The frames for the discussion on how the US deals with COVID fall into two camps:

• Save the economy vs lockdown the country
• Wear a mask vs don’t wear a mask

So long as that’s what everyone concentrates on, the disease will not be “managed” until there is a set of vaccines (different vaccines will be necessary for different cohorts) and effective treatment protocols. And that’s not going to be near-term. Until that happens, cases will continue to rise, and will keep spreading, and it will happen stealthily, that is, we won’t know it’s a problem until after it is already a disaster. UNLESS we re-frame the discussion and adopt a program that will work to stem the spread. Honest, other countries have done it, and we need to do it here.

This is the United States, where politics trumps reality far too often. We have no national leadership, and we won’t until such time as the Orange Menace has been removed to the cell he so richly deserves and takes his minions with him. Therefore, solutions need to be at the state and local level, and there actually ARE ways to do this, get the case counts down, and simultaneously keep as much of the economy operational as possible.

What everyone forgets is the information on pandemic control “below the fold”. That means test as many people as possible, isolate the positives, and seriously contact trace. And yes, New York is the exact model that every state and locale should follow. Because it works. That means not only testing, tracing and isolating, but providing daily, transparent data at a micro level.

Tests are available, and tests are free. If you have insurance, they’ll take your card and bill your insurer, but the cost to you should be either zero or minimal. The more people who are tested, the better the chances of finding out where coronavirus is hiding. And it is hiding. Until we find it, it will keep spreading. The ONLY job the virus has is to infect every single person. That’s what it will do. If we can’t find it, we can’t get the R-Naught down below 0.8, which is where we need to be. For example, here in PA, the lowest transmission rate we’ve had was .82 in April, and our rate has been rising statewide since May 7th. It won’t be a disaster for another couple weeks, but it will keep rising because we are neither testing enough nor tracing nor isolating. You can see your state data here. And remember, there is a lag between date of infection, hospitalization, ICU and death. And that doesn’t even include the number of people who are permanently damaged or disabled from having a mild to moderate case of the disease. Not to mention the inflammatory syndrome in kids.

Testing doesn’t matter if there is no way to isolate people who are positive, whether they are symptomatic or asymptomatic. Municipalities and regions need hotels and other options for people who cannot isolate at home. If you are positive, and you go home to a place shared with other people, there is a high probability they too will become infected.

Testing is less effective if there is no contact tracing. If someone is positive, that person was infected by another person, and likely passed it on to one or more additional people. The chances of someone getting infected if he/she lives alone, and has 100% of everything delivered and has had no human contact since the original lockdown is zero. Contact tracing, testing contacts and then isolating the infected is what brought infection rates down in every single country that has successfully beaten back the scourge.

So what can you do? I hear you: “But I wear a mask, never touch my face, socially distance and wash my hands until the skin is coming off.” Should you be doing those things? ABSOLUTELY. But unless everyone does it, it’s not enough. Therefore, do this:

1. Go get tested.
2. Convince everyone you know to get tested.
3. Call/write your local and state reps to allocate funding for contact tracing and isolation facilities. The system in most places (except NY) is not really viable. Here’s an example.
4. Contact your city, county and state Health Department to get them to collect and disseminate data about daily new cases at the zip code level, percent positives, number of people tested, hospitalizations, ICU bed utilization, and deaths. That data needs to be tracked and disseminated daily. NOT total numbers to date, but accurate, daily numbers. The earlier trends can be spotted, the earlier they can be handled.

If you are unemployed, take a course (many are free) and get certified to be a contact tracer. Here’s one. Then apply for a job doing so. One of the reasons for a lack of contact tracing is a lack of people to do it. In addition, in many places, they are using unpaid volunteers – if you’ve got the time, find a local program to help in the effort.

In addition, if you can stay home. STAY HOME. Certainly, this isn’t an option for everyone, but if there is any possible way that you can minimize your interaction with other humans outside your household, do so.

The American economy is dependent on consumers buying goods and services: if you can, find a way to contribute to the economy, especially the local economy. But do it in a way that minimizes your interactions with other people. It’s a fallacy to believe that “opening” the economy while the virus is rampant will “save” the economy because if people don’t have confidence, they won’t spend money even if places are open. And as we’ve seen, often places re-open, and then close a day or two later because a worker or a customer tests positive, which brings us back to why testing is so critical.

To support businesses, consider curbside pickup in lieu of going inside – this provides the same amount of income to the vendor, and minimizes human contact. If you want to support your “touch” provider (e.g. hairdresser, manicurist, massage therapist, etc.) consider paying what you’d pay and then not getting the service. Certainly, not everyone can afford this, but if you can, this is the time to spread your money around. If you want to avail yourself of restaurant food and drink – stick to curbside instead of “dining in”.  It costs the restaurants less to serve you, they do less work, you’re still supporting them, and above all – please tip your server/delivery person well — they depend on tips.

As the numbers go up, most people are frightened, and should be. In the vacuum where leadership should be, it’s incumbent on each of us to do what we can to stay safe, and keep others safe. So get tested, and pester your officials to do all that’s possible on a local level. What EACH AND EVERY one of us does affects the case count. We can each be as diligent as the New Yorkers who faced the earliest assault were, or at the other end of the spectrum, we can be the covidiots who protested for the right to get their hair cut, refused to follow protocol, and are now part of the case count.

The choice belongs to each of us – be diligent, stay safe, and pressure all your elected officials to set up programs to test, trace and isolate.