Caitlin Rivers, PhD+ Your Authors @cmyeaton Outbreak science + epidemiology + health security. Assistant professor at Johns Hopkins Center for Health Security (@JHSPH_CHS). ELBI alum. May. 07, 2020 2 min read + Your Authors

I’ve been noticing a dangerous polarization in our discussions around navigating our way through the pandemic. Reopening is said to be playing games with people’s lives. Continuing stay at home measures is said to be without regard for the economy. This is a false choice. 1/

We were the first group to put out detailed reopening guidance back in March, the same week that many states were issuing stay at home orders. The goal is and has always been to reopen – the question is how to do it safely. 2/

Staying home was always meant to be temporary, to prevent the healthcare system from being overwhelmed and to put in place capacities to enable a transition to case-based management. The question is how and when we will reopen. It was never about if we will reopen. 3/

I’ve written about the answers to these questions extensively. The ‘how’ is through test-trace-isolate. The ‘when’ is as soon as we have that in place. The ‘then what’ is by re-introducing low risk activities, waiting to see what happens, and moving up from there. Links at end 4/

As I’ve said many times, what we want to avoid in the reopening process is creating the conditions that led to us having to stay home in the first place. The conditions of NYC, Lombardy, Wuhan. And yes, those places are all urban centers, but rural areas are vulnerable, too. 5/

My answer to Q's about whether x, y, z place is ready to reopen is to ask whether those places have the capacities, and if not, how do we build them. Yes, it’s a big lift, but (my current fav phrase) we have done hard things before. We can do this too. 6/

But – and I’ve said this before too – there are many dimensions to health and well-being, many of which build fundamentally on economic stability. I worry as much as anyone about secondary consequences of e.g. poverty and other gaps in care of chronic conditions 7/

My job is to provide public health counsel, and so that’s what I do. It’s a missed opportunity to have a deeper discussion when I or other experts are set up in an either-or, economy-public health discussion. It’s about how we do both, safely. 8/

Links 9/9
[1]  https://www.aei.org/research-products/report/national-coronavirus-response-a-road-map-to-reopening/ 
[2]  https://www.centerforhealthsecurity.org/our-work/publications/public-health-principles-for-a-phased-reopening-during-covid-19-guidance-for-governors 
[3]  https://healthpolicy.duke.edu/sites/default/files/atoms/files/covid-19_surveillance_roadmap_final.pdf 
[4]  https://www.centerforhealthsecurity.org/our-work/publications/a-national-plan-to-enable-comprehensive-covid-19-case-finding-and-contact-tracing-in-the-us 


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