We Can Eliminate Covid-19 if We Want To

We are always four to six weeks from being able to do what countries around the world have done.

We can virtually eliminate the virus any time we decide to. We can be back to a reasonably normal existence: schools, travel, job growth, safer nursing homes and other settings. And we could do it in a matter of weeks. If we want to.

Take New Zealand. With its fancy curve and life back to normal. Why can’t we? Not fair, you say. It’s an island nation. Okay. What about Germany? Not an island nation, large, growing diversity. Don’t like that comparison? What about countries that have been in big trouble? There’s Italy, France, and Spain. Those countries had it reasonably bad the same time we did. In fact, pick virtually any country you want.

But don’t tell me the United States can’t take action if we want to. And we can’t face the families of 150,000 people who didn’t have to die and tell them this had to happen. And I think it’s why our national political leaders won’t go near these families and the grieving process.

The good news — and it is good news — is we are always four to six weeks from being able to do what countries around the world have done.

Let’s say we threw the kitchen sink at Covid-19 in the U.S. Let’s say we started now with the goal of being open for business in October — meaning schools, in-person voting, sports, everything. If we did everything. What would happen?

So let’s define the kitchen sink:

1. Start with universal mask wearing. We didn’t do this in March and April, and let’s chalk it up to faulty instructions. But we know better now.

2. Keep the bars and restaurants and churches and transit closed. All hot spots.

3. Prohibit interstate travel.

4. Prohibit travel into the country (no one will let us into their country so that shouldn’t be hard).

5. Have hotels set up to allow people with symptoms to isolate from their families at no cost.

6. Instead of 50% lockdown (which is what we did in March and April), let’s say it’s a 90% lockdown. Meaning most of the Americans who couldn’t stay home in April because they were picking crops or driving trucks or working in health care would stay home with us.

That means the economy would take a several-week hit. And we would need extended unemployment insurance.

It would be a tough few weeks, but we could still do things: be outside, enjoy nature, gather safely with friends. Our grandparents who lived through a decade-long depression, a six-year world war, or whatever hardship they faced in their country would tell us we would make it.

We could even create friend and family bubbles. The NBA has been in a bubble for three weeks, and starting with 10% positives, have found and eliminated all cases. You could even enjoy some of your time in the bubble.

So what would happen? At first, absolutely nothing. Cases would still grow from the prior weeks and the incubation period. Hospitals would still be full. We would still see people die. The Covid-19 truthers would have a field day, tweeting every day the same routine.

“America has become a fascist government.” “We need to liberate.” “We’ve been doing this and nothing’s happening.” “More people are dying from non-Covid than Covid.” But if someone took Trump’s phone, it would help.

(By the way, welcome to all the new people who suddenly care so much about public education, mental health, and access to care. While this is the first time you may have ever uttered these concerns, your passion and commitment to funding them once and for all is appreciated.)

After a few weeks, what would happen is what happened in other countries. In many countries, the R dropped to .3. Let’s say in the U.S. it dropped to .5. If you have 60,000 cases in your community, in 50 days, it would drop to 58. Six thousand becomes six. Six hundred becomes one.

How does that work? Some of the fancy people call this “exponential decay.” I call it #Zachsmath. Explained here. Or just multiply 60,000 by .5. And then .5 again until you do it 10 times. Like Zach does. And other high schoolers.

So after eight weeks, you don’t have zero cases, but you have embers. A small enough number that someone in the health department in a big city could call them on the phone in one morning. In a small city, you could feed them with two large pizzas. In a small town, it would be Earl.

Earl was my dad’s name. He grew up in a small isolated town. He never loved the name but I like it a lot now. In this case Earl would be fine because everybody would bring him soup and check in on him.

Then what? You know how we don’t have enough tests? We would have plenty. Plenty to test everyone going into work, to school, to church, to an event. And if there’s a stray case or a dozen, we would find it in a day.

Because we would get the tests back the same day, we could very easily let everybody who had been around Earl the last few days know they should get a test. And if anybody tests positive, they would isolate, either at home or if there’s not enough room, in a hotel.

All the PPE we keep running out of? We would have way too much. Ventilators? Way too many. People who have suffered mental health crises? They could begin to deal with them. The light at the end of the tunnel would be blinding.

The man who cured smallpox and is the greatest expert I know, Larry Brilliant, puts it this way:

Would we be done at this point? Sadly not. Outbreaks can happen if you’re not paying attention. But before you get horrified, look at the units. These are in the hundreds. Even if an outbreak was 5,000 across the United States, we would have more than enough testing and contact tracing.

Whether we do this or not, let’s not pretend this isn’t an option. This is done mostly with the things we were born with or are very low-tech. The ability not to breath on people. A mask. Common sense. (Yes, I’m beginning to recognize the flaw.)

And while we do this, what else happens? Well, our nurses and doctors can catch their breath, recover, and go back to healing our other issues. We hug our parents again. Our scientists can work on vaccines they can get right and safe. They can be speedy without rushing.

We still take precautions. Masks in larger settings. In elevators. Around sick people. Because we care. It will take a while for societal norms like these to develop, but we can operate the way we did with tobacco control and build the norm.

Communities would have green, yellow, orange, and red days so we would know how to take precautions. Both before and after a vaccine. For as long as necessary. We could manage the illness by exception, not with a broad brush.

The cost of this has been and continues to be six to eight weeks of your life. This would disrupt the rest of your summer. But of the 4,000 weeks of your life, it’s a fraction of a percent so that many more can have many more weeks.

Does a vaccine make this unnecessary? Unless it’s 100% effective and everyone takes it, no. But that may be the wrong way to look at it. A vaccine just makes this easier to do. It allows more people to circulate with the same positive impact. It’s a tool, not a panacea.

The major objection to all this? People who think this infringes on their “rights.” But on the way to Walmart, they had to drive 30 mph. They couldn’t park in a handicapped space. And they can’t just eat the cheese balls in the store. Their rights can’t harm others.

Herd immunity is just herd thinning. And that assumes we understand how immunity works. Which we don’t. I’m not willing to lose 500,000 mostly older and low-income people. And subjecting tens of millions with chronic illness to protect a right you didn’t know you had three months ago.

We will do this. There is no other way. The question is when. The question is who will convince us. The question is the leadership it takes. But there’s not much question if we should.