future might look like and when it might be here.
But it's at least as important for political reasons. There are numerous things our government needs to be doing right now to prepare the ground to be able to relax the severity of restrictions on activity. Building out testing capacity, constructing hospitals, developing protocols for travel in a world where the virus is a persistent threat — these are all things the government can and must be doing. We can only hold them accountable for not doing it fast enough if we have a timeline, a goal of getting restrictions relaxed in a certain number of weeks or months based on certain infrastructure being in place. So we should demand precisely that — and hold them to it.
The alternative is a kind of fatalism that, in the era of coronavirus, could prove all too literally fatal.
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