Thread by @propublica

We interviewed experts and frontline officials from Italy, Germany, Spain, Singapore, Taiwan and South Korea.

Of all of them, we found more commonalities than differences. So…

These are the 7 things we must do before we open up America.

A thread:

1. Build an army of contact tracers

*Every* expert we talked to said it’s important to know exactly where the virus is spreading.

The only reliable way to do this is via “contact tracers” who can track down the contacts of anyone who tests positive.

While this sounds like an obvious step, it comes with demanding logistics that few — if any — U.S. states are able to carry out right now, such as:

“It usually takes four or five people over three days to do one full contact trace, on average,”

— @ASlavitt, fmr head of @CMSGov during the Obama administration.

He said California (40M pop) could need up to 20k contract tracers, depending on circumstances.

Wuhan, China (11M pop) deployed 9,000+ contact tracers…

@NYDailyNews reported last month that NYC was hoping to triple the number from 50 to 150.

NYC’s health department did not respond to a request for comment.

2. Test. Constantly.

You’re sick of hearing about it, we know.

BUT. Our experts agreed that the inability to do widespread testing for the virus is the central reason it has spread so widely in the U.S.

3. Isolate people w/ suspected infection from their families.
This is a really tough one.

It goes against everything the family-centered American society supposedly treasures.

That said, what we’ve learned in Italy, Taiwan and our country is sobering.

NY authorities originally told anyone with symptoms to “self-isolate” in a single room in their home for 14 days, avoiding contact with other people living in the same place.

But that ignores a lot of fundamental facts of life. What about people who:

-live in single-room apartments
- don’t have two bathrooms.
- aren’t meticulous about wiping down door handles or wearing gloves and masks when they wash dishes

The result?

In city after city: horrifying stories about one parent, then a second parent, then the children ending up dead or ill.

Separating people for 14 days is tough. It would be massively unpopular.

Many experts suggested using hotels to isolate those who test positive.

(Also could be helpful for the hotel industry).

4. Protect health care workers.

Protect. Your. Healthcare. Workers.

One of the lessons from Wuhan and Italy is that you have to be utterly meticulous about protecting doctors and nurses. If you don’t…

...the hospitals become a vector for infection and you lose the frontline people.

Or worse — If you need them to handle a second wave of infections, even a smaller one, they may stop coming to work.

You need to stockpile PPE & supplies before reopening. This is not optional.

5. Don’t try to go back to “normal”

Our goal isn’t to get back to a pre-pandemic way of life, but instead to employ whatever tools it takes to keep transmission as low as possible while restarting your economy.

This means:

-masks
-temperature checks
-6-foot distancing

Things that are relatively new concepts for the US, and are already proving unpopular.

Too bad, our experts said.

These measures save lives.

6. Watch out for the 2nd wave

The initial success stories in fighting COVID-19 — Singapore, Hong Kong, South Korea — all saw a rise in cases in March. Even after getting new cases down, you have to maintain constant vigilance to keep the rate low.

What will this take?

For starters, a national system tracking flu-like symptoms. Epidemiologists call it “sentinel surveillance.”

It’s the kind of system we should have had in the first place…

And lastly…
7. Communicate. Clearly. Constantly.

***Governors and other state leaders:***
One thing that came through in many of our interviews around the world was the importance of communicating clearly and consistently about the actions you take.

You’re going to have to…

...persuade voters to do things they won’t like at a moment of unparalleled partisan rancor, record unemployment, disarray in your state’s traditional media outlets and divisions among eminent scientists.

After those interviews, we asked American experts If they thought we could do it.

Their answer?

None of you are close to being ready.

All of the above are things that America’s governors need to do and take seriously.

Feel free to @ yours.

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