Exit ramp

Social distancing, albeit unevenly applied (Georgia's governor Brian Porter Kemp claims he had no idea it could be spread by people not exhibiting symptoms; and then exempted churches and beaches  - unbelievable), has applied the brakes to covid-19's spread. That may prevent the tragedy of millions of unnecessary deaths from an overwhelmed health care system. But what next? Models suggest that unless the virus is completely eliminated (as New Zealand seems to have done by acting swiftly and aggressively), going back to "normal" will simply allow the virus to propagate again. Since we have not crushed the infection, we need an off-ramp from the lock-down that doesn't put lives at risk again.

Long term a vaccine will help as will herd immunity, but what about the next 9 months?   

One possibility is that a cure for the most severe cases be found that will reduce the mortality rate. People will get sick but their chances of surviving will increase significantly. But that's not here yet.

So before we have a vaccine and if no cure is found, what then?

The first is to get more data, in real time rather than lagged by three weeks, on who has the infection. That will involve massive amounts of testing and hopefully 'instant' results. That data should also be aggregated into a database to understand where hot-spots may be emerging.

While not perfect one could require people get tested weekly and provide proof on demand that they are covid-free that; without that they should not be allowed to circulate in public.

Finally, a method of back- and forward contact tracing is needed. Once an case of infection is identified, those that person has been in contact with need to be identified and tested; and those they have been in contact be identified and tested too (like a snowball social network data collection effort).

Technology could help here; an app if widely adopted that recorded all other apps in Bluetooth range proximity could help in that contact tracing effort, but like all apps with network effects, widespread adoption is needed to make it effective. Once such an app is developed, adoption might be accelerated if localities (towns, counties) required all restaurants to require the app be installed and active for all their patrons.

Another possibility is to require Fit-bit and similar health monitoring app companies to share data; this could be aggregated and annonymized giving a broad picture of small regions that may be heating up, triggering localized lock-downs; or it could be shared with personal data sent to the CDC (and the local authorities) to ensure that infected people are prevented from circulating freely in the community.   

None of these fit comfortably with American individualism; and they need not be federally mandated. states or counties could implemented these requirements more locally (although, as The Economist noted, there may be legal challenges to such measures). But if we are to avoid the two extremes, an enormous number of deaths or an economic depression, such seemingly unthinkable measures may be needed.