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Editorial: The way back

President Donald Trump’s suggestion that Americans could be returning to work in large numbers and even packing churches on Easter could charitably be described as aspirational. Easter, after all, is the most significant holy day for Christians as it represents rebirth and renewal.

But wishful thinking might be a more appropriate descriptor given the continual rise in the COVID-19 infection rate, death totals and hospitalizations that threaten to overwhelm the nation’s health care system. Places like New York City are already near the breaking point, and we are bombarded with stories about shortages in medical protective gear, ventilators and intensive care beds.

As of Friday, New Mexico had 191 cases and one death.

But the president – who does say he will listen to advisers like Dr. Deborah Birx and Dr. Anthony Fauci before deciding whether to extend the current “15 Days to Slow the Spread” – is on the right track when he says we need as a nation to assess how and when we can smartly bring people back to work while using strategies beyond “shelter in place” and business shutdowns to slow the virus.

Trump says we can’t let the cure be worse than the disease, but that can’t mean throw caution to the winds and simply let the elderly and other at-risk populations die. The message has to be to find that sweet spot that protects people but doesn’t lock down the economy for so long we fundamentally destroy it.

There are serious people thinking along the same lines.

Columnist Thomas L. Friedman in the New York Times reported on Dr. John P.A. Ioannidis, an epidemiologist and co-director of Stanford’s Meta-Research Innovation Center. Ionnidis wrote in a March 17 essay that we still don’t have a firm grasp of the population-wide fatality rate of coronavirus, but the best evidence suggests it may be 1% or lower. “If that is the true rate,” he wrote, “locking down the world with potentially tremendous social and financial consequences may be totally irrational. It’s like an elephant being attacked by a house cat. Frustrated and trying to avoid the cat, the elephant accidentally jumps off a cliff and dies.”

Dr. Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University, told Friedman that closing businesses and locking down companies may be necessary to curb community spread but could harm health in other ways. “Income is one of the stronger predictors of health outcomes,” he said. “Lost wages and job layoffs are leaving many workers without health insurance and forcing many families to forego health care and medications to pay for food, housing and other basic needs.” People of color and the poor will suffer the most.

Dr. David L. Katz of Yale University’s Yale-Griffin Prevention Research Center is an expert in public health and preventive medicine. He said in an op-ed published in the New York Times that we have three goals now: save as many lives as we can, make sure our medical system does not get overwhelmed – and make sure that in achieving the first two goals we don’t destroy our economy, and as a result even more lives.

Katz argues we need to pivot from horizontally restricting movement and commerce of the entire population without considering varying risks for severe infection to a more surgical, vertical strategy that would focus on protecting and sequestering those most likely to die or suffer long-term damage by exposure to coronavirus. We would basically treat the rest of society as we have done with familiar threats like the flu.

“Risk would not be zero,” but the “rejuvenating effect on spirits, and the economy, of knowing where there’s light at the end of this tunnel would be hard to overstate,” Katz told Friedman.

Of course people would need to continue to practice social distancing and handwashing. Hopefully, we have learned some lessons. A vaccine would be wonderful, and effective medical treatments for the virus would be as well. Widespread, immediate testing capabilities so those coming up positive could isolate would help.

But for now, we play the cards we have.

New York Gov. Andrew Cuomo, at the epicenter of the COVID-19 outbreak in the U.S., is giving serious thought to next steps. “What we did is, we just closed everything down as quickly as we could. Shut all the doors and boarded all the windows. There was no art to what we did. No nuance. …”

Cuomo said in his briefing on Thursday we will need a modified health strategy coupled with a get-back-to-work strategy that could see younger people and people who have already had the virus back on the front lines while targeting resources to the vulnerable and sheltering them. “It’s not right to do public health or economic development,” he said. “You have to do both.”

And be smart about it.

Our leaders at the national, state and local levels are facing difficult situations where lives are at stake. There is no roadmap for how to do this. But even though we haven’t seen the worst of this pandemic, it’s time to start thinking how we reboot in a smart, “surgical” way. If we don’t, the nation we leave for the 99% of people who survive COVID-19, and the next generations, will be a bleak and desolate place.

Keep in mind, there is a limit to the number of multi-trillion-dollar bailouts we can expect from Uncle Sam. In fact, the one that cleared Congress on Friday is borrowed money.

This editorial first appeared in the Albuquerque Journal. It was written by members of the editorial board and is unsigned as it represents the opinion of the newspaper rather than the writers.