Three steps to consider for a more pre-pandemic normal

Let’s assume we’re not going to try for herd immunity, for two reasons. First, unless much better treatments are developed, reaching herd immunity is likely to involve a large number of deaths as well as not-yet-quantified — and possibly debilitating or permanent — severe complications. Second, antibodies appear to quickly decline to undetectable levels in at least some patients. This means there is a small but real chance that it might be impossible to reach herd immunity without a good vaccine. It could be years before such a thing exists.

In the meantime, preventing the majority of the country from catching covid-19 will be an arduous job. Over the past six months, we’ve learned that the virus spreads best indoors, with prolonged proximity and possibly assisted by air conditioning. This describes the environments where most Americans spent most of their time in the pre-coronavirus era. How, then, can we start to rebuild something approaching our normal lives?

Here are three suggestions that deserve more attention.

First, move everything outdoors — as much as possible and much more than has been done already. Many buildings in this country are oversupplied with parking lots, so let’s use that stockpile. With the addition of a simple high roof, you’ve got a farmers market, a sidewalk cafe or an open-air cathedral.

Obviously, no one will sit down for a four-course meal in a Minnesota parking lot in January, no matter how many propane heaters are deployed. But most of the country is not Minnesota, and if the alternative is getting sick, some surprising things become tolerable. While staying with my covid-positive father in April, I kept all the windows in my bedroom open to a steady, damp, 35-degree wind and managed to put in a full workday. I’m not saying that’s ideal, but we’re long past searching for ideal solutions. We’re now hunting for adequate.

Second, we need masks. Not just more people wearing them but also better masks. Americans are caught in the mother of all collective-action problems: Cloth masks can catch droplets that would otherwise spew into the air, but they’re less effective at stopping a virus that’s already there from getting into your lungs. So I wear a mask for your benefit, and you wear one for mine. People naturally worry less about the health of others than themselves, and the result is visible on every street corner: Too many folks are leaving their noses uncovered, or wearing a mask beneath their chin, or just going without.

It’s urgent to mass-produce masks that better protect the wearer: ideally, N95 masks or the closest substitute available technology and materials allow. Moreover, these masks have to be produced here so our supply doesn’t get interrupted by the export bans that wreaked havoc with U.S. supply chains in February and March. The federal government should be prepared to fund literally any amount of capital investment in the necessary space and equipment. Even if those investments become worthless the day a vaccine rolls out, they will pay for themselves by helping to steady the economy over the coming months or years.

Third, we need not just freely available mass testing but also a reliable process for certifying a recent test result — and a lack of shame about demanding to see a very recent certificate before letting someone into your home or place of business. Before I left my dad in Massachusetts and returned to my covid-free husband and mother, I took an Abbott Labs rapid test at a drive-through CVS clinic that returned results in less than an hour. Such options need to be within walking or driving distance of everyone in the country, and we need to create a social norm about getting tested often, possibly weekly, if you want to be out and about.

These are big, ambitious adaptations. They will be costly. They will be annoying. They will be very, very hard for governments and businesses to execute competently. In fact, the only thing that can be said for them is that they aren’t the two failed solutions we’ve already tried: ignoring the virus in the hope that it won’t be so bad or huddling in our houses and waiting for a medical breakthrough that may be years away.

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