Apocalypse: Now What? Quarantine goals

A reader asks: What exactly is the goal of quarantine, and are we there yet?

Stickers signifying patients and staff have been screened

Stickers signifying patients and staff have been screened for COVID-19 seen on a table at Country Doctor Community Health Centers in Seattle's Central District, April 1, 2020. (Matt M. McKnight/Crosscut)

Coronavirus has changed our reality for the foreseeable future, prompting questions from you about how to navigate our strange new normal. In this weekly column, we hope to answer them with practical advice, ideas and solutions. Ask your question at the bottom of this story.


Question: I've heard some skeptics in my family say that hospitals are more prepared than a month ago, and if we’re simply flattening the curve of deaths, the number won’t change if we open up now versus later. Plus, opening now will further herd immunity. What's the actual goal of quarantine and how might it differ or not from this?

I’ll start by just admitting I’m pretty exhausted. I was up late at the house party I threw last night; I was in close proximity to my loved ones, so my rotator cuffs got wicked sore from all the hugging I haven’t done in months.

This was just after an all-day hike together, on a faraway trail near my favorite mountain town. I’ll have to answer this quickly, since I’ve got rezzies for us all at my favorite restaurant tonight, which just reopened without a hiccup and even hired back all the staff. Can’t believe I got a table for that big of a group; I’ll have to high-five Tom. I’m not sure what to order, because I can barely remember what restaurant food even is, but it probably will have duck fat in it or an oyster on it. Hello, Normal! So good to see you! Why is my face so wet?

OK, now that I’ve wiped away those bitter Proustian tears, I feel your relatives, I really do. With each passing day, “stay at home” feels more like shorthand for “reenact Misery at home.” We’re all looking for a pinprick of light at the end of a very long, dark tunnel

If you squint, there is one — in the form of that flattening curve and the slowing of cases and deaths in Seattle and Washington state. Some public lands and industries could open in early May. Hospital capacities on average are at 70% statewide. According to some models, it is within the realm of (distant) possibility that a wider, safer reopening could happen by June. That it’s even on the table is precisely because of you and your family’s strict adherence to stay-at-home orders and social distancing. (Yes, I can see you like Santa Claus. No, I will not give you a Dyson in December.)


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But this is the really important part: 21 people died Tuesday in Washington from COVID-19. We are still very much in the thick of it, and lives are still at stake. Our actual numbers are fluid, and going from stay-at-home to 100% operational could very quickly erase the gains and sacrifices we’ve all made. We must go slow precisely because the virus can move so fast, and so mysteriously. In fact, we’re rethinking what we know about coronavirus almost every day — from airborne transmission to summer reprieves to the impact of smoking or vaping

About that herd immunity: It’s often heralded in some circles as a Horcrux to our Voldemort; a One Ring to our Sauron; a horribly designed and then cleverly retconned thermal exhaust port to our Death Star. But like those films, for now it’s probably best to consider it fantasy (quiet, nerds). Herd immunity works when the majority of a population builds up a resistance and so the disease peters out. But scientists think as much as 80% of a given population must be exposed to coronavirus before herd immunity can suppress it.

Even if fatality rates for the virus fall on the low end of estimates — 1%, say — that would mean 56,000 deaths in Washington alone. A gradual path to reopening and longer adherence to stay-at-home orders and social distancing can prevent many of those deaths. (Revisiting those classic film series listed above ought to get us to Memorial Day, at least.)

In the most pointed way, saving lives is the “goal” of quarantine (and maybe this whole human project business? But I digress.). To that end, your family deserves a “job well done; keep it up” pep talk. But I would also encourage your family to start thinking about the future differently, because though this stay-at-home order will likely end, there’s a decent chance some version will come back. Tomas Pueyo’s now-famous “The Hammer and the Dance” article does a fine job of explaining the delicate seesaw of social distancing and gradual reopening and possible reclosures we’ll need to employ to keep saving lives. This piece by Ed Yong describes what life under pandemic might look like into the summer and beyond.  

Spoiler alert: “Normal,” at least as we knew it, probably isn’t coming back. This makes it all the more important to celebrate the things we love as they return, each at its own excruciatingly slow but necessary pace. Every socially distanced hike, spaced-apart house party, or reopened duck-fat-’n’-oyster takeout window we get in the coming months or years should be a precious reminder of what we’ve earned back and what we stand to lose again. 

And Tom: We will high-five again. I will find you.

 

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