Reopening New York — and Keeping It Safe
NEW York City has been through hell. Now we need a clear strategy for what we do next. There is growing consensus that the way forward is through “containment”: confronting a pandemic using four key tactics: widespread testing, contact tracing, social distancing and isolation/quarantine of confirmed cases and their contacts. It will take a massive effort and unprecedented coordination among the city, state the region. Containment must be our new mantra.
Testing: We need sufficient supplies of both PCR tests, which diagnose active infections, and antibody tests, which screen for prior infections.
Mayor de Blasio has announced that we should have 100,000 PCR tests per week soon. This is good news; we need to be able to PCR-test everyone who wants a test, regardless of symptoms. That means dozens of temporary testing sites throughout the city available to everyone, regardless of immigration status or insurance. New Yorkers also need clear guidance on how, when and where to get tested.
Meanwhile, Gov. Cuomo and the state Department of Health’s work on antibody testing has been extraordinary. We need to build on this by running clinical trials on antibody tests to determine their sensitivity, what percentage of cases are asymptomatic, whether people develop immunity from infection and, if so, for how long.
Contact tracing: Once someone tests positive for COVID-19, we have to be able to trace all of that person’s recent close contacts. This is labor-intensive and specialized work. Before COVID-19, the social distancing.
That will be easier for some than for others. The pandemic has exposed the inequity that runs deep in our city, and it has had deadly consequences. Black and brown communities have been hit hardest, by far. We need targeted policies that factor in race and socioeconomic status to make social distancing possible for everyone.
Isolation/Quarantine: We need to ensure that someone who’s COVID-19-positive doesn’t spread the infection further. Because much of the community spread occurs ‘ We need to be able to PCR-test everyone who wants a test, regardless of symptoms.’ city had only 50 contact tracers for all five boroughs. We need to immediately bring on thousands if we’re serious about containment.
Technology can help. Apple and Google are teaming up to create a system to let iPhones and Androids ping one another within six feet for a period of time. Using anonymized coding to protect privacy, these phones will remember one another, and if the owner of one tests positive for COVID-19, the owner of the other will be notified.
This can’t replace the essential shoe-leather work of contact tracers, but it may complement it. Of course, we must set checks on any encroachment on our civil liberties, and Apple and Google have committed to strict limits.
Social Distancing: While our heroic essential workers — healthcare, grocery and food workers, pharmacists, police, firefighters, sanitation workers, MTA workers, delivery workers, nonprofit staff — have been showing up on the front lines every day, millions of us have spent the past five to six weeks largely indoors. This has been key to flattening the curve.
We adapted, because we know the stakes. We must keep it up, even as we reopen our city. Protecting fellow New Yorkers means doing your part by maintaining within households, Drs. Harvey Fineberg, Jim Yong Kim and Jordan Shlain recently wrote in The New York Times of one approach, “smart quarantine”: creating a tiered framework where people who test positive are isolated (at no expense to themselves) and those in their household are quarantined and quickly tested themselves.
If they test positive, they will also be isolated. In addition to slowing the spread of COVID-19, this would help relieve the massive pressure on our health-care heroes.
Of course, this entails sacrifice. Families might be disrupted and endure separation for weeks. But we know New Yorkers are willing to sacrifice to protect one another; we’ve done it time and time again.
None of these tactics alone will work. But if we do them all together, with a sense of purpose and shared sacrifice, we’ll be able to safely reopen the city, slowly and responsibly.
The next outbreak will come. Transmission of COVID-19 will resume, and we know how fierce it will be. But with a clear strategy and preparation now, we can contain the next outbreak. We have to: The future of our city depends on it.
Stephen Levin is a member of the City Council. Corey Johnson is speaker.