Scientists say a moonshot effort is needed to end social distancing and this pandemic. Will leaders listen?

The failures of the United States’ initial response to the Covid-19 pandemic are already well established: Officials were too slow to recognize the threat of the disease and too slow to get diagnostic testing in place, and were ill prepared for the strain on our health care system.

But now, largely, Americans are doing something right: social distancing.

The outright lockdowns of movement in some cities, as well as the less severe policies in place across the country, can slow the spread of the pandemic.

Frustratingly, though, we must be patient in our isolation. The impacts of social distancing lag in case-count data and may take a few weeks to show up. Right now, there are infections out there, in the public, that were seeded long before these orders came into effect. It can take 10 days or more between when a person is infected and when they show symptoms — during which they can spread the virus to others.

The social distancing measures in place also aren’t airtight, so these infections will still seed some others. And just the cases that are already out there are expected to overrun hospitals.

It’s important to recognize it could be months until it’s safe to lift social distancing restrictions. And the timeline might vary depending on where you live and when the virus strikes the hardest.

We need social distancing because it slows the spread of the disease to manageable levels. When that happens, we can move to a more sustainable mitigation strategy. But we’ll need to be careful. Just look at Hong Kong: After a month of strong control measures, including social distancing, cases are on the rise again, perhaps fueled by residents returning from abroad.

Know this: Ceaseless social distancing is not the only way to end this outbreak. And President Trump has painted a false choice between saving lives and saving the economy. We can find a balance. It’s just that the current orders of social distancing would need to be replaced by a comprehensive, extremely ambitious plan.

Epidemiologists and pandemic experts have been telling me about what it would take to end social distancing safely while fighting the spread of Covid-19. It isn’t easy. It will require an immense amount of leadership, coordination, and more sacrifice. It would take a sort of moonshot-level effort. But the tactics they outline aren’t unfamiliar. They’re textbook epidemiology — they just need to be scaled up to a level never really seen before.

“We really do need a Manhattan Project effort to get this stuff in place in really a two- or three-month period,” Jeremy Konyndyk, a senior policy fellow at the Center for Global Development, says.

We need social distancing across the country, and we need to keep it in place for some weeks, if not months, to buy time. If social distancing works, is enacted broadly, and is kept up, the number of new infections could decrease. It would give us a pause in the action, to potentially move on from social distancing to a more targeted pandemic strategy. Right now is the time to get plans ready so when that pause comes, we can make things right.

Why the US can’t open back up soon: It’s too dangerous

It’s understandable that some — maybe most — people want life to go back to normal already. Trump was anxious too, and was, until Sunday, saying he hoped to reopen the country by Easter, April 12.

That is “a nightmare scenario for epidemiologists and health care workers,” says Tara Smith, who studies emerging infectious diseases at Kent State University. “Imagine the mixing of populations that would happen at Easter if given the ‘all clear’ — people who may be carrying the virus without knowing it, hugging their loved ones, spending hours in close contact, and then everyone going back home afterward.” Luckily, Trump announced Sunday he would extend the federal social distancing guidelines until the end of April, at least.

Although data show that all age groups and people without preexisting risk factors can fall critically ill from the disease, social distancing isn’t just for you. It crucially protects vulnerable people from the disease. Without it, they become vulnerable again.

“If we all just went right back to how things were before, transmission would start again with the same intensity,” says Caitlin Rivers, a professor at Johns Hopkins Center for Health Security. “It’s hard to experience so many restrictions, and so many hardships, and not feel like it’s not working. We need to recognize that we are doing the right things. You just have to be a little bit patient.”

From sledgehammer to scalpel

It’s worth remembering why we’re in this situation. “The facts remain that we wasted a lot of time in terms of ramping up testing,” Saad Omer, director of the Yale Institute for Global Health, says. Testing in an outbreak provides two functions. One is to diagnose those who are sick. The other is surveillance: to see where the virus may be lurking, especially in cases where symptoms are mild or don’t manifest at all. The US has barely had enough testing capacity to test the sickest, let alone the capacity to do surveillance. Many doctors are telling patients with milder symptoms to just stay home and not get a test.

“Social distancing is basically a sledgehammer,” Konyndyk, who has worked on past outbreaks, like Ebola, says. “You’re just stopping everything and hoping that in the process you will also slow transmission.” What we need to do, he says, is turn that sledgehammer of social distancing into a scalpel: widespread testing and contact tracing.

“The classic epidemiological approach to controlling disease is not to shut down society; it’s to target the people you know to have the disease and understand who they’re spreading it to,” Konyndyk says. “We can’t do that right now because we don’t have enough testing to know who has the disease.”