Are states easing restrictions prematurely? What factors should citizens be looking at to understand when it’s safe to resume activities?
It will take many weeks for us to see the consequences of our current move to relax social distancing/lockdown measures. Ideally, we would like to be increasing other non-pharmaceutical interventions (NPIs) counterbalancing the effect of loosening restrictions. This would include increasing the size as well as the efficiency of the testing program in a state so that we could find many more asymptomatic carriers before they spread virus to others; creating and offering a better isolation regime (which might include providing free housing to some, so that members of a household could be protected); encouraging the use of masks by making them costless or at least more accessible and affordable; and setting up a timely contact tracing apparatus.
The American Enterprise Institute’s road map for reopening has been widely adopted. Does it make sense from a public health point of view?
Yes. It is an excellent road map. Unfortunately, the “devil is in the details.” There are still too many obstacles to getting rapid (less than 24-hour turnaround to result) testing done: I still know of individuals who are unable to reliably get a test on demand. Too many individuals are still dissuaded from even being tested. On this basis alone, I would imagine that no single state is actually in position to move toward reopening (despite all but one having done so). This does not mean that many counties are not in a great position, but since this is a statewide decision, it would be far better to have reliable data to affirm that there is consummate access and timeliness as well as reaction to testing.
Has testing capacity increased enough to open schools and workplaces over the next few months?
On a national basis, and within some regions, I believe we will have appropriate testing capacity. I am concerned that the variation in capacity, by region, may make some locales unable to safely re-open and that others will be seen to be “hoarding” testing capacity without such need.