BY DOUG TERRY, VETERAN REPORTER, WRITER,
This is a draft of a plan to defeat the novel Coronavirus, to stop it
in its tracks.
There is likely no single plan that can do the trick, but, having
investigated the best ideas of epidemiologist and virologists, this is
intended as the start of plan provided the best minds in science
indicate its potential viability and, at the same time, modify it to meet
the conditions at the time of implementation.
First off, the premise is that the start made around March of 2020,
while working in some areas, is not working in others. This is due to
resistance by governors, the lack of a clear direction on the national
level, the resistance of the public and, importantly, the lack of a
concerted campaign of public education. (All of these issues will be
addressed here in turn, when appropriate.)
The original plan was worked out in the bowels of government during
the administration of G.W. Bush. It could be considered a “catch all”
plan rather than one tailored to this particular emergency.
Furthermore, the outlines of its recommendations for action might
have been limited by the perception of what could be done, what could
be asked of the public.
It is time to move past the perceptual limitations of public and
governmental cooperation and move to WHAT MUST BE DONE to
defeat the virus. This is the purpose of this outline.
Some elements of the pandemic virus are known, others lie between
known and presumed, awaiting scientific proof.
We know the following:
1. The point of infection to the appearance of symptoms, most
people go five days without becoming seriously ill. This can be
viewed as a kind of gestation period, a time when the virus is
taking root in the body, reading to do its damage.
2. We know about 40% of those who are infected never show any
symptoms. It is believed that people who are asymptomatic
can infect others, but this has been a subject of controversy.
The safe conclusion is to act as though they can transmit
infection, provided a means can be found to reduce the
3. From Harvard Medical School:
People are thought to be most contagious early in the course of their illness,
when they are beginning to experience symptoms, especially if they are coughing and sneezing. But people with no symptoms can also spread the coronavirus to other people
if they stand too close to them. In fact, people who are infected may be more likely to spread the illness if they are asymptomatic, or in the days before they develop symptoms,
because they are less likely to be isolating or adopting behaviors designed to prevent spread. We know that transmission mainly occurs person to person either by close
personal contact when breathing or with the second person coming into
contact with larger droplets expelled by singing, yelling, coughing, sneezing or
other expulsive verbal or non-verbal mouth and throat actions.
4. We know that transmission mainly occurs person to person
either by close personal contact when breathing or with the
second person coming into contact with larger droplets
expelled by singing, yelling, coughing, sneezing or other
expulsive verbal or non-verbal mouth and throat actions.
5. We know that indoor spaces without adequate ventilation are
ripe for virus transmission. We also know that the issue of
ventilation has been somewhat ignored in the battle and the
concept of “adequate” has not been carefully or widely defined.
Do central building air conditioning/heating systems capture
enough viral droplets to reduce or stop transmission? The
likely answer is no.
6. We know that testing, with its current delays, is almost totally
useless from a public health standpoint, only providing a
delayed yes/no outcome for the person who gets the test,
someone who might be deathly ill by the time the results or
available or who might have infected others while waiting.
Here is the beginning of a plan to address all of these issues:
We should consider a national or regional hard shutdown of 15 days.
This could first be implemented in the states that, at the time, have the
highest number of increasing cases and deaths.
What would a hard shutdown involve? Close everything, including
supermarkets, any gas station that cannot operate by credit cards
alone, all restaurants, all stores, even grocery stores. Only police, fire
and hospitals other identified emergency services would remain open
and, to the extent possible, with reduced staffs. Electrical power and
water would still be required, of course, but these could be provided
with minimum personnel and minimal interaction with the public.
One month or so before the hard shutdown, people would be advised
to get ready, to buy food, medicine and anything else they need.
Special provisions would need to be made of those who need
constant in home or nursing home care, again always looking to the
minimum required. Home nurses, for example, would be encouraged
to stay in the home where they work for this period.
In cities, such as New York, where thousands depend on public
transpiration daily, special arrangements would be required. It could
be a fleet of buses, with isolation capacity, would be put into service.
Since hospitals would remain open, those who must travel to their
work could anticipate their needs in advance and communicate them
to transit authorities. Some people, where necessary, could be housed
in hotels, again with minimal staffs and no regular room cleaning or
The issue of protective masks needs to be re-examined. Is it possible
to get better masks to those who would have to be out and about
during the shutdown, masks that protect the wearer as well as those
with whom she might come into contact? Mask strategy, instead of
relying on everyone to go their own way, would have to be part of the
plan. How a mask should be worn and what type of mask is best
would be part of an educational effort.
This 15 day hard shutdown would have good effects in that random
public spread would be halted, for the most part. In places where
people are crowded into small apartments or other tight spaces,
unfortunately, person to person spread would continue. This is an
issue that needs further examination and a plan toward resolution. In
New York State, as infections began to fall during its shutdown,
indications were the 60% of new infections were taking place inside
To be most effective, a 15 day plan needs to take place once rapid
tests are available, most favorably tests the individual could do at
home. If something like universal testing could place, we could be
assured that very few infected, transmitting people were going back
into public spaces.
The only other option for testing, barring rapid home tests, would be
the idea of pool testing whereby people were tested as a group to
determine if they needed individual testing. This kind of testing, on a
mass basis, seems very difficult to implement but should not be ruled
out. During the 15 day shutdown, those who were going to get sick
from the virus would be self identified by their illness. If 90% of the
public were to wear masks at the end of the shutdown, we should see
good results rapidly.
Returning to work could be done over, perhaps, a one week period with
alphabetical order used to determine the exact day. This would allow testing
of at least a high percentage of those going back to ordinary life.
One tremendous problem for businesses, individuals and families with
the indefinite shutdowns that took place largely on the east coast from
mid-March onward is the fact that no one had any idea when the all
clear would be sounded. How do you plan your budget for a family or
a business when you have no idea when your income will resume?
The answer is you don’t. Desperation sets in and people start to
wonder if the cure is worse than the disease.
A 15 day shutdown would be finite and most normal activities could resume at
the end, excluding super spreading events, like parties and gatherings in bars,
for an addition 15 days.
PROBLEMS WITH THE PLANS AS THEY EMERGED
For one thing, few scientists stopped to consider the needs of ordinary
life. Millions of people have little or no savings and rely on paychecks
to pay for vital needs, like rent, mortgages and food. The actions of
the federal government helped, but they were not closely tuned to the
way people live and their immediate needs.
Having a plan for a finite shutdown that would likely occur in the fall,
2020, the programs to provide support could be better organized. For
example, a mass distribution of a food stamp type program could
occur before the shutdown began. Likewise, cash distribution to cover
the period could take place in advance.
All of this would have to be carefully planned, point by point. It is
estimated that 20% of the population has some form of disability. The
means of getting groceries and food to this population would be a
central concern and some way to respond to emergency shortages
would have to be devised.
For most people, putting in two weeks of provisions for food, with cash
or other payment in hand, would not be a major problem as long as
money is available. Of course, millions don’t have extra money. What
they get in their paychecks is dedicated to immediate needs ahead, so
there is a need for supplemental income in advance.
A public education campaign would have to be conducted on this
issue as well. Some means of getting emergency food to those who
were not able to plan ahead would have to be implemented, perhaps
by having police officers or firemen directly deliver food when called.
This plan will work best when it is thought of as a near complete
shutdown for two weeks and a day. People would be encouraged, of
course, to continue outdoor activities, getting exercise, taking long
walks and biking. No one other than those who are proven to be ill
would be confined to their houses or apartments.
Here is the outline for the beginning of a plan that would be carefully
reviewed by virologists, epidemiologists, scientists and public health
1. A 15 day maximum shutdown is planned for the US with about
30 days notice (45 if possible)
2. Everything is closed commercially, including grocery stores,
schools, all businesses. There is no division, in the main, between
essential and non-essential.
3. Cash payments or money cards are distributed to the public in advance.
4. The public is advised to buy more than a two week’s supply of food, three
to four weeks if possible. Stores would be advised in advance to have as
much stock on hand as possible. Some provision would be made should the
stores run out before the shutdown begins.
5. Police, firefighters, hospitals and ambulance services remain available but
with reduced staffs where possible. Whatever provisions that can be made for
hospital workers to stay in walking distance of their work (AirB&B, etc.) are
made in advance. The definition of "essential workers" would need to be as
narrow as possible.
6. Whatever mass testing, including tests that are not 100% reliable,
would be employed at the end of the 15 days.
7. Once the shutdown ends, 1/3 of the work force would return to their
jobs (some method, such as sorting by alphabetical order would be
employed). This staged return would allow to test more of those
returning to work immediately. One week later, the rest of the work
8. Bars, indoor dinning, gym clubs, etc. would remain closed for 15
more days after the shutdown. Take out only during this period.
9. There would be no limitation on people going outside their homes
other than, perhaps, curfews in major urban areas after 10 PM or
midnight each day. If crime were to accelerate radically, the curfew
could be made much earlier.
10. There would be no limitation on interstate travel, other than those
imposed by the states involving quarantines. The public would be
asked not to travel unless a trip was absolutely necessary and only if
they had a test for the virus showing they were negative.
11. The wearing of masks, including better masks that protect the
wearer, would continue. The mask mandate would be reviewed every
14 days after the shutdown for potential removal.
12, After 31 days from the start of the shutdown, all normal business
activities and travel would resume, consistent with safety measures
imposed by businesses, such as airlines.
13. Prior to and during the shutdown, special attention would be paid
to the issue of indoor air ventilation and whether it would be
necessary, on the return to normal business, to find a means to allow
outside air to circulate in otherwise closed spaces.
14. As employees return to work each employer could, to the extent
possible, establish their own testing system. If rapid tests become
available, even without high reliability, they would be employed. It is
better to know something than nothing. Pool testing could also be
The national social and psychological impact of a complete shutdown
would likely greatly reduce the resistance to masks and other
protective measures. In general, this effort would be explained as the
last “full force” effort to stop deaths from the virus prior to a vaccine.
With a broadbased educational effort, the shutdown could, with good
fortune, help to create a sense of a clear national emergency. If a vaccine
were to become available before the complete shutdown, it seems unlikely
that enough of the population could receive shots to obviate the need for the
shutdown. Specific strategies could be employed, however, such as, first,
making the vaccine available to older citizens and then inoculating regions of
the country so that shutdowns would only be needed in other regions. Overall,
it seems highly unlikely that a vaccine would be available in time to prevent a
shutdown effort in the early fall, 2020.
People need to know what the likely course is for the future. The
educational campaign envisioned also needs to explain why
recommendations have changed based on developments and new
discoveries about the virus. The idea that masks help protect
everyone, including those with compromised health, needs to be
better explained. That fact that masks are not likely to be
recommended, or demanded, as a permanent feature of America life
needs to be emphasized.
Any approach that is not comprehensive, that does not involve a
multilevel effort, will not likely to succeed. What we have had to this
point is piecemeal in the extreme: varied recommendations that
change week by week, resistance from governors and other officials,
propagandized statements on talk radio and right wing television and
no sense of a national emergency due to mixed messages from the
White House. A coordinated, carefully planned effort can work. The
alternative could be 100,000 or more unnecessary deaths coming in
the fall and through the winter.
(more to come, this is a draft, not the final form)
By Doug Terry, written during July and August and first posted here 8,7.20,
8:43 PM, eastern
A method of contact and to post on this draft will be available 8.8.20
The SPRP outlines the public health measures that need to be taken to support countries to prepare for and respond to COVID-19. It can be used to rapidly adapt National Action Plans for Health Security (NAPHS) and Pandemic Influenza Preparedness Plans (PIPP) to COVID-19, taking what we have learned so far about the virus and translating that knowledge into strategic action that can guide the efforts of all national and international partners to support national governments, scroll below for more.