Our worlds are rapidly shrinking. Busy urban centers now look like ghost-towns, our lives have become restricted – from lockdowns and school closures to travel restrictions and bans on mass gatherings.
There has been an unprecedented global response to COVID19. But when and how will the lockdown end? When will we be able to get on with our lives? Will this illness permanently change the way we live?
News reports are filled with comparisons to the Great Depression, periods of war, the great plague and the Spanish flu of 1918. Each of these events changed our societies in lasting ways. COVID-19 and the global lockdown will change how we live, travel, the way we dress, eat and socialize, everything down to the level of security and surveillance we are willing tolerate.
In order to predict the magnitude of these changes, we first must understand how long it might take for things to return to normal. Prime Minister Boris Johnson has said he believes the UK can “turn the tide” against the outbreak within the next 12 weeks and the country can “send coronavirus packing”. President Trump said last Friday that he is eager to get America back to work, and that he has a target date in mind.
The current strategy of shutting down large parts of society is not sustainable in the long-term. The social and economic harm is disastrous. Public health officials are hesitant to set an end date for social distancing. “It is not going to be a light switch that we say, ‘Okay, it’s now June, July whatever” said Dr. Anthony Fauci on CNN.
Countries need an exit strategy, a way of lifting the restrictions and getting back to normal. It is not just the UK and the USA though; no country appears to have an exit strategy.
We can look to countries that are further down the path than we are. In China, the first phase of the lockdown has come to an end, but many controls have been put in place to quickly react to a resurgence.
Security guards are in place outside residential apartment buildings, initially in easily avoided makeshift structures. Later, fences and more permanent structures were erected, so that comings and goings could be tracked and restricted as necessary.
Some shops and restaurants have re-opened, granting access to customers who have their temperatures taken. Food delivery services staple receipts to the food packaging noting the body temperature reading of the cook and the courier.
At reopened restaurants, capacity is limited, and people are not allowed to sit facing each other directly. To enter busy public spaces like shopping malls, people must scan QR codes which reveal if they have travelled to infection hotspots in the last two weeks. The stringent measures in place are claimed to have significantly reduced the virus’s estimated reproductive number from 3.86 to 0.32, meaning each infected person is expected to infect 0.32 new people.
Elsewhere in Asia a significant proportion of public spaces have been fitted with thermal scanners to spot outbreaks and support contact tracing. Much of this infrastructure was put in place after the 2003 SARS outbreak.
This level of intrusiveness seems unlikely in countries where individualism and liberty from a prying government are more valued. What will the end of the lockdown look like in Europe and the United States?
Many Westerners expect that shortly, everyone can return to work and school. Hospitals will be geared up to deal with the sick, and a vaccine will become available. Many hope that the coming summer weather will be unhospitable to the virus. Yet COVID-19 is spreading rapidly in Australia, currently in its summer season.
Most of the existing economic resumption plans do not involve a quick return to normalcy absent an effective vaccine.
A Harvard University paper titled When Can We Go Out? estimates an initial phase of the lockdown phase of at least forty days which would mean an end to the first phase on May 15th in the USA.
Neil Ferguson of Imperial College London suggests a five month phase of aggressive social distancing, unheard of in the history of quarantines.
A possible outcome noted in the Harvard paper involves an initial two months quarantine followed by a rhythm of two month lockdown followed by one month off, with the pattern continuing for two to four cycles.
Many plans for the end of the lockdown envision a second phase with electronic surveillance of the population.
Under this plan, citizens download a mobile phone app to track their movements and contacts. The app notifies citizens of contact with someone later found to have COVID-19, at which point they would enter a mandatory fourteen-day isolation. Those not using the app would be prevented from using public transportation or entering high-risk public areas. GPS tracking would be used to enforce quarantine on those who test positive until full recovery.
Obstacles to implementing such mass surveillance in free societies are huge.
Face masks might be required for a long time after lifting the initial lockdown. While wearing facemasks is not unusual in Asia, the idea could be more controversial in the United States. In States with no motorcycle helmet law in the United States, less than half of riders wear helmets. Wearing masks could be stigmatized and wearers might be assumed to either sick or cowardly.
It is worth remembering how many restrictions came into place after the 9-11 attacks in 2001. Before 9-11 you could cut through lobbies of skyscrapers, no employee passes were required like today. Airport security was much simpler pre 9-11.
Just because these ideas are proposed does not mean they will be taken up. Sweden’s government is controversially not requiring a lockdown, arguing that people can be trusted to socially distance and follow guidelines.
Restaurant reservation data from the app OpenTable shows that the public was practicing self-isolation in advance of changes in the law. In the days leading up to executive orders, people in the seven countries served by OpenTable were already beginning to self-isolate.
The most likely end to social distancing is brought about by the development of a vaccine. It took fifteen years from the discovery of the AIDS virus until the first generation of drugs that kept infected people alive. It took five years to develop a vaccine for Ebola. Last December, COVID-19 did not have a name, today, human trials for the coronavirus vaccine are underway throughout the world.
If a vaccine does not come along, herd immunity is our next defense. This would happen when a majority of people have been infected such that the virus can no longer cause large outbreaks.
The idea of immunity passports or certificates is being suggested – if you’ve had the disease and have antibodies that can kill the virus then you can go about your daily life. However, we don’t yet have an accurate antibody test or know how long immunity lasts.
Alternatively, if an effective medication could stop Covid-19 from progressing into a serious disease needing intensive care, we could quickly resume normal life.
We might get closer to normality in the months to come, our healthcare systems will get better at treating COVID-19, and science will eventually come up with solutions, but we should not expect this to end quickly and we should expect a lot of changes ahead. In tomorrow’s article we will explore what changes we can expect.