Read: The official coronavirus numbers are wrong, and everyone knows it
Social distancing may become the norm, as governments and organizations close schools, halt mass transit, and cancel sports, entertainment, religious, and political gatherings. People could be quarantined in their homes, medical facilities, apartments, or dormitories. During the SARS outbreak, Ontario implemented “work” quarantines whereby health workers could travel only between home and hospital. Telecommuting and remote learning could become common for businesses and universities. People may elect not to go to movies or restaurants, or to limit travel, disrupting daily life and the economy. The State Department has recommended against travel to several countries, and that list will expand. Conceivably, the federal government might warn against, or restrict travel to, American cities or states experiencing major outbreaks. The U.S. resorting to mass lockdowns like in China seems inconceivable, but small-scale, temporary cordons sanitaire (guarded areas no one can enter or leave) might be put into place.
So what can we do? Quite a lot, actually. Here are some straightforward steps we could take right now to limit the damage from this outbreak.
The Centers for Disease Control and Prevention and state and local health departments have been starved of funds, impeding crucial functions such as surveillance, case detection, and contact tracing. Public-health budgets have been slashed by one-third in recent years. Public-health advocates have pushed for a new Federal Emergency Response Fund, but one has never been created. Although the Trump administration requested just $2.5 billion for COVID-19 (half taken from existing funds for the Department of Health and Human Services), Congress passed an emergency appropriation of $8 billion, in line with prior allocations for H1N1 ($7.6 billion) and Ebola ($5.4 billion). That funding needs to pay for a range of activities and organizations, including vaccine research, health departments, hospitals, and social safety nets.
Read: You’re likely to get the coronavirus
Americans will need to agree on a “social compact” whereby individuals subject themselves to social separation for the common good, while the government meets their essential needs. People separated from society may be highly vulnerable, including persons who are elderly, disabled, or with chronic health conditions. The government will need to provide food, medicine, and support for the lonely, fearful, or depressed.
Inequity creates America’s biggest gap in preparedness. Nearly 28 million Americans are uninsured, and many millions more underinsured. Large migrant and undocumented populations have limited access to essential health services. Rural, disabled, and low-income populations face additional barriers. If the uninsured have reduced access to health care or fear deportation, they may stay away from hospitals even as they remain in the community, spreading COVID-19 and other viruses.