As coronavirus cases and hospitalizations are rising across the United States, Dr Ashish K Jha writes: “Let’s talk about lockdowns... and how we get through the next few months.”
First published in October 2020.
Cases and hospitalizations are rising across the United States. And I’m getting asked repeatedly whether we are heading toward lockdowns.
Short answer – no – not if we are smart.
Long answer? It’s complicated.
So let’s talk about lockdowns – and how we get through the next few months.
Lockdowns – shelter in place orders – are extreme. And awful. Super costly and usually not necessary.
We locked down in March/April because the virus spread across the United States in January/February. And we were blind. We had no testing. We had little choice. The situation now is different. We know more.
First, let’s talk about why everyone is concerned:
- Cases are rising in most US states;
- Hospitalizations are rising in most US states;
- Test positives are going up too.
As the weather gets colder, expect things to get worse in much of the nation. Why? People will spend more time indoors. But not just that.
Colder, drier air spreads SARS-CoV2 more efficiently. And here is the problem: States across the political spectrum are too relaxed. Many are loosening restrictions on bars and indoor dining. And, a lot of the spread is happening in homes via gatherings. Homes, unfortunately, are not safe from virus spread.
Oh – you know where we are NOT seeing a lot of spread? In K-12 schools. Schools are not immune but we are likely overestimating their danger. We really do need to open more schools. (By the way, private schools across the nation have largely opened, public schools not. But I digress.)
A key failure of our pandemic response is that we always act while looking in the rear view mirror. We consistently act too late. We wait until cases rise, percentage of positivity rises, before we pull back. And we are doing that now.
And here is another problem: the time period we are in. All of our political leaders are focused on the US election. It makes sense, but that means we are not hearing much clear communication about the virus.
You know the old saying: Never have a pandemic during a Presidential election year.
So here is our job: Avoid lockdowns and get through the next few months without another 100,000 Americans dying.
It’s the old boring stuff, with some twists. So let’s make a list:
- Be diligent about masks. Indoors whenever not home. Outdoors when close to people, when speaking;
- Avoid indoor bars and restaurants. Outdoors or takeout;
- Stay in as small a bubble as you can tolerate;
- Avoid house parties and gatherings. Want to see friends? Outside. Too cold? Indoors: wear a mask, stay apart, open windows – even a little (This is not the year to be energy efficient);
- Push for more testing. We hear tests are coming. But where are the tests?? Also, if you get called by contact tracer, please respond;
- Push local leaders – mayors, governors – to prioritize schools, not bars and restaurants. Let’s provide bars and restaurants with money so they can survive.
There is a light at end of the tunnel, I swear.
We have zero national leadership so WE need to step up. The election is coming – please vote! But do not lose sight of the virus.
Lockdowns are awful and fully preventable. But they require that we be smart and demand more from our leaders.🔷
Dr Ashish K. Jha, Physician, health policy researcher. Dean of the School of Public Health, Professor of Health Services, Policy and Practice, Brown University, Rhode Island.