You’re describing ramping up a massive, complex program at a time when states are going broke and the federal government is dysfunctional.
Yes, it’s a huge job, but in a lot of ways, our economy and society depend on it. So we have to get it right…. Make no mistake, this is hard. We need a large workforce and it needs to be trained well. Around the world, the kind of services that are provided for contacts who test positive range from housing to stipends to food, laundry, medication delivery. There are a lot of needs for people who are not supposed to go outside if they’re going to adhere to the recommendations.
Is there even a ballpark figure of how many people need to be brought on board in New York to do contact tracing effectively?
I think we’ll learn with time exactly what it takes. In Wuhan, the ratio was about one tracer per thousand population. In Singapore it has been about one per 5,000 population.
So on the low end, in a state of 19 million, we’re talking about 3,800 tracers. You mentioned Wuhan. What’s your level of confidence in the public health information we’re getting from China now?
I have no doubt about what’s going on in China now. We have an office there, and we’ve gotten extensive daily reports every day since January 29. Whatever you want to say about how they responded in January, what’s clear is that China has taken this enormously seriously. They’ve done contact tracing on more than 730,000 people. The city of Wuhan has been doing 50,000 tests a day for the last few weeks. Fifty-thousand, for one city of 11 million, at a time when the United States was doing 150,000 a day for 330 million people.
What we hear in China—and this is relevant to the reopening question here in the U.S.—is that President Xi Jinping is encouraging people to go back to work. And people are quite reluctant. They’re scared. They saw how bad this was. And so people are going back very gingerly. But fundamentally, with extraordinary amounts of testing, physical distancing, contact tracing, isolation, and quarantine—a box—China has controlled this. And whatever we think about what they did or didn’t do right in January, we will be less safe if we don’t learn lessons from every place around the world. That includes China, that includes Taiwan, that includes Singapore, that includes Hong Kong. We need to learn the lessons from what’s working.
States are reopening on different schedules with different restrictions. How could that complicate the effort to reduce the spread of the virus?
We will not be “open” as we were before coronavirus until we’re all immune. We need to restart without rekindling, and we do that by making decisions based on data. Even within states, there may not be a one-size-fits-all approach. We need to monitor and quickly identify any increase in cases within states. These are likely to occur many weeks after a decrease in physical distancing. Society needs to be ready to reduce exposures quickly again if needed.
How likely do you think it is we will see major upticks in infection in states or regions of the country in the next six months?
There have been more than 1.25 million confirmed coronavirus cases in the U.S and more than 75,000 deaths, but we know that most people in the U.S. have not yet caught the virus, so there is still huge potential for transmission. As we restart the economy, we may see multiple waves of infection over the coming months, though we hope the peak is not as high. We have to be ready and we have to track it very closely.