Even as the state responds to a rising daily death toll from coronavirus, even as we see new orders including a face mask mandate, Gov. Ned Lamont is looking at a wide range of information and guidance as he crafts a plan to restart Connecticut after May 20.
Part of that guidance comes from the White House, which revealed a detailed, three-phase plan Thursday night that governors can use to reopen their economies — after they achieve two weeks of declines in new coronavirus cases.
That standard, two weeks of declines, is shaping up as a near-universal touchstone, along with the need for more testing and plans to isolate people with COVID-19.
Beyond that, the central questions in reopening include how quickly businesses and public spaces can handle people safely; and as the disease spread winds down, how public health authorities can identify, isolate and contain new cases.
“I do believe the people of Connecticut need a sense of direction,” Lamont said during his daily briefing at the state Capitol. “And schools is obviously a key part of that decision. We’re going to do it in a safe way to make your state safe.”
While a few businesses and politicians are pushing for a rapid return to normalcy, virtually all experts agree it must be gradual, based on the public health issues. Lamont suggested the smaller and most critical businesses would open first, with huge gatherings such as sports events and arena concerts the last to return.
“The Travelers golf tournament will be played in Connecticut, in June, without fans,” Lamont said.
Strict health practices
Some common tactics have emerged, some of which are reflected in the White House guidance.
People should continue frequent hand-washing, mask-wearing in public and staying home if they are sick. Employers will be expected to develop policies for temperature checks, to disinfect high-use areas and tp continue social distancing in the workplace.
As the number of cases declines, and as people’s lives return to normal, each new case will be monitored much more closely than is happening now, when many sick people are simply told to stay home without getting a test.
Authorities would then need to force those people to self-quarantine in attempt to cut off further transmission of a virus that Ko said is highly contagious.
“The big question is how to do that,” said Albert Ko, the prominent Yale epidemiologist who co-chairs Lamont’s restart committee. “This is one of the key cornerstones of our program. It’s going to take hard work, quickly. This is not like the normal flu.”
Ko said that current scientific evidence does not indicate whether people who have been infected and recovered build up enough immunity to fight off future COVID-19 infections.
The aggressive containment could mean significantly more oversight over how people with COVID-19 are isolated — raising questions about how far the state and health authorities can go, especially when it comes to technologies deployed to track the illness.
“Something the governor has said repeatedly is, we are a free society and we need to balance that with the public health needs that we know a reopening is going to require,” Lamont spokesman Max Reiss said.
Locally, ideas for reopening begin with members of the restart committee Lamont named this week, headed by Ko and Indra Nooyi, the retired chairwoman and CEO of PepsiCo, a friend of Lamont’s from Greenwich and co-chairwoman of AdvanceCT, the state’s business recruitment arm.
Supply chains for materials and the acquisition of testing equipment are among the keys to getting the state back to work, Nooyi said. “Testing capacity is getting increased three-fold and four-fold,” she said on a teleconference call with reporters, Ko, Lamont and others.
The federal recommendations are intended to assist state officials, who will maintain all authority to determine when and how states reopen, President Donald Trump said during a briefing Thursday night. That was a retreat, under pressure, from a claim he made earlier this week that he held the sole power to determine how states lift restrictions.
“Every state is very different,” Trump said. “If they need to remain closed, we will allow them to do that. ... We have large sections of the country right now that can think about opening.”
In the first phase of reopening, vulnerable people should still shelter in place and everyone should avoid gatherings of more than 10, but people can return to work in shifts, White House officials said. Schools should remain closed and people should avoid non-essential travel, although outpatient elective surgeries can resume.
Phase two, after 14 days of sustained declines in cases and hospitalizations, suggests that more workers can return to the office and group socializing can rise to 50 people and non-essential travel can resume. Schools, day-care centers and camps can reopen but vulnerable people would stay home.
After another good two weeks, in phase three, vulnerable people — like seniors and those with preexisting conditions — can return to society and workplaces can resume normal operations.
“This is a rather robust program for re-entering into normality,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. “The dominating drive of this was to make sure this was done in the safest way possible.”
Politically connected docs
Also on the governor’s committee, so far, are two other very influential medical doctors: Scott Gottlieb, a Westport resident and former head of the U.S. Food and Drug Administration under President Donald Trump; and Ezekiel Emanuel, a bioethicist, cancer specialist and vice provost at the University of Pennsylvania.
Emanuel is the brother of Rahm Emanuel, a former White House chief of staff, member of Congress and mayor of Chicago. Ezekiel Emanuel is also a partner at Oak HC/FT, the venture capital fund where Annie Lamont, the governor’s wife, is co-founder and managing partner.
Gottlieb is the author of a March 28 report by the American Enterprise Institute, which favors free-market policies, and is co-author of an April 7 report by Duke University, both of which detail aggressive standards for controlling COVID-19 before reopening the economy.
The Duke report describes a medical “surveillance system” that includes stepped-up monitoring and isolation of new cases.
“The proposed COVID-19 surveillance system builds on existing models and principles of public health surveillance, but recognizes that the transmissibility and virulence of COVID-19 require a much more substantial capacity for rapid detection and public health response,” the Duke report said.
There’s nothing in either report that spells out electronic monitoring of individuals or involuntary confinement of sick people. It remains unclear whether the principles in the Gottlieb reports would clash with civil liberties and privacy concerns, but the reports appear to outline standard, if aggressive, techniques for gathering health information and isolating cases.
Gottlieb’s work, Lamont spokesman Reiss said, “is one of a multitude of sources that the governor and the advisers from AdvanceCT are going to be using to help make the decision of what a recovery and reopening of CT is going to look like.”
Gottlieb’s Duke report said the state and federal governments “should encourage the adoption and widespread use of electronic standards and reporting to enable rapid electronic reporting of COVID-19 related laboratory test results from health care providers, laboratories, or other testing sources using existing automated electronic reporting infrastructures.”
“We’re still really early here,” Reiss said. “There might be modern technologies, part of the gig economy, that we can use. … If there’s a way to take information like maybe Waze does, that’s another thing that we’re looking at too.”
Lamont introduced Nooyi and Ko and called for a “soft landing” in which the state is “building the airplane while flying it.”
Paul Mounds, Lamont’s chief of staff who along with Nooyi and Ko represent Connecticut on the seven-state regional group coordinating a return to normal life, said Thursday that public health is inextricably linked to the functioning of the economy.
“The governor has said repeatedly that one of the best resources our state has is its people,” Mounds said. “We have the best workforce in the world and the proof of that is the portfolio of employers that call Connecticut home. That workforce must be healthy and safe in order for our economy to function at full capacity.”