It is increasingly recognized that the way forward is through “containment”: facing a pandemic using four key tactics: generalized screening, contact tracing, social distancing and isolation / quarantine of confirmed cases and their contacts . It will take a massive effort and unprecedented coordination between the city, says the region. Containment must be our new mantra.
Test: We need sufficient supplies of both PCR tests, which diagnose active infections, and antibody tests, which screen for previous infections.
Mayor Bill de Blasio announced that we will soon have 100,000 PCR tests per week. It’s good news; we need to be able to test by PCR anyone who wants a test, regardless of the symptoms. That means dozens of temporary citywide test sites accessible to everyone, regardless of immigration status or insurance. New Yorkers also need clear advice on how, when and where to get tested.
Meanwhile, Governor Cuomo and the State Health Department’s work on antibody testing has been extraordinary. We must take advantage of this by conducting clinical trials on antibody tests to determine their sensitivity, what percentage of cases are asymptomatic, whether people develop immunity to the infection and, if so, for how long.
Contact tracking: Once someone is positive for COVID-19, we must be able to trace all of the person’s recent close contacts. This is intensive and specialized work. Before COVID-19, the city had only 50 contact tracers for the five boroughs. We must immediately bring thousands of people if we are serious about containment.
Technology can help. Apple and Google are teaming up to create a system that allows iPhones and Androids to ping each other within six feet for a period of time. Using anonymous coding to protect privacy, these phones will remember each other and if the owner of a positive test for COVID-19, the owner of the other will be notified.
This cannot replace the essential work of the shoe-leather of contact tracers, but it can complete it. Of course, we have to control any intrusion on our civil liberties, and Apple and Google have committed to strict limits.
Social distancing: While our heroic essential workers – health care, grocers and food workers, pharmacists, police, firefighters, sanitation workers, MTA officers, delivery people, goalkeepers nonprofit – show up on the front lines every day, millions of us have spent the past five to six weeks largely indoors. This was essential to flatten the curve.
We have adapted, because we know the issues. We must continue, even when we reopen our city. Protecting your fellow New Yorkers means doing your part by maintaining social distance.
It will be easier for some than for others. The pandemic has exposed the inequity plaguing our city and has had fatal consequences. The black and brown communities were the hardest hit. We need targeted policies that take into account race and socioeconomic status to allow everyone to distance themselves from society.
Isolation / Quarantine: We need to make sure that a person who is positive for COVID-19 does not spread the infection further. Because much of the community spread occurs in households, Drs. Harvey Fineberg, Jim Yong Kim and Jordan Shlain recently wrote in the New York Times an approach, “smart quarantine”: create a multi-layered environment where people who test positive are isolated (at no cost to themselves) and those of their households are quarantined and quickly tested.
If they are positive, they will also be isolated. In addition to slowing the spread of COVID-19, it would help relieve the massive pressure on our health heroes.
Of course, this involves sacrifices. Families can be disrupted and separated for weeks. But we know that New Yorkers are ready to sacrifice themselves to protect each other; we’ve done it over and over again.
None of these tactics will work on its own. But if we do them all together, with a shared purpose and sacrifice, we will be able to reopen the city safely, slowly and responsibly.
The next epidemic will come. Transmission of COVID-19 will resume and we know how fierce it will be. But with a clear strategy and preparation now, we can contain the next epidemic. We have to: The future of our city depends on it.
Stephen Levin is a member of the city council. Corey Johnson is a speaker.