The Covid-19 omens are not good.
Yes, over the past two weeks ending Monday, Covid-19 cases were down by 41 percent and deaths by 22 percent. Yes, people are wearing masks. In a recent national survey, 80 percent of the respondents said they “very closely” followed public health recommendations to don a mask outside the home. And yes, since the fall, fewer Americans are attending in-person gatherings with family and friends.
This is all good. Americans confronted the realities of a dark winter and stepped up. But this feel-good moment is obscuring what could be a dismal spring and the potential of further lockdowns unless we can continue to slow the spread of this virus.
Some signs point in the wrong direction. We probably just had millions of Super Bowl parties, ideal spaces for increasing spread. More worrisome, states are celebrating prematurely, rolling back their mask mandates, opening up indoor dining and permitting large gatherings, such as religious services and funerals — all well-established mechanisms for superspreading events.
Compounding these threats, new virus variants, especially B.1.1.7, are spreading across states. Their increased transmissibility could lead to tens of thousands of additional Covid-19 cases and, inevitably and tragically, a surge in hospitalizations and deaths, not to mention longer economic pain.
The three of us were part of a 16-member advisory board that counseled Joe Biden on Covid-19 during the presidential transition. Five other members of that board have contributed to this article. We urge President Biden to specify clear thresholds for government action and announce them to the public. States will then understand the rules, and Americans will know when to expect public health interventions, right up to full lockdowns. The public needs to know the number of Covid-19 cases per 100,000, the rate of increase and hospital and intensive care unit bed capacity. When these are going in the wrong direction, they serve as warning signs.
Even so, we have the ability to avoid lockdowns in March or April. Here’s how.
Every American needs to wear a high-quality mask, and wear it correctly.
The government needs to mail a package of surgical masks to every household. This should be paired with a multilingual, multicultural media messaging campaign to show people what a good mask looks like — multiple layers of fine fabric with an adjustable nose piece — and how to wear them correctly. That is: over your mouth and nose and under your chin, with a tight fit across your nose and on the sides so the air you breathe goes in and out through the mask, not the sides. The message should also emphasize that it may be even more effective to wear two masks, a cloth mask over a surgical mask, to reduce viral transmission.
We need to stay in our household bubbles.
We need to stay away from groups — meaning no parties of 10 or more people. We need to do as much of our grocery and retail shopping online as we can. And if we need to shop in person, buy in bulk to reduce trips to the store and possible exposure to the virus.
Take a vaccine.
When it is your turn to get vaccinated, get vaccinated — with any vaccine authorized by the U.S. Food and Drug Administration. You should get vaccinated as soon as you are eligible. Take whichever vaccine is available. The studies suggest they all fully protect people from Covid-19-associated hospitalization and death.
The government must help small businesses.
We know indoor dining, bars and gyms are perfect for spreading the virus. Keeping them closed is essential. But small business owners and their employees should not be forced to choose between their livelihoods and the nation’s public health. The government needs to provide them with financial support, strictly conditioned on those businesses being closed to indoor service. Similarly, workers need paid sick leave when they must stay home to quarantine.
Protect our workers.
We all are relying on workers in health care, farms, factories, grocery stores, police departments, child care and schools, as well as millions of others. Employers of these frontline workers must ensure they are as safe as possible with personal protective equipment, including N95 masks where needed, high-quality air ventilation and filtration systems and the like. The government needs to mandate that all workers at higher risk for exposure to Covid-19 have these safety measures. It must also work with manufacturers through advance purchasing agreements and other mechanisms to ramp up production of all necessary protective equipment to keep the health care system and economy working safely.
The virus is not done with us.
When we see a small rise in cases, that is a big red flag. It’s the tremor before the earthquake. As we have seen over and over, four weeks after small increases in cases, there is an exponential rise in cases, to hundreds of thousands, followed in a few weeks by thousands of deaths per day. When Covid-19 rates begin to creep up, the surge is inevitable and imminent unless we take decisive action. Waiting until the spike occurs is thousands of deaths too late.
We may be done with Covid-19, but the virus is not done with us. We are all exhausted and frustrated, tired of masks and feeling constrained and bored with the monotony of life. We desperately want life to go back to normal.
But how soon we get there depends on the actions we take today. If we don’t take the new virus variants more seriously than we have, tens of thousands more Americans will become sick and die.
Ezekiel J. Emanuel is the vice provost of global initiatives and a professor of medical ethics and health policy at the University of Pennsylvania. Rick Bright is an immunologist and a vaccine expert who was the director of the federal government’s Biomedical Advanced Research and Development Authority from 2016 to 2020. He filed a whistle-blower complaint against the Trump administration over what he said was an ineffective response to the pandemic. Céline Gounder is an infectious disease specialist and an epidemiologist and an assistant clinical professor of medicine at New York University’s Grossman School of Medicine and Bellevue Hospital Center.
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