For millions of Americans who believe that COVID-19 is real, dangerous, and requires a plan of action, Joe Biden’s election to the presidency has finally offered a path out of the seemingly never-ending pandemic. Indeed, compared to President Donald Trump’s approach—which centered on financing the development of vaccines, but did little else to mitigate the spread of the virus or even to ensure proper distribution of vaccines—Biden’s approach seems, in the words of one commentator, “maddeningly obvious.” But in truth, it is not nearly enough.
Naturally, we are optimistic. Biden has a plan and Trump didn’t. But our optimism is a mirage. The new president does not aim to eliminate the virus. Rather, he wants to “[m]itigate spread through expanding masking, testing, data, treatment, workforce, and clear public health standards.” This is a fancy way of saying he plans to manage the pandemic so that infections and deaths don’t overwhelm hospitals and ICUs all at once. He simply wants to try to spread out the pain. Is that the best we deserve?
True, there are vaccines being manufactured, distributed, and deployed as fast as possible via the patchwork and chaotic systems that were forced to develop under Trump’s non-existent leadership. But already we are seeing new variants of the virus develop as it festers through cities across the world, variants that are less responsive to vaccines, forcing vaccine producers to scramble to develop more effective booster shots. Even Biden himself admitted that Americans must prepare for hundreds of thousands more deaths this year before seeing relief.
Meanwhile, California Gov. Gavin Newsom appears to have simply given up, announcing—to most people’s shock—that since deaths and infections in the state dropped slightly, it was time to lift some restrictions. The most populous state in the nation, which has also been the latest epicenter of the disease, may see some “potential economic rewards” as per one report describing Newsom’s decision. In other words, people may start to die again, but at least businesses may start to reap profits once more. Somehow we are supposed to take heart from that callous calculation.
Between Biden’s federal plan to mitigate the virus and state-level approaches that place profits over people, we are likely to remain stuck in this deadly pandemic, treading water, for many more months—unless the newly seated president takes drastic short-term measures. All he has to do is look to the East.
Scientists have seen far greater success at ending the pandemic in China, Hong Kong, Taiwan, South Korea, Vietnam, New Zealand, and Australia. Certainly, some island nations have a geographic advantage in being able to bar all air travel to help eliminate the virus. But large nations like China, South Korea, and Vietnam have proven that one need not be a small island in order to successfully tackle the disease. These nations have the benefit of experience with earlier deadly diseases, and early on they adopted an “elimination strategy” rather than mitigation.
There are scientists in the United States calling for such measures as well. Yaneer Bar-Yam is the founding president of the New England Complex Systems Institute, where he is an expert on pandemics and other complex systems and works with initiatives like CovidZero and the COVID Action Group. In an interview, he explained to me that “there is no point in time where it’s not worthwhile to get rid of this within a period of five to six weeks.”
Yes, it is true that were the United States to take an elimination approach to COVID-19, we would be done with this pandemic in a short period of time, and like many Eastern nations, we could have been done with it months ago had we had leadership with foresight. What Bar-Yam is proposing is that the United States adopt the same strategy that nations like China and Vietnam took. He explained, “if we start now, taking really strong action, much of the country would actually be cleared of the disease in about four weeks, and a lot of it, if not all of it, would be cleared by six weeks.” At that point, “we could start getting back to normal within a few more weeks, just being careful how we reopen,” he said.
By “strong action,” Bar-Yam means a complete halt to all travel and a strict social distancing for a short four to six weeks. While this sounds horrifying to a population already weary of 10 long months of restrictions, it is a sensible way to squash the disease. Anyone who is infected with the disease at the beginning of the strict shutdown would not be infected at the end of the shutdown. Even accounting for the time that it takes for an infection to spread within one’s household, by four to six weeks, intra-household transmission would be over with, and none would remain infectious. Meanwhile, inter-household transmission would have been stopped via the strict measures.
Coming out of the harsh shutdown, we would emerge into a world largely free of the disease. Only at that point would a strategy of masking, testing, and contact tracing of the type that Biden is offering actually be effective at stopping small outbreaks. We would still need mass vaccinations, but the shots would be more likely to work if we stop the virus from spreading and thereby mutating.
In order to adopt the necessary elimination strategy, the United States faces two hopelessly insurmountable challenges: the intransigence of a population that has been fed misinformation and believes the virus is a hoax, and the refusal of politicians to pay Americans to remain at home rather than having to choose between employment and infection.
If returning to normalcy is what most Americans want, and resumption of economic activity is what politicians and businesses want, the fastest, most efficient way to get there is to spend the four to six weeks eliminating the disease rather than months and perhaps years hopelessly trying to mitigate it, and ultimately failing.
Bar-Yam explained that the longer we wait to take strong action, the harder it will be to take it and the worse the crisis will get. He painted a grim picture of the near future saying that the new highly transmissible variants could overwhelm health care facilities by March 2021. An incredibly strict shutdown would be difficult to accomplish but offer rewards so high that it would be worth the pain. After all, millions of Americans have been stuck in a semi-shutdown for months with no end in sight. It is akin to a wounded patient opting for a painful surgery that has a guaranteed outcome of success rather than accepting endless band-aids to staunch the bleeding and prolonging the pain indefinitely.
Offering a tantalizing view of what Americans could enjoy if we followed an elimination strategy, Bar-Yam said that the reopening wouldn’t be the kind of haphazard approach we are using now where an endless cycle of reopening and shutting down throws society into chaos and puts normalcy ever out of reach. It would be a slow yet methodical reopening, “which is what people are experiencing in Australia almost all the time” right now, Bar-Yam said. When outbreaks do emerge (say, from an international traveler), they are very small, and quick localized action can squash them without disrupting society as a whole.
We do not have to accept Biden’s prediction that 200,000 more Americans will die. Adopting an elimination strategy minimizes infections and the terrifying long-term health effects of surviving COVID-19, and it minimizes the massive rising death toll that we seem to have become numb to.
The New York Times assessed the state of Wuhan, China, a year after the pandemic was first declared. The city that became synonymous with death and suffering, offering a grim preview of the disease to the rest of the world, is now largely back to normal. Except that the Times, in noting that today’s Wuhan “heralds a post-pandemic world where the relief at unmasked faces, joyous get-togethers and daily commutes conceals the emotional aftershocks,” made no mention of the starkly different approaches that China and the United States have taken against the novel coronavirus. Americans are unlikely to return to the pre-pandemic normal that Chinese residents now enjoy simply because we are not trying to eliminate the virus like China did.