The following is a post from Asaf Bitton MD, MPH, Executive Director of Ariadne Labs, Brigham and Women's Hospital/Harvard T.H. Chan School of Public Health:
I know there is some confusion about what to do next in the midst of this unprecedented time of a pandemic, school closures, and widespread social disruption. I have been asked by a lot of people for my opinion, and I will provide it below based on the best information available to me today. This is my personal and well-informed opinion, and my take on the necessary steps ahead.
What I can say as a physician and public health leader, is that what we do, or don't do, over the next week will have a massive impact on the local and perhaps national trajectory of coronavirus. We are only about 11 days behind Italy and generally on track to repeat what is unfortunately happening there, as well as much of the rest of Europe very soon. At this point, containment through contact tracing and testing is only part of the necessary strategy. We must move to pandemic mitigation through widespread, uncomfortable, and comprehensive social distancing. That means not only shutting down schools, work (as much as possible), group gatherings, and public events. It also means making daily choices to stay away from each other as much as possible to Flatten The Curve.
Our health system will not be able to cope with the projected numbers of people who will need acute care should we not muster the fortitude and will to socially distance each other starting now. On a regular day, we have about 45k ICU beds nationally, which can be ramped up in a crisis to about 93k. Even moderate projections suggest that if current infectious trends hold, our capacity (locally and nationally) may be overwhelmed as early as mid-late April. Thus, the only set of interlinked strategies that can get us off this concerning trajectory is to work together as a community to maintain public health by staying apart.
The wisdom, and necessity, of this more aggressive, early, and extreme form of social distancing can be found here. I would urge you to take a minute walking through the interactive graphs - they will drive home the point about what we need to do now to avoid a worse crisis later.
So what does this enhanced form of social distancing mean on a daily basis, when schools are cancelled?
I can suggest the following:
I realize there is a lot built into these suggestions, and that they represent a real burden for many people, businesses, and communities. Social distancing is hard and may negatively impact others, especially those who face vulnerabilities in our society. I recognize that there is structural and social inequity built in and around social distancing recommendations. We can and must take steps to bolster our community response to people who face food insecurity, domestic violence, and housing challenges, along with the many other social inequities.
I also realize that not everyone can do everything. But we have to try our absolute best as a community, starting today. It is a public health imperative. If we don't do this now voluntarily, it will become necessary later involuntarily, when the potential benefits will be much less than doing so right now.