- Healthcare Website contacted several public health specialists to see what they think of reopening the country amid the COVID-19 pandemic.
- Experts say some sort of physical distancing will still be required over the long term.
- Additionally, reopening too quickly could mean a resurgence of the virus.
All data and statistics are based on publicly available data at the time of publication. Some information may be out of date.
Regardless of when states choose to “reopen,” many people are concerned about how doing so will affect our health.
Healthcare Website contacted several public health specialists to see what they think.
- Pamela Aaltonen, PhD, RN, professor emerita of nursing, Purdue University
- Dina L.G. Borzekowski, EdD, research professor of behavioral and community health and interim director of The Global Health Initiative, University of Maryland
- Benjamin M. Brunjes, PhD, assistant professor specializing in Public Management and Leadership, University of Washington
- Boris D. Lushniak, MD, MPH, dean and professor of the School of Public Health, University of Maryland
- Amira Roess, PhD, MPH, professor of Global Health and Epidemiology, George Mason University
- Rodney E. Rohde, PhD, professor in the College of Health Professions who focuses on public health microbiology, Texas State University
What do you think will happen in governments that open on May 1? June 1? Do you think there are benefits to waiting past June 1 to reopen?
Borzekowski: We have too many unknowns to reopen. We must rely on, respect, and be patient for good science. Despite hard-working public and private laboratories, the science won’t be ready by May 1.
We do not have in place knowledge about antibodies. We lack a vaccine — and the infrastructure to access such a vaccine for all. Until these protocols are in place for all members of our community, we face continued risk of morbidity and mortality in reopening.
Brunjes: Until testing and hospital treatment capacity improves, full reopening simply is not going to happen. I would expect at least a few states to start the reopening process before June 1, but no one will be back to business as usual.
Lushniak: The date should be based on the epidemiology of the pandemic in the specific regions. Specific parameters should include a 14-day period of decreasing number of new cases, hospital admissions, and deaths. Even under those circumstances, reopenings should occur in a staged fashion with close monitoring and reactions to any resurgence of COVID-19.
Roess: This really is going to depend on the epidemiology of the virus. Right now the date of May 1st seems premature. The last thing that we’re going to want to do is have everybody jump right back and try to resume life as they had known it, only to have to shut down again.
Rohde: If we fully open in the coming weeks, or June 1, I believe we will see an acceleration of cases and additional deaths. Yes, there are benefits to waiting. We obviously need to get back to work, but until we handle testing and testing personnel questions, we must be cautious.
Are there aspects of reopening that should come first or be delayed?
Lushniak: The goal even with reopening is to make sure people stay at least 6 feet away from each other with or without the use of personal masks and adhere to the other public health recommendations. Healthcare needs to be able to readjust the flow and the grouping of patients and patient visitors to achieve this goal.
Roess: It’s likely that for the summer and possibly until the end of this year we will have to proceed cautiously with limited gatherings coupled with robust surveillance and contact tracing to minimize outbreaks due to reopening the economy. This can change if we have therapeutics in place or a vaccine, or if something fundamentally changes in the transmission of the virus.
What will be the new normal of life by the end of the summer or next flu season?
Brunjes: Until we have an effective treatment (vaccine or otherwise) for this virus, we will probably continue to experience periods of social distancing in response to increasing infection rates.
It appears likely that we’ll see a resurgence of infections either when we reopen or beginning in the late fall next year. The new normal life may be one of periods of normal activity followed by periods of social distancing to allow the medical system to recover and ensure that we’re not overrun with cases.
Lushniak: My hope is that by the end of summer the current pandemic crisis will be waning, provided that we have correctly implemented a staged reopening and reacted quickly to any resurgence of COVID-19. We should be into a full containment strategy which will include the 3 T’s: testing, treatment, and tracking (quarantining).
If COVID-19 follows the same pattern [as the flu] (and this is still to be determined) then we should brace for another wave, likely in the fall/winter, which also coincides with the beginning of flu season. If necessary, we need to quickly implement aggressive measures again.
For the immediate future, handshaking won’t be encouraged, and we’ll figure out more hygienic ways to greet each other.
Roess: It’s likely that most people will continue to distance, will wash their hands more, and will avoid greeting with hugs or handshakes. Temperature scanning may be required in some buildings as it is now, but the important thing to realize is that this can give a false sense of security.
It may be the case that we will see more people continuing to wear masks in public, particularly if they have underlying health conditions that put them at a greater risk of having severe outcomes from the virus or if they develop respiratory symptoms.
We may see a rise in substance use due to individuals trying to cope with the stress caused by the pandemic. There may be a rise in depression and suicide associated with the effects of the pandemic.
Rohde: At least for a while, I think we will have some “fear” of closed in, tight spaces like aircrafts and subways.
Are you concerned that states or counties may open too soon?
Lushniak: Yes, I’m concerned that the economic concerns will outweigh the public health concerns. Reopening too soon and not doing it wisely will lead to another wave occurring quickly. We need to follow the data!
Roess: There are some states that have been talking about opening up for the last couple of weeks and that’s very concerning, especially as the country as a whole is heading toward the peak of cases.
A lot of lessons will be learned from those counties and states that open up first. It’s important to realize that the epidemiology of the virus will ultimately dictate the right time and way to reopen the economy.
Rohde: Yes. I just don’t think people understand fully how this virus can overwhelm healthcare. If we reopen too soon, especially unregulated, we will accelerate cases and it will overwhelm our hospitals. Personally, I think we need to at least wait until May 1 and possibly “regulate” openings over the summer. Unless we get our testing and personnel figured out.
What rules should be in place to protect our health as the states or counties reopen?
Borzekowski: People are not and should not feel comfortable packing into the rush-hour metro until we have a way to know who’s still at risk. Widespread testing, with immediate results, must identify those who are asymptomatic or have recovered. We need a simple at-home reliable test to know who has antibodies and are not carriers of this virus.
Roess: Hospitals, nursing homes, and long-term care facilities will likely have to continue operating as though they are at risk for outbreaks.
Rohde: I definitely think “we” need to rethink design of common sitting areas, waiting rooms, and workspaces for more physical distancing. The most difficult will likely be public transportation and dense business areas. We will also need guidelines on stronger, more periodic cleaning and disinfection of “high touch” surfaces.
Lushniak: The concern is that the most recent data show that those harboring the virus may be spreading it during a totally asymptomatic period. Because of this, scanning for fevers may not be fully fruitful.
In every setting we still need to be distancing by 6 feet, or in many circumstances, especially in the early stages of reopening, be wearing masks. We need to keep emphasizing the basics especially in healthcare settings: individuals with symptoms should first call in for instructions — they should not come in and be mingling with others.
What do you think workplaces will need to do as they welcome back employees — any rules there to protect health?
Roess: Employers should consider allowing broader telework than was allowed prior to the outbreak. It will be important to allow individuals who do develop respiratory symptoms to have excused absences more liberally than has been the case prior to this pandemic.
Rohde: I think, much like 9/11 changed how we approach air travel, this pandemic will change how we approach others’ “personal space” and cleaning and disinfection of public and private spaces.
When will we see the end of masks, and if some people continue to wear them, will there be issues with that?
Aaltonen: I am only speculating that mask wearing will become more of a permanent part of some individuals’ interactions with their communities.
Rohde: I actually believe we may see more U.S. citizens wearing them, especially if traveling. We see this in other countries more and this pandemic may cause a culture change on masks for U.S citizens now. I don’t think anyone will be in a position to “judge” others that wear masks in light of this pandemic.