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After a month of isolation, more and more people are talking about “opening the country” back up again, or getting back to “normal,” especially in time for the summer. For Ed Yong, a science writer at the Atlantic, the big question about this is: What will “normal” look like? The curve is not flattening in America. We don’t have an exit plan for safely reopening the economy. And we’re way past the point where things could just go back to the way they used to be. Whenever we can go back outside, things will be fundamentally different. We need to prepare for that.
On Thursday’s episode of What Next, I spoke with Yong about what our new normal will look like. Our conversation has been edited and condensed for clarity.
Mary Harris: So this question of when can we get back to “normal”—is it fair to say getting back to normal would require a vaccine?
Ed Yong: I think it will require the vast majority of people to be immune to the virus in some way. The safest and best way of doing that is through a vaccine. The other possibility is that enough people become infected to develop what is called “herd immunity,” where the virus can’t easily spread from one susceptible host to another. It could happen if enough people are infected. But as several countries have already realized during this first wave of the pandemic, you can’t really rely on that happening naturally in the way it might have. The virus spreads too fast and is too dangerous. So if you shoot for the herd immunity option, as the U.K. and several other countries initially seemed to be doing, you’re just going to end up with a lot of dead people.
And there’s no guarantee that once you’ve had this coronavirus, you’re completely immune forever, right?
That’s correct. It is not clear how long the immunity lasts, or the extent to which one infection will protect you from future ones. It’s likely that any immunity generated against this new virus would last for maybe a year, maybe a couple of years. So it’s not like if you will encounter it or get a vaccine that you will be protected for the rest of your life.
For most of the milder coronaviruses, like SARS and MERS, immunity lasts for less than a year. It may last for several years, but it starts dropping sharply early on in that time frame. We’ve only known about this novel virus for a few months now, so no one really knows what the duration of immunity will be. But it isn’t something like, say, chickenpox, where you get it and are immune for the rest of your life.
Given all that, I feel like when we talk about getting back to “normal,” it’s not even getting back to normal. It’s some kind of new normal, a moderated normal.
I think the idea that life will be dramatically different is correct. You could argue that a failure of imagination has led us to the point we’re currently at: where even people who’ve been thinking about this for a long time didn’t foresee some of the stumbling points in America’s past, like its inability to get a good diagnostic test up and running throughout the country in time.
It’s going to take feats of imagination to steel ourselves—not just in terms of material resources and logistical plans, but also psychologically—for the idea that the summer, the rest of the year, maybe even longer, is going to be different.
You made this point that this gradual reopening should not be like flipping a switch, with everything zooming back to the way it was before. We need to help scientists understand what works in terms of preventing the spread of this disease, because we shut everything down so quickly that we don’t know.
We were forced into a situation where swift, decisive action had to be taken because the virus was already everywhere and spreading very quickly. A lot of social distancing measures were rolled out in very short order. And it is difficult to know which of those things made the most difference and can therefore be used again during future waves of this pandemic.
Hopefully we’re going to get into a more stable situation. We can find out by slowly easing off on these restrictions and seeing what happens to the virus. Obviously, to do that, we need either widespread testing, which we don’t have and are probably not in a position to have anytime soon, or an immense public health effort where we can identify cases and trace their contacts.
Massachusetts is one of the states that’s thinking pretty concretely about this. Can you explain why the testing and tracing is so important, and what Massachusetts is doing?
The standard protocol for trying to contain a new outbreak is to find people who are infected, isolate them so they can’t infect someone else, and interview them to find all the people they’ve encountered since they became infected—to find all those contacts and to then either test or isolate them. This is all part of the standard public health playbook. It is especially hard for a virus like this because it can spread from one person to another without causing symptoms, or before causing symptoms. And that means that, by the time you identify someone who actually has COVID-19, they’ve probably encountered a lot of contacts and had the chance to infect a lot of other people. So the scale of the challenge is already very difficult. And it’s compounded by the fact that the United States’ public health infrastructure has been weakened through decades of disinvestment that transcends administrations but has certainly continued in this one.
In your recent article, you have this stunning number, which is that between 2008 and 2017, local health departments lost 55,000 workers. And now they’re going to be asked to do very labor-intensive work.
There was a fund that was meant to prepare the country and its public health infrastructure specifically for this. But it’s been slowly sapped over time, which means that jobs were lost, which means that, now that there is a crisis, the people necessary to do the legwork aren’t there. And you can’t get them back very quickly.
You can try to get some of that capacity back. That is what Massachusetts is trying to do: It’s trying to train a core of volunteer contact tracers. Those are the workers who would call up infected people to find all the other people whom they’ve had contact with, and then notify and interview those people.
You can’t turn someone into a fully fledged epidemiologist overnight, but you can certainly train them to do parts of the necessary public health work that needs to be done. It’s a necessary step, and it might also help with some of the economic burden of this pandemic. You might give people something to do in times when they’ve been furloughed or lost their jobs.
In your story, you say that in this new normal period where we’re living a different kind of life, there are all of these places that don’t make sense anymore: restaurants and school buildings and day care centers. Their employees are in need of work. It seems like we need to flip things around in a dramatic way. I wonder if the states on their own can do the work to turn normal inside out in the way we need to.
There is a very clear road map for how to reopen the country safely in the wait for a vaccine. Those plans have come from former Trump administration officials, former Obama-era officials, and political leaders like Elizabeth Warren. The White House either has no strategy or has not disclosed it yet, and that is deeply concerning. Many of the experts I spoke to were critical of the lack of central coordinated leadership from the federal government. It has left states in a lurch. Many of them have risen to the challenge by instigating their own plans and measures. Somewhat ironically, several groups of states have formed their own miniunions and tried to form coordinated plans for what to do in the near- and medium-term future. We’re meant to be in the United States of America and those states are being left to unite on their own. That’s a very strange situation to be in, and it’s going to lead to significant disparities across the country in terms of how different states are coping with this ongoing problem.
Typically, the CDC would step in here, right? So where is it?
The CDC has long been viewed as one of the greatest public health agencies in the world, if not the greatest. It’s the model on which the African CDC and the Chinese CDC and similar agencies around other parts of the world are based off. So it’s very strange that the CDC has been silent. The details of how and why that silencing has happened, I think, still need to be reported. But it’s very clear that it doesn’t have a voice. It isn’t part of the press briefings. That is a huge problem because not only do we not have enough public health officials to do on-the-ground contact tracing work, but we also don’t have enough experts to provide advice to the local leaders who are sorely in need of it as they are left to make their own decisions.
You got this quote from a public health expert who said, “We almost need to devise a public-health government in exile.” It stood out to me because public health people don’t usually put themselves out there like this. Now they’re saying they need to form their own coalition that acts outside of the federal government.
It’s a hell of a thing to say. It’s certainly not unwarranted! I think it speaks to the extraordinary situation that we’re currently in, where that lack of federal coordination has people wondering what we should do. One of the questions I asked people was, “Do you think states can do this on their own?” I think the general view was that they can succeed up to a point. But we do need some kind of national coordination that is sorely missing right now. At the moment, we have a ludicrous situation where states are having to bid against each other and the federal government for much-needed supplies. If America is pretending it’s at war with this virus, then it’s currently forcing all 50 states to fight their own separate wars.
This is not going to be over anytime soon. We are still in the middle of this. I think that’s the big risk—that we are psychologically ill-suited to understanding that. I’ve written before that the U.S. and other countries goes go through these cycles of panic and neglect when it comes to diseases. Things happen. People freak out. They get things under control. Make investments to ready themselves for the next time. Complacency then sets in during peacetime and preparedness wanes. I think the real risk now is that we are going to go into that neglectful phase before the panic is actually over. And that cycle where we leave ourselves vulnerable again is going to happen at an accelerated pace because we are thinking about this in too short-term of a way.